• Document # - Date

  • Audit Title

  • Hatchery / Site

  • City

  • Prepared by

  • Personnel attending assessment

  • Conducted on


  • Form completed

  • Annual Inspection

  • One time inspection

  • Hatchery Name

  • Hatchery Manager

  • Number of FTE

  • Phone Number

  • Regional Safety Coordinator


  • Do you have a written Hatchery Safety & Health Manual signed by the Chief of Hatcheries?

  • Is the manual up-to-date with the most recent revisions, including the revision record?

  • Do you have a site specific Hatchery Safety Plan (Appendix)?

  • Has the plan been updated within the year?

  • Have you contacted and discussed safety related items with your Regional Safety Coordinator?

  • Did you communicate with your Regional Safety Coordinatorany hazards that couldn't be closed in 30 days of your submittal of the report?


  • Have all employees, including part-time, FTE, temporaries and volunteers, received applicable and documented safety orientation and training?

  • Was a Temporary/Volunteer Safety Orientation Checklist completed for all those applicable?

  • Have all applicable employees received special-skills training for hazardous work activities (e.g., heavy equipment operators, welders, chainsaw operators, crane operators, etc)?

  • Is this training reproducible and documented?

  • Do all employees know how to access the Basicsafe website and its components?

  • On a scale of 1 to 10, how many trainings of the available trainings have been completed by all employees?

  • On a scale of 1 to 10, how many manager-led trainings have been conducted for all employees?

  • Do you document all training and can you produce those records?

  • Do all employees receive additional training following incidents and near-hits?

  • Have employees been trained in proper lifting techniques?


  • Are employees given a briefing on the specific hazards and risks involved in their work activies?

  • Is the briefing documented?

  • Are employees encouraged to make reports of unsafe and/or unhealthful work conditions, and know that they can do so without reprisal?

  • When a hazard is identified, it it abated right away?

  • Any examples?

  • Are all incidents and near-hits reported promptly through the online Origami link?

  • Are all injury incidents investigated promptly by the manager?


  • Do employees who conduct work activities in the field file a "trip plan" or "float plan" verbally or in writing before leaving?

  • When possible, do employees conducting work activities in remote locations work in pairs?

  • Are emergency communication equipment provided for employees working in remote location?

  • Type of communication?

  • Does the facility have written protocols in place for responding to an overdue employee situation?


  • Are annual lab inspections conducted and documented? Informal inspections conducted monthly.

  • Is all food for human consumption kept out of lab areas, including in refridgerators?

  • Has a Chemical Hygiene Plan been developed as specified in the manual?

  • Are all production systems and waste water systems routinely inspected and maintained?


  • Do you have a Discharge Permit?

  • Is all of your associated instrumentation calibrated?

  • Do you maintain a calibration log?

  • Are employees trained in spill prevention, the proper response to a spill, proper clean-up and disposal of materials?

  • Are employees trained on the proper operation and cleaning of production and waste water systems, including feeding procedures and proper use of equipment?

  • Records are maintained of frequency of cleaning, inspections, maintenance and repair, and training on spill prevention?


  • Are all chemicals stored in a manner to prevent spills, especially into water ways?

  • All unknown containers of chemicals or material have been properly disposed?

  • Are you properly managing any hazardous waste materials? Including rechargeable batteries, auto batteries, fluorescent light bulbs, lab wastes, and ANY electronics?

  • Is it properly disposed by a qualified contractor?

  • Are your bone-yards and/or bulk-waste storage being actively managed?

  • What is the source of your drinking water?

  • Do you test your water for e-coli, nitrates, nitrites, copper and lead?


  • Have any JSAs been developed that are applicable to the work at this or all hatcheries?

  • Have supervisors assessed workplaces for hazards?

  • Have any JSAs been developed by the time of this inspection?


  • Are compressed gasses stored correctly?

  • Are fuel gasses separated from oxygen by either a 5 foot half hour fire wall or 20 feet? (Oxyacetylene separated if used rarely).

  • Are hoses bled down at the end of use?

  • Are all air compressors, including small portable units, drained regularly? (Daily)

  • Are liquid oxygen tanks grounded with adequate size and length grounding rod?


  • Are confined spaces identified on the Hatchery Plan (Appendix)?

  • How are spaces identified? Photo, map, description, list?

  • Are there any permit-required confined spaces at the hatchery?

  • Are entrances to these spaces secured by either a lock, device or weight?

  • Are the physical spaces signed as "Danger - Confined Space -Authorized (or No) Entry Only?"

  • Are employees that enter these spaces identified and trained?


