Title Page
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Conducted on
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Building/Facility Audited
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Lead EHS Auditor
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Additional EHS Staff Present
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Facility Escort
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General Housekeeping
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Chemical Spills/Leaks
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Hazardous Material Storage: Secondary Containment
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Hazardous Material Storage: Chemical Compatibility
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Hazardous Material Storage: Chemicals Labelled Appropriately
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Hazardous Material Storage: Compressed Gas Cylinders Secured During Storage, Use & Transport
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Chemical Inventory & SDSs Present
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Personal Protective Equipment: Appropriate & Available
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Personal Protective Equipment: Stored Appropriately
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Personal Protective Equipment: Use Communicated & Enforced
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Ladder Safety: Manufacturer's Labels Visible
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Ladder Safety: Quarterly Inspection Completed
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Electrical Safety: No Daisy-Chaining Extension Cords
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Electrical Safety: Extension Cords & other Electrical Cords in Good Condition
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Electrical Safety: No Open Breaker Boxes
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Electrical Safety: Electrical Panels Closed & Unobstructed
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Hearing Conservation: Area Free of High Noise
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Record of Completed Noise Exposure Monitoring Accessible
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Lock-Out/Tag-Out: Appropriate Use of Locks & Tags Observed
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Training: Training Current & Documented for all Site-Specific Hazards
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Lock-Out/Tag-Out: Staff Trained
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Lock-Out/Tag-Out: LOTO Procedures Developed & Implemented for Equipment
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PITs/Man-Lifts: Operators Trained
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PITs/Man-Lifts: Inspections Performed
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Machine Guarding: Machines have Appropriate Guarding
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Power Tools: In Good Condition
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Hand Tools: In Good Condition
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Confined Spaces: Appropriately Labeled
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Fire Protection: Items Stored no less than 18" Below Ceiling
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Fire Extinguishers: Unobstructed
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Fire Extinguishers: Inspected & Within Date
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Eyewashes & Safety Showers: Unobstructed
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Eyewashes & Safety Showers: Inspected Weekly or Annually
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Eyewashes & Safety Showers: Location & Condition
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First Aid Kit: Available & Unexpired
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Warning Signage: Appropriate & Consistent
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Emergency Response: Spill Kits Available & Appropriate
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Other Safety Concerns
Acknowledgement
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Signature of Departmental Representative (if present for audit)