Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Safety Read Board

  • BO 5100.31B- Is there a Safety Read Board to keep employees up-to-date on changes in safety policies, procedures, and/or mishap records. Organizations/activities occupying the same facility shall have their own documentation properly posted

  • If yes, does the Safety Read Board have, at a minimum;

  • DD Form 2272, Department of Defense Ground Occupational Safety and Health Protection Program

  • NAVMC 11400, Occupational Safety and Health Deficiency Notice

  • NAVMC 11401, Unsafe or Unhealthful Working Conditions

  • Commandant of the Marine Corps Safety Policy Letter

  • Commanding General (CG), MCB Policy Statement on Safety

  • Unit/Organization Safety Policy Letter

  • Emergency Action Plan

Deficiency

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

  • Is there another deficiency to report?

  • Area

  • Defeciency

  • List Defeciency

  • RAC

  • Picture of Deficiency

Administrative Facility Checklist

  • Would you like to use an Administrative Workplace Checklist?

Sign Posting/ Labeling

  • Is a written EMERGENCY / EVACUATION PLAN posted and up-to-date?

  • Are BOMB THREAT procedures posted near doors and phones?

  • Are industrial Hygiene Surveys available and up-to-date?

  • When required, are floor loading signs posted? (i.e. mezzanine areas)

Housekeeping

  • Are aisle ways and exits clear and unobstructed?

  • Are offices and storage areas clean, orderly, and free of debris and slipping/tripping hazards?

  • Are cabinet tops clean and not used as storage?

  • Are mops and brooms stored in a well-ventilated area with heads up off the floor?

  • Are janitors closets clean and not used for storage?

  • Are food appliances and eating areas kept clean?

  • Are floors adequately swept, mopped, vacuumed and free of slipping/tripping/fall hazards?

  • Are fluorescent light tubes properly disposed of?

  • Are filing cabinet drawers evenly loaded to prevent tipping over?

Electrical

  • Is the use of extension cords eliminated when possible?

  • Are only UL-approved extension cords and/or power strips used?

  • Are electric cords in good repair (not spliced or taped, ground prong intact, plug secure on cord)?

  • Are electric cords arranged so they do not present tripping or other hazard?

  • Are electric cords kept out of doorways and aisles?

  • Are breaker boxes and junction boxes securely covered?

  • Are heat-producing appliances plugged directly into hard-wired outlets, not extension cords?

  • Do portable heat-producing appliances have tip over safety feature?

  • Is emergency lighting operational?<br>

  • Do electrical panel boxes lock and close properly?<br>

Fire Protection

  • Are emergency egress lanes clear and unobstructed?<br>

  • Are personnel EXIT signs posted and clearly visible?<br>

  • Are fire exits kept free of obstructions?<br>

  • Are the directions to exits, when not immediately apparent, marked clearly with visible signs?<br>

  • Are emergency egress EXIT signs illuminated and in working order?<br>

  • Are fire suppression sprinkler heads kept clean?<br>

  • Are sprinkler heads protected by metal guards when exposed to physical damage?<br>

  • Is proper clearance maintained below sprinkler heads (18 inches)?<br>

  • Are appropriate fire extinguishers mounted, located, and identified so they are readily accessible to employees?<br>

  • Are all fire extinguishers inspected monthly and recharged regularly and noted on the inspection tag?<br>

Hazardous Material

  • If secondary containers are used, are they properly labeled?<br>

  • Are SDS logs current and readily available?<br>

Training

  • Are all personnel assigned appropriate (Core) duty/task(s)?<br>

  • Are all personnel assigned correct job specific duty/task(s) that correctly identify their training requirements?<br>

  • Are all personnel current with required training and Medical Surveillance?<br>

Miscellaneous

  • Are office furnishings and chairs in good repair?<br>

  • Do rolling chairs have 5 casters?<br>

  • Are step stools and ladders sturdy and fitted with rubber caps to control movement while in use?<br>

  • Are paper cutters equipped with safety latches, finger guards, and stored with the blade locked?<br>

  • Are fans equipped with adequate blade guards?<br>

  • Are all employees briefed on the office emergency evacuation plan and re-assembly point?<br>

  • Are ergonomic hazard mitigations being used?<br>

  • Are Area JHAs for the area up to date, and are they available for worker review?<br>

Industrial Facility Checklist

  • Would you like to use an Industrial Workplace Checklist?

Sign Posting / Labeling

  • Is a written EMERGENCY / Evacuation PLAN posted and up-to-date?

  • Are CAUTION EYE HAZARD signs posted at entrances to eye hazard areas?

  • Are CAUTION NOISE HAZARD signs posted in noise hazard areas?

  • Are CAUTION FOOT HAZARD signs posted in foot hazard areas?

  • Are BOMB THREAT procedures posted near doors and telephones?

  • Are NO SMOKING signs posted by outdoor flammable storage areas, fuel tanks, etc.?

  • Are gas and hazardous material pipe/lines labeled as to contents and appropriately color coded?

  • Are Industrial Hygiene Surveys available and up-to-date?

