Horizon North Camp and Catering

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Company / Rental Vehicle Inpections

• Unit Number or License Plate Number

  Yes

  No

  N/A

• Journey management book present in truck

  Yes

  No

  N/A

• Is all safety equipment in Vehicle - Tow rope, Fire ext, First aid kit, Triangles, Ratchet straps, Winter kit, Safety vest..

  Yes

  No

  N/A

• Current mileage on Vehicle

  Yes

  No

  N/A

• Last oil change completed at

  Yes

  No

  N/A

• Condition of interior of vehicle

  Good

  Poor

• Condition of exterior of vehicle

  Good

  Poor

• Condition of tires

  Good

  Poor

• Condition of windshield

  Good

  Poor

Outside Of Camp and Building

• Camp signs are clean and and in good repair

  Yes

  No

  N/A

• Muster point signs are installed

  Yes

  No

  N/A

• Decks are level and do not impede with swing of door

  Yes

  No

  N/A

• Tin on camp is in good condition and in place

  Yes

  No

  N/A

• Drip caps installed above exit doors

  Yes

  No

  N/A

• Outside lights are operational with water tight seal and covers properly installed

  Yes

  No

  N/A

• Vents on side of trailers are in good condition and not plugged

  Yes

  No

  N/A

• Walkways are clear of debris and are in good condition

  Yes

  No

  N/A

• Grounds are clean of debris and stored in proper place

  Yes

  No

  N/A

• Outside buildings are free of garbage and kept clean

  Yes

  No

  N/A

• Parking lot plugs are in good shape and cables are secured to boxes

  Safe

  At Risk

  N/A

• Lift station are sealed tight and high level alarms are in working order and spill trays installed

  Yes

  No

  N/A

• Sewer tanks have High Level Alarms installed and working

  Yes

  No

  N/A

• Heat tape are plugged in and working

  Yes

  No

  N/A

• Electrical connections appear to be in good condition and out of the elements

  Safe

  At Risk

  N/A

• Plumbing system free of leaks

  Yes

  No

  N/A

• Pipe insulation is in good shape and no missing pieces

  Yes

  No

  N/A

Roof of Camp

• Are all chimney extensions installed and proper Vent caps

  Yes

  No

  N/A

• Roof is free of tears and holes

  Yes

  No

  N/A

• All flashings are sealed properly and secured to roof

  Yes

  No

  N/A

• All flashings are free of holes

  Yes

  No

  N/A

Shop area

• Is shop tidy and equipment and parts stored where they belong

  Yes

  No

  N/A

• Is there fire extinguishers and emergency lights by exit doors

  Yes

  No

  N/A

Water Storage Buildings

• Fire extinguisher located by exits

  Yes

  No

  N/A

• Emergency light installed, working and being tested monthly

  Yes

  No

  N/A

• Is Water Storage only being used for potable water and not other products that could effect water system

  Yes

  No

  N/A

• Lights and electrical in good condition

  Yes

  No

  N/A

• Piping and pumps are free of leaks

  Yes

  No

  N/A

• Pressure Switch Settings Set at

  Yes

  No

  N/A

Fire Suppression Room

• Fire suppression pipes and pump free of leaks

  Yes

  No

  N/A

• Fire pressure setting at

  Yes

  No

  N/A

• Electrical system is in good condition

  Yes

  No

  N/A

• Fire extinguisher mounted by exit door

  Yes

  No

  N/A

• Emergency light installed and working

  Yes

  No

  N/A

• Room is clean And orginized

  Yes

  No

  N/A

Generator Building

• Is their a fire extinguisher in the generator building

  Yes

  No

  N/A

• Is emergency light installed and being checked on a monthly basis

  Yes

  No

  N/A

• Lights and electrical in good condition

  Yes

  No

  N/A

• Generator is clean and no visible leaks

  Yes

  No

  N/A

• TDG classification permit posted (1202 / 1978)

  Yes

  No

  N/A

• Is spill kit on site and located by generator

  Yes

  No

  N/A

• Are the Date and Hours written on the filters when they were changed

  Yes

  No

  N/A

• Used oil and oily rags being stored properly

  Yes

  No

  N/A

Refueling Stations

• Is spill kit Available

  Yes

  No

  N/A

• Has trigger lock been removed from nozzle

  Yes

  No

  N/A

• Tank is secure with no signs of leaks

  Yes

  No

  N/A

Waste Oil Storage

• Are old pails being broken down and stored in spill tray

  Yes

  No

  N/A

• Are all drums stored in spill tray

  Yes

  No

  N/A

• All materials are stored properly with lids closed

  Yes

  No

  N/A

Fire system

• ERP plan posted

  Yes

  No

  N/A

• Are Emergency lights working and being tested monthly

  Yes

  No

  N/A

• Are Exit lights are illuminated through out camp

  Yes

  No

  N/A

• Main Fire alarm panel free of troubles and not in alarm? Fire alarm certified?

