Title Page

  • Conducted on

  • Building/Facility Audited
  • Lead EHS Auditor

  • Additional EHS Staff Present

  • Facility Escort

  • General Housekeeping

  • Chemical Spills/Leaks

  • Hazardous Material Storage: Secondary Containment

  • Hazardous Material Storage: Chemical Compatibility

  • Hazardous Material Storage: Chemicals Labelled Appropriately

  • Hazardous Material Storage: Compressed Gas Cylinders Secured During Storage, Use & Transport

  • Chemical Inventory & SDSs Present

  • Personal Protective Equipment: Appropriate & Available

  • Personal Protective Equipment: Stored Appropriately

  • Personal Protective Equipment: Use Communicated & Enforced

  • Ladder Safety: Manufacturer's Labels Visible

  • Ladder Safety: Quarterly Inspection Completed

  • Electrical Safety: No Daisy-Chaining Extension Cords

  • Electrical Safety: Extension Cords & other Electrical Cords in Good Condition

  • Electrical Safety: No Open Breaker Boxes

  • Electrical Safety: Electrical Panels Closed & Unobstructed

  • Hearing Conservation: Area Free of High Noise

  • Record of Completed Noise Exposure Monitoring Accessible

  • Lock-Out/Tag-Out: Appropriate Use of Locks & Tags Observed

  • Training: Training Current & Documented for all Site-Specific Hazards

  • Lock-Out/Tag-Out: Staff Trained

  • Lock-Out/Tag-Out: LOTO Procedures Developed & Implemented for Equipment

  • PITs/Man-Lifts: Operators Trained

  • PITs/Man-Lifts: Inspections Performed

  • Machine Guarding: Machines have Appropriate Guarding

  • Power Tools: In Good Condition

  • Hand Tools: In Good Condition

  • Confined Spaces: Appropriately Labeled

  • Fire Protection: Items Stored no less than 18" Below Ceiling

  • Fire Extinguishers: Unobstructed

  • Fire Extinguishers: Inspected & Within Date

  • Eyewashes & Safety Showers: Unobstructed

  • Eyewashes & Safety Showers: Inspected Weekly or Annually

  • Eyewashes & Safety Showers: Location & Condition

  • First Aid Kit: Available & Unexpired

  • Warning Signage: Appropriate & Consistent

  • Emergency Response: Spill Kits Available & Appropriate

  • Other Safety Concerns

Acknowledgement

  • Signature of Departmental Representative (if present for audit)

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