  • Are routine (monthly / quarterly) Supervisor Workplace Safety Inspections conducted and recorded?

  • Are Unsafe/Unhealthful report forms readily available to employees?

  • When required, are floor loading signs posted? (i.e. mezzanine areas)

  • Are aisle ways and all shop areas clean, orderly and free of debris and slipping/tripping hazards?

  • Are cabinet tops clean and not used as storage?

  • Are mops and brooms stored in a well-ventilated area with heads up off the floor?

  • Are waste cans available, covered, and emptied daily?

  • Are exits clear and unobstructed?

  • Are storage cabinets and shelving units secured to a wall, floor, or together, to prevent tipping over?

  • Are storage drawers evenly loaded to prevent tipping over?

  • Are janitors closets clean and not used for storage?

  • Are food appliances and eating areas kept clean?

  • Are floors adequately swept and free of slipping/tripping/fall hazards?

  • Are unauthorized extension cords removed from service?

  • Are heat-producing appliances plugged directly into hard-wired outlets?

  • Are electric cords in good repair (not spliced or taped, ground prong intact, plug secure on cord)?

  • Are electric cords kept out of doorways and aisles?

  • Are breaker boxes and junction boxes securely covered?

  • Are heat-producing appliances plugged directly into hard-wired outlets, not extension cords?

  • Do portable heat-producing appliances have tip over safety feature?

  • Are electrical outlets not overloaded?

  • Is emergency lighting operational?

  • Do electrical panel boxes lock and close properly?

Personal Protective Equipment

  • Is PPE adequate for work performed in the area?

  • Is PPE cleaned and inspected as needed, and in good shape?

  • Is eye, face, hand, and hearing protection used and appropriate for the process/task?

  • Is safety footwear being worn where required?

Safety Devices

  • Are eyewash/shower units clean, serviceable, clearly identified and unobstructed? Are they being inspected as required?

  • Are slings and other lifting devices inspected, marked with weight limit and within certification date?

  • Are hoist directions clearly marked? Is load capacity marked on a supporting beam? Are hoist/beam load capacities compatible?

  • Are machine guards in place and being properly used?

  • Are grinder tool rests adjusted to no more than 1/8 inch from abrasive wheel? Are tongue guards adjusted to no more than 1/4 inch from wheels?

  • Are shatter-resistant shields in place on pedestal grinders?

  • Are pedestal grinders, portable drill presses, and lathes secured to a bench or the floor?

  • Are appropriate tags and/or locking devices installed in out of service equipment?

  • Are degreasers and chemical tanks equipped covers/lids? Are lids closed when tanks are not in use?

  • Are hazardous waste drum lids on at all times?

  • Are work stands locked down and secured to prevent movement?

  • Are legs of step stools, ladders, and stands fitted with rubber end caps to prevent movement while in use?

Fire Protection

  • Are fire aisles, access to stairways, and fire equipment kept clear?

  • Are personnel EXIT signs posted and clearly visible?

  • Are fire exits kept free of obstructions?

  • Are the directions to exits, when not immediately apparent, marked clearly with visible signs?

  • Are egress EXIT signs illuminated and in working order?

  • Are fire suppression sprinkler heads kept clean?

  • Are sprinkler heads protected by metal guards when exposed to physical damage?

  • Is proper clearance maintained below sprinkler heads (18 inches)?

  • Are appropriate fire extinguishers mounted, located, and identified so they are readily accessible to employees?

  • Are all fire extinguishers inspected monthly and recharged regularly and noted on the inspection tag?

Hazardous Material

  • If secondary containers are used, are they properly labeled?

  • Are SDS logs current and readily available?

Training

  • Are all personnel assigned appropriate (Core) duty/task?

  • Are all personnel assigned correct job specific duty/task(s) that correctly identifies their training requirements?

  • Are all personnel current with required training and Medical Surveillance?

Miscellaneous

  • Are local ventilation units working properly?

  • Is furniture in good repair, including shop chairs and office furniture?

  • Do rolling chairs have 5 casters?

  • Is machinery attended while in operation?

  • Is the wearing of jewelry banned when working around rotating equipment?

  • Are compressed gas cylinders properly secured to avoid tipping over? Are caps in place?

  • Are all employees briefed on the office emergency evacuation plan and re-assembly point?

  • Are ergonomic hazard mitigations being used?

  • Are Area and Job Specific JHAs developed and up to date? Are they available for worker review?

Respiratory Protection

Personal Protection Equipment

  • Do employees wear respirators?