  • Do all electrical boxes, outlets, junction boxes and switches have proper covers?

  • Do all electrical installations meet UL and NEC requirements?

  • Are electrical breakers and switches labeled as to their purpose, when the purpose is not obvious?

  • Is there at least 36" of clearance maintained around all breaker panels?

  • Are GFCI's installed outdoors or within 6' of wet areas?

  • Are all electrical cords, extension cords, power tool cords free from cracks, breaks or strain damage?

  • Are all extension cords rated for heavy-duty use? Flat household cords and those without a grounding prong are not permitted.

  • Are all extension cords used for only temporary purposes?

  • Are all above ground storage tanks, including liquid oxygen, electrically grounded?

  • Are electrical tools either grounded with a grounding prong or double insulated?

  • Are surge protectors used solely for low draw electric equipment?


  • Are all portable fire extinguishers mounted properly and signed so that they are easy to locate?

  • Are all fire extinguishers readily/immediately accessible?

  • Are fire extinguishers maintained in good working order and inspected monthly by employee?

  • Are fire extinguishers serviced annually by a qualified contractor?

  • Are employees trained annually in the use of portable fire extinguishers?

  • Do you discuss the fire drill procedure at least annually?

  • Does the fire plan including family members when they live on the hatchery?

  • Are smoke detectors used near kitchens and sleeping areas (including in state-owned housing), are they in good working order?

  • Are areas under stairwells, furnace or electrical rooms kept free from flammable and/or combustible materials?

  • Are firearms, ammunition and pyrotechnics stored properly? Locked and in red magazine box.

  • Is an inventory of all firearms, ammunition and pyrotechnics maintained?

  • Are only flammable and combustible liquids stored in flammable containers?

  • Is gasoline and diesel stored in approved safety cans or cans that are effectively closed?

  • Is an emergency shut-off switch provided for all fuel storage tanks, that is greater than 20' but less than 100' away?

  • Is the emergency shut-off switch easily accessible, clearly labeled, and visible from the tank(s)?

  • Are tanks protected from vehicular traffic by bollards of other barriers? Bollards have very specific installation requirements.


  • Do you have or know how to access your current chemical inventory?

  • Does each chemical container have a complete, legible label indicating the contents and primary hazard?

  • Are above ground storage tanks and propane tanks labeled as:<br>Gasoline: No Smoking, Flammable, Gasoline<br>Diesel: No Smoking, Combustible, Diesel<br>Propane: No Smoking, Flammable, Propane


  • Do all emergency exits function properly?

  • Are all emergency exits properly signed with the words EXIT?

  • Are either glow-in-the-dark or lighted EXIT signs are used?

  • Are the batteries/ light bulbs in working order?

  • Are all emergency exit doors unlocked for egress from the inside and without the need for any device (keys, tools, etc.)?

  • Are all means of egress free from obstructions?

  • Do stairwells have adequate lighting, including emergency lighting?

  • Is a railing provided for all stairways with four or more risers?

  • Are handrails and stair treads in good condition, meeting the minimum requirements?


  • Do you have any equipment specific LOTO procedures developed and maintained with the Hatchery Plan (Appendix)?

  • Does the appendix identify all machines with a LOTO procedure?

  • Are all employees who are affected by and authorized for LOTO properly trained?

  • Identify employees that are Authorized.


  • Are all employees observed at the time of assessment wearing proper, approved PPE?

  • Is PPE provided to all employees and is available at no cost? (Supplies distributed?)

  • Have employees been trained on the specific PPE required for each common task, how to properly don, care and maintain it?

  • Are protective goggles, face shields or safety glasses worn in areas where there is a risk to eye injuries?

  • Are protective gloves, aprons, shields provided where employees are exposed to cuts, burns, chemicals?

  • Is protective foot wear provided where there is risk of foot injuries from common Hatchery work including crushing, falling objects, chemical splash, slippery surfaces?

  • Are hard hats provided and worn when operating and working around heavy equipment including fish loaders and construction equipment? Hard hats not required if operating equipment that is equipped with proper roll cage.

  • Is PPE inspected at least annually and maintained in proper condition?

  • Do you have emergency eyewash facilities within the work area where employees are exposed to injurious corrosive materials including formalin and disinfectants?

  • Are eyewash stations inspected at least monthly? (Documented)

  • Are eyewash stations located within a 10 second travel distance and without any complicated route?

  • Does the eyewash station provide tepid (lukewarm) water and flush for at least 15 minutes?


  • Have all employees that voluntarily wear a "filtering face-piece" (dust mask) read and signed Appendix D, Voluntary Respirator Use form, located at the end of the respiratory section in the manual?