  Yes

  No

  N/A

• Are Fire hose are attached and hose clip secured, and hoses with in 5yr of date stamp, and tamper sticker on glass

  Yes

  No

  N/A

• Have Fire extinguishers been certified in the last year from present date

  Yes

  No

  N/A

• Are Fire extinguisher being inspected monthly

  Yes

  No

  N/A

Camp Main Entry and Main Hallways

• Free of bad odor

  Yes

  No

  N/A

• Boot room is in good condition - lights, floors, walls, trim, exhaust fan, emergency light

  Yes

  No

  N/A

• Main washroom are in good conditions - sinks, toilets, walls, floors, trim, emergency light, exhaust fan

  Yes

  No

  N/A

• Gym is in good condition - equipment, trim, floors, mirrors, lights, walls, emergency light, fire ext.

  Yes

  No

  N/A

• Doors close properly and door mags are working

  Yes

  No

  N/A

• Trim / moulding and baseboard are secure and not missing pieces

  Yes

  No

  N/A

• Floor seams are welded together and not separating

  Yes

  No

  N/A

• Wall board is free of holes and damages

  Yes

  No

  N/A

• Ceiling tiles in good condition and in place

  Yes

  No

  N/A

• Lights working and covers in place

  Yes

  No

  N/A

• Electrical panels and outlets in good conditions

  Yes

  No

  N/A

• Are baseboard heaters signs installed above heaters

  Yes

  No

  N/A

• Are all pipe connection tight and free of leaks

  Yes

  No

  N/A

• Is there any signs of roof leaking or signs of water damage

  No

  Yes

• Hallway are free of trip hazard and clutter such as extension cords

  Yes

  No

  N/A

• Are Fire extinguishers mounted by exit door

  Yes

  No

  N/A

• Are emergency lights working in corridors

  Yes

  No

  N/A

Dorm Bedrooms

• Bathroom exhaust fan working

  Yes

  No

  N/A

• Ceiling, bathroom, vanity and bunk lights are working

  Yes

  No

  N/A

• Plumbing drains are free flowing and no visible leaks

  Yes

  No

  N/A

• Trim / moulding and baseboard is secured and no pieces missing

  Yes

  No

  N/A

• Window screen in place and no holes

  Yes

  No

  N/A

• Carpet in good condition

  Yes

  No

  N/A

• Furniture in room is in good condition and fully functional, edging is not separating

  Yes

  No

  N/A

• Gfi receptacle installed by sink or on a protected circuit

  Yes

  No

  N/A

• Are baseboard heater signs installed in room

  Yes

  No

  N/A

• Shower and Lav taps - cold is cold and hot is hot

  Yes

  No

  N/A

• Shower head provides a good even flow of water

  Yes

  No

  N/A

• Are Toilet floats are adjusted and flapper in good condition

  Yes

  No

  N/A

• Shower and Sink vanity are silicones nicely

  Yes

  No

  N/A

• Floor register and return air grills in place - clean and good condition

  Yes

  No

  N/A

• Tv channels are clear and good sound present

  Yes

  No

  N/A

• All doors swing freely and close properly

  Yes

  No

  N/A

• Smoke detectors functional

  Yes

  No

  N/A

• Are there any signs of roof leaking or water damage

  No

  Yes

Dorm Mechanical Room

• Is their a fire extinguisher mounted in mechanical room

  Yes

  No

  N/A

• Is emergency light installed and working

  Yes

  No

  N/A

• Is all trim installed and door closes properly

  Yes

  No

  N/A

• Are pipes free of leaks and drips

  Yes

  No

  N/A

• Room is free of garbage, material is not stored in front of hot water tanks

  Yes

  No

  N/A

• Freash air is installed for Hot Water Tank

  Yes

  No

  N/A

• Does the operation of Hot Water Tank appear to be working properly

  Yes

  No

  N/A

• Does mechanical room door open and close freely and closure installed

  Yes

  No

  N/A

Dorm Laundry Room

• Emergency light installed and working

  Yes

  No

  N/A

• Exhaust fan is working

  Yes

  No

  N/A

• Laundry sink drain is free flowing

  Yes

  No

  N/A

• Laundry taps are free of leaks

  Yes

  No

  N/A

• Dryer vents are lint free

  Yes

  No

  N/A

• Lights working, light covers in place, and receptacles are in good condition

  Yes

  No

  N/A

• Washing machine and dryers are functioning properly

  Yes

  No

  N/A

• Does laundry door open and close freely and closure installed

  Yes

  No

  N/A

• Is eyewash station being check monthly, and does it appear to be in good operation

