Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Administrative

  • Safety Huddles and Coach Cards for the week have been reviewed, site is on pace to meet minimum required amounts.

  • Pre-Shift Warm up routines are being conducted.

  • All origami Incidents have appropriate reports; Auto Liability(AL) and Auto Physical Damage (APD) claims have photographs.

  • All worker's compensation claims have been processed, including entering of OSHA determination. Roll has been reviewed for personnel who may have been determined "no" but had subsequent restrictions or time off assessed after the initial incident.

Hazardous Chemical Exposure

  • Employees are trained in safe handling of hazardous chemicals such as acids, caustics, etc.

  • Employees are aware of the potential hazards involving various chemicals stored or used in the workplace, such as acids, caustics, epoxies, etc.

  • All drivers have completed HAZMAT training and their certificate is uploaded into their DQ file

  • Employee exposure to chemicals is kept within acceptable levels.

  • A less harmful method or product is used whenever possible.

  • Eyewash fountains and safety showers are provided in areas where corrosive chemicals are handled.

  • All containers, such as storage tanks, etc. are labeled as to their contents, e.g. "CAUSTICS".

  • All employees are required to use the necessary personal protective clothing and equipment (gloves, eye protection, respirators, etc.) when handling chemicals.

  • Flammable or toxic chemicals are kept in closed containers when not in use.

  • Chemical piping systems are clearly marked as to their content

  • Where ammonia is drawn from storage vessels, adequate means are readily available for venting and removing fumes properly and safely.

  • Standard operating procedures have been established, communicated to employees and are being followed when cleaning up chemical spills.

  • Spill Kits are stocked and readily available and positioned in close proximity to hazardous materials.

Respiratory Protection

Respiratory Protection

  • Where needed for emergency use, respirators are stored in a convenient, clean, and sanitary location.

  • Emergency-use respirators are adequate for the various conditions in which they may be needed.

  • There are written standard operating procedures for the selection and use of respirators where needed.

  • If you have a respirator protection program, employees are instructed in the correct use and limitations of the respirators. The respirators are NIOSH approved for the particular application and are regular1y inspected, cleaned, sanitized, and maintained and such inspection and maintenance is documented.

  • There is someone knowledgeable with the Threshold Limit Values or Permissible Exposure Limits of airborne contaminants and physical agents in your workplace.

  • Control procedures have been established for hazardous materials where appropriate (respirators, ventilation systems, handling practices, etc.).

  • Whenever possible, hazardous substances are handled in properly designed and exhausted booths or similar locations.

  • General dilution or ventilation exhaust systems are used to control dusts, vapors, gases, fumes, smoke, solvents, or mists that may be generated in your workplace.

  • Ventilation equipment is provided for removal of contaminants from operations such as grinding, buffing, spray painting, and/or vapor degreasing, and is operating properly.

  • The volume and velocity of air in the exhaust system is sufficient to gather the dusts, fumes, mists, vapors, or gases to be controlled, and to convey them to a suitable point of disposal.

  • If two or more types of operations are being controlled through the same exhaust system, you are certain that the combination of substances being controlled will not constitute a fire, explosion, or chemical reaction hazard in a duct.

  • Adequate makeup air is provided to areas where exhaust systems are operating.

  • The source point for makeup air is located so that only clean, fresh air which is free of contaminant will enter the work environment.

  • If internal combustion engines are used, carbon monoxide is kept within acceptable levels.

  • Vacuuming is used whenever possible for cleanup, rather than blowing or sweeping dusts.

  • Consider the use of an industrial hygienist or environmental health specialist to evaluate your operation.

Hazardous Substance Communication

Hazardous Substance Communication

  • There is a list of the hazardous substances used in your workplace and it readily available to employees. QR code for MSDS should be posted where employees will have access.

  • There is a written hazard communication program dealing with Safety Data Sheets, labeling, and employee training.

  • Each hazardous substance container (bottle, storage tank, etc.) is labeled with product identity and a hazard warning (communication of the specific health and physical hazards).

  • Each hazardous substance container (bottle, storage tank, etc.) is labeled with product identity and a hazard warning (communication of the specific health and physical hazards).

  • There is a Safety Data Sheet readily available for each hazardous substance used.

  • There is an employee training program for hazardous substances.

  • This Program includes, an explanation of an SDS and how to use and obtain one, the SDS contents for each hazardous substance or class of substances, identification of where employees can see the employer's written hazard communication program and where hazardous substances are present in their work areas, the physical and health hazards of substances in the work areas, the physical and health hazards of substances in the work area, and specific protective measures, and details of the hazard communiication program including how to use the labeling system and SDS's

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.