Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • NAME OF SUPERVISOR

GENERAL SAFETY

  • CHEMICAL HYGIENE PLAN

  • Is the Chemical Hygiene Plan accessible in the lab?

  • Has the Plan been reviewed and signed by lab workers?

  • Has lab-specific safety information been updated (annually)?

  • REQUIRED SIGNS

  • Are eye protection and special signs posted on doors (if applicable)?

  • Are there signs on contaminated equipment?

  • PROHIBITED ITEMS IN LAB

  • Are food and drinks being excluded from the lab?

  • EYE PROTECTION

  • Are appropriate safety glasses/goggles being worn?

  • SECURITY

  • Are lab doors locked when not in use?

  • Are extra-lab areas blocked?

  • ELECTRICAL

  • Are extension cords being used properly and within limitations?

  • Are any outlet circuits being overloaded?

EMERGENCY

  • MEANS OF EGRESS AND EXITS

  • Are aisles free and is there at least 36 inches of clearance?

  • Are exits marked?

  • EMERGENCY PLANS

  • Is the evacuation plan posted?

  • Are emergency phone numbers near a phone or outside the door?

  • Are the locations of fire extinguishers and alarms posted?

  • Are the locations of eyewash stations/showers posted?

  • SPILL CLEAN-UP

  • Is there a plan for hazardous chemicals?

  • Is there a spill kit available in the lab with a posted/known location?

HOUSEKEEPING

  • FLAMMABLES

  • Are flammables stored in proper containers?

  • Is the flammable cabinet being used properly?

  • Are total flammable liquids under maximum amount allowed per lab?

  • COMPRESSED GASES

  • Are cylinders stored properly and capped if unused?

  • Are cylinders properly labeled and secured?

  • Are empty cylinders being managed or returned?

  • HOUSEKEEPING

  • Are floors, walls, workbenches, etc. clean?

  • Is the lab neat and clean in appearance?

  • Is there adequate space to perform work?

  • Is there at least 18 inches of ceiling clearance?

  • CHEMICAL STORAGE

  • Are storage containers compatible and appropriate?

  • Are breakables above eye level and away from shelf lips?

  • Are tubs in use?

  • CHEMICAL CONTAINER LABELS

  • Are containers labeled appropriately?

  • Are labels legible?

  • HAZARDOUS WASTE

  • Is there an identified central location for hazardous waste?

  • Is waste being appropriately segregated?

  • Are proper containers being used with appropriate labels?

  • CHEMICAL HOOD

  • Does hood chemical storage conflict with its designated use?

  • Is the sash placed in the proper position when not in use?

  • Are employees trained in hood use?

  • UNSAFE CONDITIONS

  • Is there any broken equipment?

  • Are there any leaking gas or water lines?

  • Is any of the lab shelving unstable?

  • Are there guards on sharp edges or drive belts?

  • SHARPS CONTAINERS

  • Is the proper container in use?

  • Are needles and syringes being stored appropriately?

DEPARTMENTAL ITEMS

  • RESPONSIBILITIES OF OTHER PERSONNEL*

  • Are eyewash station/shower inspections current?

  • Are chemical fume hood/biosafety cabinet inspections current?

  • Are chemical fume hoods functioning properly?

  • Are fire extinguisher inspections current?

  • * To be checked by inspection teams. Laboratory personnel should report to the Safety Officer if they notice that these items are not being done.

  • ADDITIONAL COMMENTS

  • INSPECTOR SIGNATURE

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