  Yes

  No

  N/A

Dorm hallway

• If Pod is independent, is the Fire alarm panel active and certified

  Yes

  No

  N/A

• Are emergency lights installed and working

  Yes

  No

  N/A

• Electrical systems appears to be in good working condition

  Yes

  No

  N/A

• Lights are working and covers installed

  Yes

  No

  N/A

• Are baseboard heater signs installed above heaters

  Yes

  No

  N/A

• Does Fire door swing and close freely

  Yes

  No

  N/A

• Does exit door at end open freely and closure installed

  Yes

  No

  N/A

• Does side emergency door open freely and closure installed

  Yes

  No

  N/A

• Carpet is tight , clean and trim is installed and in good condition

  Yes

  No

  N/A

• Waterlines are free from leaks and Drips

  Yes

  No

  N/A

• Do ceilings appear to be free of leaks and no signs of water damage

  Yes

  No

  N/A

• Furnace rooms are clean, filters present and clean, return air grills clean and monthly inspection up to date

  Yes

  No

  N/A

• Furnace covers in place

  Yes

  No

  N/A

• Hallway is clear of obstructions

  Yes

  No

  N/A

• Bells and horn and strobe are intact and in working order

  Yes

  No

  N/A

• Trailers level and tin / drywall in good condition

  Yes

  No

  N/A

• Are fire extinguishers mounted by exit doors

  Yes

  No

  N/A

Kitchen Area

• Kitchen fire suppression last certified in the last 6 months

  Yes

  No

  N/A

• Kitchen exhaust and vent clean? And last cleaned in the last 6 months?

  Yes

  No

  N/A

• Emergency lights working

  Yes

  No

  N/A

• Is there a type K fire extinguisher in kitchen

  Yes

  No

  N/A

• Kitchen exhaust working

  Yes

  No

  N/A

• Mua working

  Yes

  No

  N/A

• Sneeze guards in place on hot food tables

  Yes

  No

  N/A

• Freezer / Cooler are maintaining temperature and defrost working

  Yes

  No

  N/A

• Grease trap being clean regularly

  Yes

  No

  N/A

• Kitchen appliance in good repair

  Yes

  No

  N/A

• Baker table is in good condition

  Yes

  No

  N/A

• Garbage is being removed from walkways and clutter free

  Yes

  No

  N/A

• Lights are working and covers are in place

  Yes

  No

  N/A

• Furnaces rooms are clean, filter are clean and covers installed

  Yes

  No

  N/A

• Gfi receptacles installed where water is present

  Yes

  No

  N/A

• Does electrical system in kitchen appear to be in good condition

  Yes

  No

  N/A

• Sink drain is free flowing

  Yes

  No

  N/A

• Kitchen equipment drains have a 1 inch air gap

  Yes

  No

  N/A

• Kitchen floors appear to be in good condition

  Yes

  No

  N/A

Diner

• Are emergency lights working

  Yes

  No

  N/A

• Floors are in good condition<br>

  Yes

  No

  N/A

• Furnace filters clean, grills are clean and motors clean

  Yes

  No

  N/A

• Countertops are in good condition

  Yes

  No

  N/A

• Cabinets are in good condition and door are still hinged and operate good

  Yes

  No

  N/A

• Tables and chairs appear to be in good condition

  Yes

  No

  N/A

• All equipment in diner is operational

  Yes

  No

  N/A

• Electrical system appears to be in good operating condition

  Yes

  No

  N/A

• Sneeze guards are in place on all cold / hot tables and sandwich stations

  Yes

  No

  N/A

• Fire extinguishers are mounted by all exit doors

  Yes

  No

  N/A

Safety

• Are MSDS available for Maintenance chemicals on site

  Yes

  No

  N/A

• Are JHA being completed on a regular basis

  Yes

  No

  N/A

• Are journey management and equipment reports being completed

  Yes

  No

  N/A

• Is proper PPE on site and being used

  Yes

  No

  N/A

• Tools on site clean / good condition for use and tool tagging system being used

  Yes

  No

  N/A

• Are hazards being identified and correction action being taken in a timely manner

  Yes

  No

  N/A

• Is Maintenance checklist being completed

  Yes

  No

  N/A

• Is proper safety forms available on site for use

  Yes

  No

  N/A

Misc Info

• Notes:

  Yes

  No

  N/A

Signatures

• Camp Representative

  Sign

• Camp Representative

  Sign

• Field Maintenance Supervisor

  Sign