  • Are all respirators kept in sanitary condition, and stored to protect them from excessive temperatures, dust, damage, contamination, and to prevent deformation.

  • Are employees wearing tight fitting respirators (half-face, full-face)?

  • For what chemicals/processes?


  • Do employees wear personal protective equipment when using hand tools?

  • Do you periodically go through hand tools and repair or replace defective tools?

  • Are tools that should be sharp, kept sharp?

  • Are all tools used for their designated purpose? Screw drivers are not chisels.

  • If compressed air is used for cleaning, are safety nozzles used or is air regulated below 30 psi?

  • Are all hoists, lifts, and cranes clearly marked as to their load capacity? (In units clearly understood)

  • Are oxygen bottles lifted by an approved means?


  • No tools are altered to be permanently locked in the on position?

  • Are all manufacturer and machine guards in place so that all nip/crushing points are effectively controlled?

  • Are all portable power tools and components in good condition?

  • Are all machines that are designed for fixed location operation anchored to prevent "walking" during operation?

  • Are large woodworking machines equipped with kickback resistant devices?

  • No pneumatic or powder actuated tool left unattended and connected/loaded?

  • Do all portable generators meet the requirements identified in the manual?

  • Are all solid grinder wheels inspected before use and periodically dressed?

  • Are bench grinders adjusted so the work rest is 1/8" and tongue guard is 1/4"?


  • Have all welders received proper and documented training?

  • Does each welder wear all required PPE when welding?

  • Is the welding kit (torch) equipped with anti-flashback devices?

  • Is adequate ventilation provided for welding operations?

  • Is a fire extinguisher immediately accessible to welding operations? This must be true no matter where welding occurs.

  • Are all flammable/combustible materials removed or covered/screened to prevent fire during welding activities?

  • Are welding screens available to protect the eyes of those not actively welding? Or does another control exist including signage?

  • Is the area where welding occurred inspected for fire 30 minutes following activity?

  • Is all welding equipment, hoses, wire leads, electrical cords, etc., in good working condition?


  • Are all areas maintained in a sanitary, clean and orderly condition?

  • Are all work areas and paths of travel free from tripping hazards?

  • Are carpeted areas and common areas free from rips, bumps, torn edges or loose tiles that can cause a tripping hazard?

  • Are break areas and food kitchens kept clean and sanitary?

  • Are ladders rated for the purpose and at least heavy duty or industrial grade?

  • Are ladders being inspected on a periodic basis?

  • If work areas are over 6' without a standard railing or off a ladder, is fall protection provided?

  • If your facility has a mezzanine or storage area above an occupied room, is the floor rating marked in a conspicuous location and visible from the main floor?

  • Does the mezzanine(s) have a standard railing along the perimeter?

  • Do employees with offices have ergonomically correct furniture and set up?

  • How likely (1-10) are you to wear ice/snow foot traction devices during the winter months? Manager must establish expectation of use?

  • Full traction

  • Heel only traction


  • Is the Vehicle Policy signed by, on file and available for all hatchery drivers?

  • Have all drivers completed the Defensive Driving Course within the last 4 years?

  • Are pre-trip inspections being performed before departure?

  • Has each vehicle been equipped with a fire extinguisher?

  • Has each vehicle been equipped with a first aid kit?

  • Has each vehicle been equipped with appropriate documentation including registration, insurance, inspections, etc?

  • Are vehicles equipped with headache rack when cargo is stored above the bed wall, on a regular basis?


  • Are forklift operators certified in each type of forklift they use?

  • Have all off-road vehicle operators been through service-approved training?

  • Does each operator wear all necessary PPE (helmets) and/or seat belts at all times?

  • Are there any specific operator rules relating to these requirements? i.e., speed limits, activities, on/off hatchery use.

  • Are all employees who operate heavy equipment trained, tested and authorized in writing by the Hatchery Manager?

  • Does each piece of equipment have back-up alarms, lights, safety equipment?

  • Are all roll protection and seat belts in good working order and per manufacturer requirements?


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ANNUAL GOALS (Self-Assessment Only)

  • What are your three top Safety, Health and/or Environmental issues or concerns that will addressed this year?.

  • 1.

  • 2.

  • 3.


  • This assessment represents an evaluation of the safety, health and environmental conditions at the time of assessment. By signing below, you only acknowledge that the deficiencies were discussed with you. Any follow-up questions or comments should be directed to the Statewide Safety Coordinator.

  • Hatchery Manager

  • Regional Safety Coordinator

  • Statewide Safety Coordinator

  • State Risk Safety and Loss Control Specialist

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