JGI-AZ: Observation & Audit of Mesa Workstation Updated 7/30/2014

• Work Center #

• Conducted on

  Date

• Prepared by

• Additional Observers/Auditors

• Revised 7/30/14

AUDIT/INSPECTION

• Is work currently being performed in the work center?

  Yes

  No

• Is the work center housekeeping being maintained to the best of ability with work being performed?

  Yes

  No

  N/A

• Have tools that are currently being used been inspected prior to beginning work and marked for the current month? Hand tools, power tools, cords, ladders etc.<br>(January & July = Yellow)/(February & August = Blue) <br>(March & September = Brown)/(April & October = Orange)<br>(May & November = White)/(June & December = Red)<br>

  Yes

  No

  N/A

• Are the proper tools being used for the current job tasks?

  Yes

  No

  N/A

• Are cords for tools and equipment being used being maintained, inspected, and covered or kept in such a way to reduce or eliminate trip/fall/electrical hazards?

  Yes

  No

  N/A

• Has the employee properly filled out the daily FLRA and does it apply to his current work tasks?

  Yes

  No

  N/A

• If employee is performing any of the following is the proper inspections and paperwork properly filled out prior and readily available? Confined space, critical lift, use of overhead cranes, use of fall protection, ladder inspections,

  Yes

  No

  N/A

• Is the employee confident in his training and ability to perform the tasks currently being performed?

  Yes

  No

  N/A

• Is there a fire extinguisher in the work center?

  Yes

  N/A

• Is the fire extinguisher in proper condition with all labels attached and legible, yearly inspection up to date, current monthly inspection complete and easily accessible should it be needed?

  Yes

  No

  N/A

• Are any chemical products being used or out in this work area?

  Yes

  No

• Has the employee reviewed the SDS recently?

  Yes

  No

  N/A

• Are gas cylinders currently being used in area?

  Yes

  No

• Are cylinders being stored properly and secured?

  Yes

  No

  N/A

• Are cylinders labeled with contents?

  Yes

  No

  N/A

• Are regulators in good condition with no broken gauges, hoses etc.?

  Yes

  No

  N/A

• Are there buckets present in work station?

  Yes

  N/A

• Are buckets properly marked with its contents?

  Yes

  No

  N/A

• If no work is currently being performed in the work center being inspected/audited, select the check box to the right.

• Was the work center left in a clean and organized manner? Everything has a place and everything in that place, swept etc.

  Yes

  No

  N/A

• If present, was the trash cans and rag containers emptied?

  Yes

  No

  N/A

• Were all the chemical products, tools and equipment put away and not left out?

  Yes

  No

  N/A

• Is equipment that has been left out such as extension cords, visibly marked with current monthly inspection?

  Yes

  No

  N/A

• Are there buckets present in work station?

  Yes

  N/A

• Are buckets properly marked with its contents?

  Yes

  No

  N/A

• If items are present in the buckets, are they items that are okay to be stored in the buckets such as nuts and bolts? (Items not okay to store in buckets would be tools that should be in work boxes; aerosols that should be in flammable cabinet storage, rags that should be in rag containers etc.)

  Yes

  No

  N/A

• Are there flammable cabinet storage in this work center?

  No

  Yes

• Is the cabinet free of spills?

  Yes

  No

  N/A

• Is the cabinet free of combustibles? Cardboard, paper etc.

  Yes

  No

  N/A

• Are there any electrical panels or boxes in this work center?

  Yes

  N/A

• Are the panels clear 36" of any obstructions?

  Yes

  No

  N/A

• Are the panels labelled with voltage?

  Yes

  No

  N/A

• Are the panels in proper order with all screws in place all knockouts present,

  Yes

  No

  N/A

• Are all breakers switches labelled including blank/non-active ones?

  Yes

  No

  N/A

• Are all breaker switch spots full/covered leaving no open holes?

  Yes

  No

  N/A

AUDIT/ INSPECTION FINAL NOTES

OBSERVATION

• Is there an employee present to observe behavior?

  Yes

  N/A

• Is the employee following all PPE requirements for his/her area?

  Yes

  No

  N/A

• Is the employee maintaining his /her area per housekeeping policy and procedure?

  Yes

  No

  N/A

• If after conducting an audit/inspection of employees work area and items were asked to be addressed, was the employees response positive?

  Yes

  No

  N/A

• Does the employee have any concerns in regards to safety, knowledge of policy and procedures, communication between employees and managements or ways to improve on any items?

  No

  Yes

• Does the employee have any positive items, recognitions etc. that they want to express?

  Yes

  No

OBSERVATION FINAL NOTES

Acknowledgment Signatures

• Completed audit to be forwarded to responsible Supervisor and Manager of area for corrective actions to be addressed and to the Health and Safety Department for record keeping.

• Employee (if applicable)

  Sign

• Auditor

  Sign