KAPSTONE Environmental Safety Health Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Facilities Photos

Previous inspection

• Has the last inspection been reviewed?

  Yes

  No

  Not Reviewed

• All prior corrective actions from previous incidents or audits have been completed.

  Yes

  No

  Not Reviewed

Record Keeping 1904

• Is the facility properly reporting incidents, including near miss, property damage, first aid, and all a recordable incidents within the reporting guidelines and time frame?

  Yes

  No

  Not Reviewed

• .33 - Have incident reports, injury/illness logs, and all recordable incidents within the reporting guidelines and time frame?

  Yes

  No

  Not Reviewed

• Is the current required OSHA Job Safety and Health Protection poster displayed in a prominent location accessible to employees?

  Yes

  No

  Not Reviewed

• Safety committee minutes are posted, maintained and available for review?

  Yes

  No

  Not Reviewed

• Job hazard analysis has been completed for all jobs?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Walking - Working Surfaces 1910.22 (Subpart D)

• (a)1 - Evacuation plan displayed and understood by all employees?

  Yes

  No

  Not Reviewed

• (a)2 - Where wet/oily process are used is drainage maintained, false floors or mats provided where practical?

  Yes

  No

  Not Reviewed

• (a)3 - Are all floors, working spaces and passageways kept free from sharp edges, splinters, holes or other hazards?

  Yes

  No

  Not Reviewed

• Is signage available to warn of hazards within the working environment or within the walking areas.

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Floor and Wall Openings 1910.23

• (a)1 - Is every stairway floor opening guarded by a standard rail?

  Yes

  No

  Not Reviewed

• (c)1 - Is every open - sided floor or platform that is 4 feet or more adjacent floor or ground level, guarded by a standard railing on all opesides? (excluding loading docks w/proper visual control)

  Yes

  No

  Not Reviewed

• No openings are present that present a slip, trip, or fall hazard from either a platform, floor level, or height of elevation.

  Yes

  No

  Not Reviewed

• (e)1 - Is all railing 42 inches high with a smooth top railing that does not overhang causing a projection hazard.

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Fixed Industrial Stairs 1910.24

• (b) - Are stairs fixed at all points where access to elevation is daily or regular?

  Yes

  No

  Not Reviewed

• (d) - Do fixed stairways have a minimum width of 22 inches?

  Yes

  No

  Not Reviewed

• (e) - Are all stairs installed and uniform at a 30-50 degree angle?

  Yes

  No

  Not Reviewed

• (f) - Are all stair treads reasonably slip- resistant finish?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Portable Ladders 1910.26

• (a)(1)(v) - Are ladder rungs and steps, corrugated, knurled, dimpled, coated with skid - resistant material, or otherwise treated to minimize the possibility of slipping?

  Yes

  No

  Not Reviewed

• All ladders are made of fiberglass material and no wooden or metal ladders are in use?

  Yes

  No

  Not Reviewed

• (c)(2)(vi)(d) - Are runs kept free of grease & oil and kept properly secured to prevent falling.

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Dock Systems 1910.30

• (a)2 - Are dock levelers and dock locks in good operating condition and anchored in a way that prevents movement?

  Yes

  No

  Not Reviewed

• Are two effective means being used to prevent unwanted movement of the truck? Dock locks - wheel chocks - glad locks

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Exit Routes 1910.36 & Exit Signs 1910.37 & 1910.38 (Subpart E)

• (b)2 - Are there at least two exit routes for employees?

  Yes

  No

  Not Reviewed

• (d)1 - Are all exit doors able to open from the inside without keys, tools, or special knowledge?

  Yes

  No

  Not Reviewed

• Exits clear of obstructions?

  Yes

  No

  Not Reviewed

• (b)2 - Is each exit sign clearly and visibly marked "Exit"

  Yes

  No

  Not Reviewed

• (b)4 - Where exits are not visible, signs posted along the exit route indicating the nearest exit discharge?

  Yes

  No

  Not Reviewed

• Indicator signs above floor level?

  Yes

  No

  Not Reviewed

• (b)(c)(1)(e) - Is the Emergency Action Plan available to employees, include all of the minimum requirements, and employees have trained on the plan?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Occupational Health (Subpart G)

Ventilation 1910.94

• (b)2 - Is a local exhaust ventilation system used or is adequate means of ventilation available?

  Yes

  No

  Not Reviewed

• (b)(3)i - Are hoods and branch pipes connected in a manner that exhaust is projected in the direction of air flow and does not cause a greater hazard to others?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Hearing Conservation 1910.95

• (a) - Has occupational noise testing been conducted?

  Yes

  No

  Not Reviewed

• (c)1 - Is an effective and continuous hearing conservation program in place for areas that exceed 85 Dba?

  Yes

  No

  Not Reviewed

• (k)3 - Is there a training program installed for hearing conservation?

  Yes

  No

  Not Reviewed

• (k)5 - Are signs posted to warn/instruct employees to wear hearing protection?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Hazardous Materials - Flammable &Combustible Liquid 1910.106 (Subpart H)

• (b)(2)(ii) - Outside storage tanks are protected from means of damage?

  Yes

  No

  Not Reviewed

• Are storage cabinets which flammable liquids are labeled "FLAMMABLE - KEEP FIRE AWAY"?

  Yes

  No

  Not Reviewed

• Are tanks used to store used oil marked with the words "Used Oil"?

  Yes

  No

  Not Reviewed

• (b)(2)(vii)(c) - Means of protection in place to retain any liquids from draining into the ground or water systems.

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

PPE 1910.132 (Subpart I)

• (a) - Is PPE provided and maintained in a sanitary and reliable condition?

  Yes

  No

  Not Reviewed

• Employees are observed wearing the appropriate PPE in the proper manner.

  Yes

  No

  Not Reviewed

• (f) (I-V) - Has training been provided on the proper wearing of PPE?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Eye and Face Protection 1910.133

• (a)1 - Are face shields or hoods bring worn when exposed to molten metal, liquid chemicals, or other injury hazards?

  Yes

  No

  Not Reviewed

• (a)2 - Are safety glasses worn in all production areas of the facility?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Respiratory Protection 1910.134

• (a)1 - Have all employees been trained respirators are not allowed in the facility, any job / task requiring the use of respirators will be contracted out?

  Yes

  No

  Not Reviewed

• (c)1 - A respiratory protection program is established and updated.

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Head and Foot Protection 1910.135 & 136

• (a)1 - Are hard hats or bump caps worn in all production areas?

  Yes

  No

  Not Reviewed

• (a) - Is foot protection being worn in all production areas?

  Yes

  No

  Not Reviewed

• Additional Comments

  Yes

  No

  Not Reviewed

Permit Required Confined Space 1910.146

• (c)(2) - Danger signs are posted at location of permit required confined spaces.

  Yes

  No

  Not Reviewed

• (c)(4) - There is a written program for confined space entry?

  Yes

  No

  Not Reviewed

• (d)(4)(l-x) - Equipment is listed on the facility confined space master list?

  Yes

  No

  Not Reviewed

• (g)(1) - Training has been provided to employees on Kapstone confined space policy?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Control of Hazardous Energy (LOTO) 1910.147

• Hands Up policy is being followed by employees within 6' of equipment prior to start up?

  Yes

  No

  Not Reviewed

• (c)(5)(i) - LOTO hardware is provided for isolating machines or equipment?

  Yes

  No

  Not Reviewed

• (c)(7)(i) - Employees have received training on the knowledge and skills of controlling hazardous energy?

  Yes

  No

  Not Reviewed

• (d)(1-6) - Procedures are developed to include preparation, machine isolation, shutdown, device application, shift changes, group LOTO, and re-energization?

  Yes

  No

  Not Reviewed

• (f)(3)(ii)(d) - Each authorized employee has personal LOTO device or lock that can be used for single or group applications?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Medical and First Aid 1910.151 Subpart K

• (c)(1) - Emergency eyewash and shower facilities are within 50 feet of areas where employees are exposed to irritants or corrosive materials?

  Yes

  No

  Not Reviewed

• (b) First aid kits are easily accessible and maintained with necessary supplies, periodically inspected, and replenished as needed.

  Yes

  No

  Not Reviewed

• Are cabinets and contents clean and orderly?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Fire Protection Subpart L

Fire Extinguishers 1910.157

• (c)(1) - Are all extinguishers mounted and identified so that they are easily accessible?

  Yes

  No

  Not Reviewed

• (c)(4) - All extinguishers maintained, fully charged, in their designated location, and inspected on a monthly basis?

  Yes

  No

  Not Reviewed

• (d)(1) - is the appropriate extinguisher available for use depending on the hazards?

  Yes

  No

  Not Reviewed

• (e)(3) - Extinguishers are subjected to an annual maintenance and inspection plan?

  Yes

  No

  Not Reviewed

Sprinkler Systems 1910.159

• (c)(2) - Main drain flow tests are performed annually on each system, check tags on units?

  Yes

  No

  Not Reviewed

• (c)(6) - Piping is protected from damaged, freezing, and corrosion?

  Yes

  No

  Not Reviewed

• (c)(10) - All materials 18" from all sprinkler heads?

  Yes

  No

  Not Reviewed

• Has the fire pump been started weekly ?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

• Are there spare extinguishers on site ?

  Yes

  No

  Not Reviewed

Material Handling and Storage 1910.176 Subpart N

• (a) - Are aisle ways designated, permanently marked, and kept clear to allow unhindered passage?

  Yes

  No

  Not Reviewed

• (b) - Are units stored, stacked, blocked, and limited in height so that they are stable and secure?

  Yes

  No

  Not Reviewed

• Are storage racks maintained with no bent legs, deformities, or damage and load ratings marked?

  Yes

  No

  Not Reviewed

• Do all storage areas have clearly marked boundaries ?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Powered Industrial Trucks 1910.178

• (a)(3) - Are all name plates and markings maintained and legible identifying the type and capacity of the lift?

  Yes

  No

  Not Reviewed

• (g)(1) - Are charging stations marked and located where they are not in the operating area?

  Yes

  No

  Not Reviewed

• (g)(2) - Are facilities provided for filling battery cells and is PPE provided at the area?

  Yes

  No

  Not Reviewed

• (m)(5)(i) - All unattended trucks are neutralized, brakes engaged, forks lowered, and powered off?

  Yes

  No

  Not Reviewed

• (n)(1) - All traffic regulations are observed including use of seat belts and speed limits, of which speed are appropriate for the environment?

  Yes

  No

  Not Reviewed

• (g)(7) - Industrial trucks, man lifts are inspected daily and recorded?

  Yes

  No

  Not Reviewed

• (g)(10) - All industrial trucks are kept in a clean condition and free from buildup of materials including grease and oil?

  Yes

  No

  Not Reviewed

• (i) - A training program has been developed and employees are evaluated on an annual basis, employee records are maintained?

  Yes

  No

  Not Reviewed

• Training program includes scissor lift and articulating boom lift operators?

  Yes

  No

  Not Reviewed

• Training includes fall protection, harness inspection and fit and lanyard inspection?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Overhead Cranes 1910.179

• (b)(5) - The capacity of all lifting devices is clearly marked and identified from all points of operation?

  Yes

  No

  N/A

• (i)(2)(vi) - Cranes and lifting devices visually inspected everyday prior to use for sign of wear, twisting, cracks, distorted links, stretching in hooks, and deformities to end connections?

  Yes

  No

  N/A

• (i)(3) - Preventative maintenance program exists and inspections completed annually for wearing of bolts, sheaves, drums, brakes, wires, and sprockets?

  Yes

  No

  N/A

• Additional comments

  Yes

  No

  Not Reviewed

Slings 1910.184

• (c)(1) - Defective or damaged slings are removed from use and tagged inoperable?

  Yes

  No

  N/A

• (c)(4) - Sling or rope capacities are marked?

  Yes

  No

  N/A

• (i)(6)(ii) - Fiber or synthetic slings are not exposed to paint, sprays, mists, or other caustic liquids?

  Yes

  No

  N/A

• Additional comments

  Yes

  No

  N/A

Machinery and Machine Guarding 1910.212 Subpart O

• (a)(2) - All moving parts, chains, gears, sprockets, and pinch points are properly guarded?

  Yes

  No

  Not Reviewed

• (a)(3)(ii) - Emergency shut off switches are easily identified and located at the point of operation?

  Yes

  No

  Not Reviewed

• (a)(5) - All fans less than 7 feet above the floor are guarded with openings not larger than 1/2 inch?

  Yes

  No

  Not Reviewed

• (b) - All machines in fixed locations are securely mounted and anchored to prevent movement?

  Yes

  No

  Not Reviewed

• All machine controls clearly labeled as to their operation?

  Yes

  No

  Not Reviewed

• 1910.217 (f)(3) - Is sufficient clearance provided around and between machinery to allow for safe operation, set up, servicing, and general movement?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Abrasive Wheel Machinery 1910.215

• (a)(2) - Guards are fastened tightly in a manner that movement is prevented during operation?

  Yes

  No

  Not Reviewed

• (a)(4) - grinders have rigid work rest with a maximum opening of less than 1/8 inch?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Hand and Portable Power Tools 1910 (Subpart P)

• 242(a) - All tools are in a safe operating condition with no defects that pose a hazard during use or storage?

  Yes

  No

  N/A

• 244(b) - Air hoses used for cleaning purposes are equipped with a pressure relief valve at 30 psi.

  Yes

  No

  N/A

• Additional comments

  Yes

  No

  N/A

Welding, Cutting, Brazing 1910.252 (Subpart Q)

• FM Global hot work program is used at the facility?

  Yes

  No

  Not Reviewed

• Have the completed Hot Work permits been audited within the past six months?

  Yes

  No

  Not Reviewed

• (a)(1)(ii) - Guards or curtains are in place when there is a possible fire hazard?

  Yes

  No

  Not Reviewed

• (a)(2)(ii) - Fire extinguishing equipment is readily available around all hot work?

  Yes

  No

  Not Reviewed

• (a)(2)(v) - The hot work area is clean from combustible debris?

  Yes

  No

  Not Reviewed

• (c)(2)(ii) - Mechanical ventilation is adequate in areas of low ceilings or concentrated welding?

  Yes

  No

  Not Reviewed

• All welding equipment has ANSI signage ?

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Oxygen, Acetylene Cutting Torch

• (b)(1)(ii) - All gas cylinders are properly marked and hazards are labeled.

  Yes

  No

  Not Reviewed

• (b)(2)(ii) - Cylinders are stored in an assigned location away from sources of heat.

  Yes

  No

  Not Reviewed

• (b)(2)(iv) - Valve caps are in place when cylinders are not in use.

  Yes

  No

  Not Reviewed

• (b)(4)(iii) - Oxygen and Acetylene are stored in separate locations at least 20' apart.

  Yes

  No

  Not Reviewed

• (b)(5)(iii)(A) - All gas cylinders are stored upright and secured from falling.

  Yes

  No

  Not Reviewed

• Additional comments

  Yes

  No

  Not Reviewed

Electrical 1910.303 (Subpart S)

• (b)(7)(i) - All unused boxes, punch outs, or housings are closed and present no opening?

  Yes

  No

  Not Reviewed

• (b)(7)(iv) - No damage to operational or mechanical parts that could cause a safety hazard?

  Yes

  No

  Not Reviewed

• (e) - Boxes are labeled with manufacturers name, voltage and other electrical ratings?

  Yes

  No

  N/A

• (e) - Boxes are labeled with arch flash labels?

  Yes

  No

  Not Reviewed

• (f)(2) - Are all disconnecting switches and circuit breakers labeled to indicate their use or equipment served?

  Yes

  No

  Not Reviewed

• (g)(1) - Sufficient space (3') is available for adjustment, servicing, and maintenance around electrical boxes?

  Yes

  No

  Not Reviewed

• Additional comments?

  Yes

  No

  Not Reviewed

Switches 1910.305

• (j)(2)(iv) - GFCI's are installed in potentially wet locations.

  Yes

  No

  Not Reviewed

• (c)(4) - All switches, receptacles and faceplates are we secured with tight fitting covers.

  Yes

  No

  Not Reviewed

• AdditionalComments.

  Yes

  No

  Not Reviewed

Use of Equipment (wiring) 1910.334

• (a)(1) - Cords are not used In place of permanent electrical wiring apparatus. (30 day max)

  Yes

  No

  Not Reviewed

• (a)(2)(I) - All cords are in good working condition with no defects or splices.

  Yes

  No

  Not Reviewed

• AdditionalComments.

  Yes

  No

  Not Reviewed

Toxic and Hazardous Substances 1910.1200 (Subpart Z)

• (e)(1)(g)(1) - An SDS is readily available to all employees and contains all chemicals used within the operations.

  Yes

  No

  Not Reviewed

• (f)(1) - All containers are labeled and marked with the identity of the substance, the hazards, and name of the manufacturer.

  Yes

  No

  Not Reviewed

• (h)(3)(iii) - The work area contains the listing of all PPE required including Work Instructions when handling hazardous chemicals.

  Yes

  No

  Not Reviewed

Bloodborne Pathogens 1910.1030

• (c)(1)(i) - A written exposure control plan has been developed and is available for review?

  Yes

  No

  Not Reviewed

• (d)(1) - Universal precautions have been taken to prevent contact with blood or other infectious materials?

  Yes

  No

  Not Reviewed

• (d)(2)(iv) - Handwashing stations or anti septic handwash is readily available?

  Yes

  No

  Not Reviewed

• (g)(1)(i)(a) - Warming labels are fixed to all containers of regulated waste?

  Yes

  No

  Not Reviewed

• Additional comments?

  Yes

  No

  Not Reviewed

5-S Housekeeping

• Work areas are clean?

  Yes

  No

  N/A

• Tools and supplies are kept in pre-determined locations when not in use, storage areas are marked and labeled for placement of items?

  Yes

  No

  N/A

• Are materials stacked and stored in a manner to prevent blind corners or intersections?

  Yes

  No

  N/A

Ergonomics

• Is the work station adjustable or at the proper height?

  Yes

  No

  N/A

• Are cushioned floor mats placed in areas where standing is required for a long period of time?

  Yes

  No

  N/A

• Are mechanical aids or equipment provided where feasible to assist with lifting or handling of materials?

  Yes

  No

  N/A

• Are ergonomic assessments completed to analyze potential injurious tasks?

  Yes

  No

  N/A

• The work area is designed to prevent twisting at the waist, reaching above the shoulder, static muscle loading, extension of the arms, or elevation of the elbows?

  Yes

  No

  N/A

Environmental Air Permit

• Air permit required?

  Yes

  No

  N/A

• Compliance calendar established?

  Yes

  No

  N/A

• Have all permit required inspections, sampling, submissions been completed timely in the past 12 months?

  Yes

  No

  N/A

• Are there items that need follow up?

  Yes

  No

  N/A

Environmental Storm Water Permit

• Storm Water permit required?

  Yes

  No

  N/A

• Compliance calendar established?

  Yes

  No

  N/A

• Have all permit required inspections, sampling, submissions been completed timely in the past 12 months?

  Yes

  No

  N/A

• Are there items that need follow up?

  Yes

  No

  N/A

Environmental Sewer discharge Permit

• Sewer Discharge permit required?

  Yes

  No

  N/A

• Compliance calendar established?

  Yes

  No

  N/A

• Have all permit required inspections, sampling, submissions been completed timely in the past 12 months?

  Yes

  No

  N/A

• Are there items that need follow up?

  Yes

  No

  N/A

Environmental SARA TEIR II Permit

• SARA TEIR II required?

  Yes

  No

  N/A

• Compliance calendar established?

  Yes

  No

  N/A

• Have all permit required inspections, sampling, submissions been completed timely in the past 12 months?

  Yes

  No

  N/A

• Are there items that need follow up?

  Yes

  No

  N/A

Environmental Hazardous waste generator license

• Hazardous waste generator licence required?

  Yes

  No

  N/A

• Compliance calendar established?

  Yes

  No

  N/A

• Have all permit required inspections, sampling, submissions been completed timely in the past 12 months?

  Yes

  No

  N/A

• Are there items that need follow up?

  Yes

  No

  N/A

Environmental permit, license ( other )

• Other permit, license required?

  Yes

  No

  N/A

• What is the name of the permit or license?

  Yes

  No

  Not Reviewed

• Compliance calendar established?

  Yes

  No

  N/A

• Have all permit required inspections, sampling, submissions been completed timely in the past 12 months?

  Yes

  No

  N/A

• Are there items that need follow up?

  Yes

  No

  N/A

Additional comments?

• Yes

  No

  N/A

• Were there additional findings?

  Yes

  No

  N/A

• Were there additional findings?

  Yes

  No

  N/A

• Were there additional findings?

  Yes

  No

  N/A

• Were there additional findings?

  Yes

  No

  N/A

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