J.B. Poindexter & Co., Inc.

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Safety

General Information

• Is the signed (by BU Exec) EHS Policy Posted?

  Yes

  No

  N/A

• Score

• Is there an active, self-running Safety Committee, chaired by other than the EHS person?

  Yes

  No

  N/A

• Score

• Is there a schedule established and is all required annual safety training completed?

  Yes

  No

  N/A

• Score

• Are all WC incidents reported to carrier within 3 days?

  Yes

  No

  N/A

• Score Average Time: 0-3 days=25, 4-7 days=15, 8-21 days=5, >21 days=0

• What is being done to improve a supervisor's skills to manage EHS in their areas?

  Yes

  No

  N/A

• Score

• General Housekeeping - Are floors clean, aisles clear and hoses off the floor?

  Yes

  No

  N/A

• Score

• No Smoking Policy - is it effective, are there butts on the ground?

  Yes

  No

  N/A

• Score

• No eating or storage of food around chemicals. Is this true?

  Yes

  No

  N/A

• Score

• Restroom Cleanliness - Are sinks and toilets clean, no trash on floor, no graffiti or writing on walls?

  Yes

  No

  N/A

• Score

• Compliance Tasks have been reviewed and regulatory and JBPCO common tasks are included in EMIS for this site.

  Yes

  No

  N/A

• Score

• Are regulatory tasks completed on time in EMIS? A calculated percentage completed on time will determine points.

  Yes

  No

  N/A

• Score

• Prepared for audit - are records available for review? Are personnel available as needed to participated in audit?

  Yes

  No

  N/A

• Score

OSHA Recordkeeping

• OSHA Poster located on all company notification bulletin boards?

  Yes

  No

  N/A

• Score

• Are incidents properly recorded?

  Yes

  No

  N/A

• Score

Hearing Conservation

• Is there a current completed survey that covers the plant? I.e. No changes been made that would require a new survey?

  Yes

  No

  N/A

• Score

• Have all team members covered by a survey been notified? Is there documentation of the notification?

  Yes

  No

  N/A

• Score

• Audiometric Testing - have all team members covered by a Hearing Conservation Program, received the annual audiometric test?

  Yes

  No

  N/A

• Score

• Audiometric Testing - Team members notified of his/her result?

  Yes

  No

  N/A

• Score

• Is there a written HCP in place?

  Yes

  No

  N/A

• Score

• Is all hearing protection appropriate for noise levels and being worn properly?

  Yes

  No

  N/A

• Score

• Is a copy of the OSHA Noise standard posted on company bulletin boards?

  Yes

  No

  N/A

• Score

• Has the annual hearing conservation training for team members in the program, been completed?

  Yes

  No

  N/A

• Score

Emergency Preparedness

Bloodborne Pathogens

Effectiveness in Incident Control

PPE

• Tap to enter information

  Yes

  No

  N/A

• Tap to enter information

  Yes

  No

  N/A

• Tap to enter information

  Yes

  No

  N/A

• Tap to enter information

  Yes

  No

  N/A

Hazardous Materials

GHS (Global Harmonization System) formerly Hazard Communication

Chemical Exposures

Hazardous Materials

Machine & Equipment

Confined Space

Machine Guarding

Lockout/Tagout

Electrical Safety

Powered Industrial Trucks

Overhead & Gantry Cranes, Hoists, and Slings

Environmental

Air

Water

Land

Fleet Safety

DOT/Fleet Safety

DOT

NonCMV

5-S