Title Page
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Facility/Area
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StampZone
- Panel Lathe/Stamp/Fab
- Supermarket/HVLS/Motorwire
- Maintenance/SQ/Small Sidewall
- Fabrahoods/BSQ
- Kitcell/LVS
- Weld/Paint/Welded Props
- Draw/Crate/Sidewall Assembly
- Sidewall/Cast Props
- CRC - Lasers/Material Stock Area
- CRC - TC5000/Press/AFS/Motor Stock Area
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Audit Month
- January
- February
- March
- April
- May
- June
- July
- August
- September
- October
- November
- December
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Audit Year
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- 2028
- 2029
- 2030
- 2031
- 2032
- 2033
- 2034
- 2035
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Audit Date
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Auditor's Name
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INSTRUCTIONS
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1. Please answer all the questions below.
2. Add Photos in "Images" and Comments in "Notes" on each question.
3. Add a Corrective Measure in "Action" Provide a description, assign to a member, set priority, and due date
4. Complete the audit by providing a digital signature
5. Share your report by exporting as PDF, Word, Excel or Web Link.
Monthly Safety Inspections Checklist
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A1. PPE : Are safety glasses with side shields being worn by all employees?
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A2. PPE : Is PPE stored in convenient locations near the hazardous functions in an accessible manner?
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A3. PPE : Are safety toed shoes being worn by all employees on the shop floor?
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A4. PPE : Is hearing protection being worn in all required areas?
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A5. PPE : Are gloves being worn in potential hand injury areas?
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A6. PPE : Are flame resistant coats, chaps, spats and other associated being worn by welders?
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A7. PPE : Is long hair tied back and jewelry removed around rotating equipment?
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A8. PPE : Are protective sleeves being worn in areas prone to forearm, wrist and elbow lacerations?
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A9. PPE : Are face shields being used in conjunction with safety glasses when grinding is being performed?
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B1. Plant Hazards : Is each work area adequately lighted?
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B2. Plant Hazards : Where compressed air is used for cleaning, are the appropriate nozzles being used (30 psi)?
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B3. Plant Hazards : Are floor mats clean and in good repair/condition?
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B4. Plant Hazards : Where floor grating is used, is it level?
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B5. Plant Hazards : Are barricades being utilized where maintenance and/or construction work is being performed?
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B6. Plant Hazards : Are materials being stored properly?
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B7. Plant Hazards : In assembly areas, are test stand lights working properly?
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B8. Plant Hazards : Do electrical panels have proper 36" clearance?
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B9. Plant Hazards : Are extension cords only being used for short term use?
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B10. Plant Hazards : Are exits clear (inside/outside)?
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B11. Plant Hazards : Are exit lights working properly?
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B12. Plant Hazards : Is each work area adequately ventilated?
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B13. Plant Hazards : Is racking in good condition, not overloaded, anchored, load beams pinned and capacity posted?
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B14. Plant Hazards : Do fire suppression system sprinklers have at least 18" of clearance?
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B15. Plant Hazards : Are workers situated such that they avoid injury relatively to machinery and process?
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B16. Plant Hazards : Are the floors, aisles/walkways and steps/stairs free of tripping hazards?
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B17. Plant Hazards : Are combustible materials not being stored under steps/stairs?
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B18. Plant Hazards : Is the facility free of live electrical hazards?
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B19. Plant Hazards : Are all electrical cords, plugs and covers free from damage and in good working order?
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B20. Plant Hazards : Are machine guards in place?
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B21. Plant Hazards : Are confined space areas identified and posted?
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C1. Fire Extinguishers : Are fire extinguishers readily accessible, unblocked (36" square clearance) and in sight?
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C2. Fire Extinguishers : Are fire extinguishers securely mounted or in an unlocked cabinet?
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C3. Fire Extinguishers : Is there signage and other identifiers in red indicating the location of the extinguishers?
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C4. Fire Extinguishers : Are operating instructions clearly legible and located on the front of the extinguishers?
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C5. Fire Extinguishers : Are pressure gauges reading in operable range?
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C6. Fire Extinguishers : Are the pins and tamper seals intact?
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C7. Fire Extinguishers : Are the extinguishers in good condition - no corrosion, pitting or cylinder damage?
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C8. Fire Extinguishers : Have the annual maintenance checks been performed and recorded?
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C9. Fire Extinguishers : Have the extinguishers been inspected within the last 30 day?
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D1. Weld Areas : Are only authorized and trained employees permitted to use welding, cutting or brazing equipment?
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D2. Weld Areas : Appropriate (and dry) PPE worn: eye, ear, and body?
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D3. Weld Areas : Are the work return leads connected to the work piece?
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D4. Weld Areas : Are cables together, without worn/damaged insulation, protected and connected properly?
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D5. Weld Areas : Area welders using local exhaust system?
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D6. Weld Areas : Are gas cylinders secure, inspected and connected properly?
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D7. Weld Areas : Is work stable and within reach?
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D8. Weld Areas : Is the area clean, traffic areas clear, no clutter, no standing water, no flammable or combustible material in the area?
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D9. Weld Areas : Are protective screens in place to protect others?
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E1. Hazardous Chemicals : Are adequate engineering and protective steps taken to protect employees from chemical exposure hazards? (handling of chemicals during production, or exposure from spills/leaks)
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E2. Hazardous Chemicals : Is proper PPE being worn by employees involved in the handling of hazardous chemicals?
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E3. Hazardous Chemicals : Are decontamination procedures being utilized by employees involved in the use of chemicals prior to removing PPE?
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E4. Hazardous Chemicals : Are workers nearby aware of the content of chemical systems and are operating procedures readily available?
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E5. Hazardous Chemicals : Is there a safety data sheet readily available for each hazardous substance used or accessed to Fortis via a computer in the area of use?
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E6. Hazardous Chemicals : Are all containers labeled, tagged or marked as to their contents? (e.g. vats, storage tanks, drums, bottles)
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E7. Hazardous Chemicals : If hazardous waste is stored, are all hazardous waste requirements complied with?
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E8. Hazardous Chemicals : Are provisions made for secondary containment of chemicals should a container become punctured and/or damaged?
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E9. Hazardous Chemicals : Are provisions made to dam, dike, divert a chemical spill/leak from storm sewers?
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E10. Hazardous Chemicals : Are spill kits stocked, identified and readily available for use should a spill occur?
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E11. Hazardous Chemicals : Are chemicals stored in an orderly fashion and protected from damage to forklift and other motorized vehicle activity?
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F1. Compressed Gas Cylinders : Are cylinders stored upright, secured and in a dry, cool area?
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F2. Compressed Gas Cylinders : Are cylinders stored away from electrical connections, flames, sources of ignition and flammable/combustible substances?
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F3. Compressed Gas Cylinders : Are acetylene and propane gas cylinders separated from oxygen by at least 20 feet or by a fire resistant partition when in storage?
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F4. Compressed Gas Cylinders : Are all compressed gas cylinder valve covers in place when the cylinders are not in use?
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F5. Compressed Gas Cylinders : Are all compressed gas cylinders labels clear and legible?
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F6. Compressed Gas Cylinders : Are all compressed gas cylinders free from visual defects?
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F7. Compressed Gas Cylinders : Are compressed gas cylinders moved by a suitable hand truck?
Additional Details
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General Comments/Recommendations
Completion
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Completed by:
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Signature: