Title Page
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Site conducted
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Conducted on
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Prepared by
Overview
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As you are walking through the plant, please look out of the following: obvious safety concerns, spills, improper lifting techniques, extension cords, missing signage, ect.
Front Lobby
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Begin at the front lobby entry
Fire Extinguisher #8
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
GFCI outlet in Office Bathroom
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Plug tester into an outlet. Does it read passed?
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Are there any other safety concerns in this area?
Manufacturing Area
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Walk the manufacturing floor clockwise, starting at the Gyro Station
Emergency Signage by Office/Plant Door
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Is the emergency exit light illuminated?
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Do the emergency flood lights function while holding the test switch?
Spill Kit Barrel (Located in Mixing Area)
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-Is the Spill Kit closed, sealed and free of obstruction?
Eyewash Pull Station - Office/Plant Door
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Is eyewash tank full?
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Was the water replaced less than 3 months ago?
Fire Extinguisher # 4
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
Emergency Signage - East Plant Door
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Is the emergency exit sign illuminated?
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Do the emergency flood lights function while holding the test switch?
Eyewash Bottle - Myers & 3-Roll Wall
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Is the bottled eye wash present and more than 60 days from expiration?
Circuit Panels - Behind Myers Mixer
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Is the panel clear of obstructions 36" in front of it?
Emergency Signage - South Plant Door
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Is the emergency exit sign illuminated?
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Do the emergency flood lights function while holding the test switch?
Fire Extinguisher # 3
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
Circuit Panels - Left of Manufacturing Office
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Is the panel clear of obstructions 36" in front of it?
Mill Rescue Cabinet - 60" 2-Roll Mill
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Is the cabinet sealed?
Eyewash Bottle - 60" 2-Roll Mill Wall
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Is the bottled eye wash present and more than 60 days from expiration?
Circuit Panel - 60" 2-Roll Mill Wall
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Is the panel clear of obstructions 36" in front of it?
Fire Extinguisher # 2
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
Emergency Signage - West Plant Door
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Is the emergency exit sign illuminated?
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Do the emergency flood lights function while holding the test switch?
Eyewash Bottle - Red Ross Mixer Wall
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Is the bottled eye wash present and more than 60 days from expiration?
Fire Extinguisher # 1
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
Fire Extinguisher # 7 (on mezzanine in between showers)
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
Fire Extinguisher #5
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
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Are there any other safety concerns in this area? Safety checklists for machinery?
Laboratory
Eyewash Bottle - Wall near Phone
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Is the bottled eye wash present and more than 60 days from expiration?
Mill Rescue Cabinet - Wall with Window
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Is the cabinet sealed?
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Are there any other safety concerns in this area?
Laboratory Closet
Main Electrical Panels
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Is the panel clear of obstructions 36" in front of it?
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Is the electrical room clean and clear of obstructions to the panels?
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Are there any other safety concerns in this area?
Kitchen / Breakroom
Fire Extinguisher # 6
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?<br>
GFCI Outlets
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Plug tester into an outlet. Does it read passed?
First Aid Cabinet
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Is the First Aid Cabinet stocked and are items non-expired?
Bloodborne Pathogen Kit
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Is the kit present and sealed?
Sharps Container
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Is the sharps container present and not full?
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Are there any other safety concerns in this area?
Manufacturing Area Bathroom
GFCI Outlets
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Plug tester into an outlet. Does it read passed?
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Are there any other safety concerns in this area?
Forklifts
Forklift #2
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Inspect the daily safety inspection sheet - Has it been completed and any issues noted?
Fire Extinguisher on Forklift #2
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?
Forklift #6
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Inspect the daily safety inspection sheet - Has it been completed and any issues noted?
Fire Extinguisher on Forklift #6
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Is the inspection date more than 12 months ago?
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Record month/year and initials on the inspection tag.
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Is the extinguisher charge gauge in the green?
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Is the tamper seal intact?
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Are there any other safety concerns in this area?
Conclusion
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Did you notice any obvious safety concerns, spills, improper lifting techniques, extension cords, missing signage, ect?