Selection and UseH

  • Are respirators used only by the person to whom they are issued? <br>Reference: NAVMC 5100.8, 13008.7

  • Are only NIOSH certified or NIOSH/Mine Safety and Health Administration (MSHA) certified respirators used?<br>Reference: NAVMC 5100.8, 13008.7

  • Is respiratory protection equipment approved in writing by ISO RPPM?<br>Reference: NAVMC 5100.8, 13008.5

  • Are personnel given the opportunity to select a different respirator face piece, and be retested, if their respirator is uncomfortable to the user?<br>Reference: NAVMC 5100.8, 13008.7

  • Are personnel prohibited from making modifications to their issued respirators?<br>Reference: NAVMC 5100.8, 13008.8a

  • Is it prohibited to use one manufacturer's parts on another manufacturer's respirator, including filters and cartridges?<br>Reference: NAVMC 5100.8, 13008.12.c

Medical Evaluation

  • Have all respirator users received a medical clearance prior to being fit tested?<br>Reference: NAVMC 5100.8, 13008.3.h

  • Are only trained and medically qualified personnel assigned tasks requiring the use of respirators?<br>Reference: NAVMC 5100.8, 13008.4.a

  • Are additional medical evaluations provided if an individual reports medical signs or symptoms that may affect their abilities to use a respirator?<br>Reference: NAVMC 5100.8, 13008.14

Training

  • Is appropriate worksite specific training provided to personnel prior to use?<br>Reference: NAVMC 5100.8, 13008.16.a

  • Are all respirators users and their supervisors trained annually?<br>Reference: NAVMC 5100.8, 13008.3.g

Fit Testing

  • Is fit testing performed initially, annually and when a different respirator face piece are to be worn?<br>Reference: NAVMC 5100.8, 13008.15.e

  • Is fit testing conducted with the same make, model, and size mask that the employee will be expected to use at the worksite?<br>Reference: NAVMC 5100.8, 13008.15.d

  • Are individuals with interfering facial hair not allowed to use respiratory protection?<br>Reference: NAVMC 5q00.8, 13008.15.e

  • Are these individuals removed or transferred from this position until they can comply with the standard?<br>Reference: NAVMC 5100.8, 13008.15.e

  • IsI fit testing performed semiannually for those individuals who work with or may be exposed to arsenic, acrylonitrile, lead, asbestos, or other materials specified in OSHA or Marine Corps standards, requiring semi-annual fit testing.<br>Reference: NAVMC 5100.8, 13008.15

  • Are additional fit tests conducted in the event of physical changes in the person that may affect respirator fitting properly?<br>Reference: 5100.8, 13008.15e

Evaluations

  • Is a health hazard evaluation of new or modified work operations performed to ensure the appropriate respiratory is specified by the Industrial Hygienist?<br>Reference: NAVMC 5100.8, 13008.3.e

  • Are workplace evaluations conducted as necessary to ensure that written respiratory protection program is being effectively implemented?<br>Reference: NAVMC 5100.8, 13008.4.b

  • MAre personnel instructed to leave the work area without delay whenever odor or taste from the work process is detected, difficultly in breathing is encountered or other signs of leakage are present?<br>Reference: NAVMC 5100.8, 13008.8.f

Maintenance and Care

  • Are respirators cleaned and disinfected after each use, following procedures provided by the manufacturer or RPPM?<br>Reference: NAVMC 5100.8, 13008.10

  • Are respirators cleaned and stored in sealed bags or containers, away from sunlight, heat, extreme cold, excessive moisture, or damaging chemicals?<br>Reference: NAVMC 5100.8, 1300.11.a

  • Are used cartridges stored separately from the respirator at the end of each use?<br>Reference: NAVMC 5100.13008.11.a

  • Is the mask storage areas kept clean and sanitary?<br>Reference: NAVMC 5100.8, 13008.11.a

  • Are respirators stored in a way to prevent crushing which can result in deformation of face piece?<br>Reference: NAVMC 5100.8, 13008.11.b

  • Is it prohibited to store respirators by hanging them from the head straps?<br>Reference: NAVMC 5100.8, 13008.11.c

Record Keeping

  • Is an appointment letter of the Assistant RPPM retained and a copy of the letter submitted to the RPPM?<br>Reference: NAVMC 5100.8, 13008.2

  • Are all records of respirator training and fit testing maintained?<br>Reference: NAVMC 5100.8, 13008.3.j

  • Is a written standard operating procedure (SOP) developed and posted in the general area?<br>Reference: NAVMC 5100.8, 13008.3.b

  • The unit must develop and post (in each work center) a worksite specific SOP; It must include the following (at a minimum):

  • Pertinent regulations from:

  • NAVMC 5100.8P

  • 29 CFR 1910.134

  • Manufactures Recommendations

  • Identify respirator hazards (painting, sanding, mixing, etc.)

  • Procedures for selecting the correct respirator/cartridge/filter for each work section. Example: Dry sanding: Half mask APR w/P100 Filters Paint mixing: Half-mask APR w/organic vapor cartridge NOTE: Information can be located on current IH SurveyP

  • Procedures for fit-function checks prior to each use. Example: Positive and Negative Pressure user seal checks

  • Mask inspections procedures: Daily/ each use, monthly (when not used) NOTE: See mask user's instructions

  • Cleaning Procedures: Daily Cleaning procedures (wipes) Weekly/monthly cleaning procedures by washing the respirator per the manufacturers recommendations.

  • Does each employee track respirator/ cartridge usage such as;

  • Hours worn

  • When cartridge was changed out

  • Mask Cleaned

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