Loss Control Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General

• Animal health coolers free of stored items used for human consumption?

  Yes

  No

  N/A

• Open burning is not recommended

  Yes

  No

  N/A

• Against the law to burn any material other than brush and untreated wood producrs

1.0-Signage

• 1.0- Is your State and Federal OSHA poster current?

  Yes

  No

  N/A

• 1.1- Is the OSHA 300A formed posted? ( Feb. 1-April 31)

  Yes

  No

  N/A

• 1.2- Are load limit signs posted at all storage locations where materials are stored above?

  Yes

  No

  N/A

• 1.3- Are signs posted warning the presence of carbon monoxide?

  Yes

  No

  N/A

• 1.4- Are "No Smoking" signs posted at entrances to the facility?

  Yes

  No

  N/A

2.0- Material Handling

• 2.0- Aisles and passageways kept clear? (28")

  Yes

  No

  N/A

• 2.1- Containers/pallets stored, stacked, blocked, and limited in height so they are stable and secure?

  Yes

  No

  N/A

• 2.2- Are idle pallets at least 10' from the building?

  Yes

  No

  N/A

• 2.3- Dock boards used when loading/unloading?

  Yes

  No

  N/A
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• 2.3(a)- Dock boards of sufficient strength and in good condition?

  Yes

  No

  N/A

• 2.4- Chock blocks utilized to secure trucks and trailers from movement during loading and unloading operations?

  Yes

  No

  N/A

3.0- Fire Protection/Egress

• 3.0- Extinguishers clears of obstructions?

  Yes

  No

  N/A

• 18" clearance on each side and 3' in front

• 3.1- Extinguishers provided in adequate number & type?

  Yes

  No

  N/A

• 50' for flammables, 75' for non-flammables

• 3.2- Extinguishers mounted and marked?

  Yes

  No

  N/A

• 3.3- Extinguishers annually serviced?

  Yes

  No

  N/A

• 3.4- Extinguishers inspected monthly and documented?

  Yes

  No

  N/A

• 3.5- Smoking prohibited in the warehouse?

  Yes

  No

  N/A

• 3.6- Safety cans used to store gasoline?

  Yes

  No

  N/A

• 3.7- Are fire doors closed in the evenings?

  Yes

  No

  N/A

• 3.8- Are fire exits free from obstructions?

  Yes

  No

  N/A

• 3.9- Fire doors unlocked or utilizes the panic bar?

  Yes

  No

  N/A

• 3.10- Are EXITS clearly marked and visible?

  Yes

  No

  N/A

4.0- Forklift Operation

• 4.0- Forklifts not in safe condition removed from service?

  Yes

  No

  N/A

• 4.1- Forklifts inspected daily?

  Yes

  No

  N/A

• 4.2- Operators have been properly trained to operate the forklift?

  Yes

  No

  N/A

• 4.3- Operators current on their 3 year PIT skills test evaluation?

  Yes

  No

  N/A

• 4.4- Operators are instructed to wear their seatbelt and is enforced?

  Yes

  No

  N/A

• 4.5- Keys are removed when not in operation?

  Yes

  No

  N/A

• 4.6- Propane tanks stored together, secured, outside and 10' from any entrance?

  Yes

  No

  N/A

5.0- Electrical

• 5.1- 3' clearance in front electrical panels?

  Yes

  No

  N/A

• 5.2- Connecting switches & breakers labeled?

  Yes

  No

  N/A

• 5.3- Extension cords, tools & equipment grounded?

  Yes

  No

  N/A

• 5.4-Multiple plug adaptor prohibited?

  Yes

  No

  N/A

• 5.5- Electrical boxes covered?

  Yes

  No

  N/A

• 5.6- Unused breakers in panel box closed?

  Yes

  No

  N/A

• 5.7- Outlets within 6' of water are GFI?

  Yes

  No

  N/A

• 5.8- Cords free from splices?

  Yes

  No

  N/A

• 5.9- Extension cords not used as fixed, permanent wiring?

  Yes

  No

  N/A

6.0- Housekeeping

• 6.0- Floors, storerooms kept clean & orderly?

  Yes

  No

  N/A

• 6.1- Adequate cleaning schedule maintained to avoid accumulation of dust, feed, and other materials?

  Yes

  No

  N/A

7.0- Working, Walking Surfaces

• 7.0- Surfaces clean & dry?

  Yes

  No

  N/A

• 7.1- Pits & floor openings covered?

  Yes

  No

  N/A

• 7.2- Greater than 4' have standard railing?

  Yes

  No

  N/A

• Top rail (42"), mid-rail (21") toe board (4" thick, with not more than 1/4" clearance from floor)

• 7.3- Railings capable of withstanding a 200 lbs load?

  Yes

  No

  N/A

• 7.4- Stairways at least 22" wide?

  Yes

  No

  N/A

• 7.5- Risers uniform in height?

  Yes

  No

  N/A

• 7.6- Stairways having 4 or more risers have a handrail?

  Yes

  No

  N/A

• 7.7- Stair railing with a height of 30-34" above tread?

  Yes

  No

  N/A

8.0- Personal Protective Equipment

• 8.0- PPE functional and in good condition?

  Yes

  No

  N/A

• 8.0- Has a Hazard Assessment been conducted?

  Yes

  No

  N/A
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• 8.0(a)- Has an annual review been conducted?

  Yes

  No

  N/A

9.0- Medical

• 9.0- AED battery still good?

  Yes

  No

  N/A

• 9.1- First-aid kit stocked?

  Yes

  No

  N/A

10.0- Chemical storage

• 10.0- Secondary containers labeled?

  Yes

  No

  N/A

• 10.1- Flammable liquids stored away from oxidizers & poisobs?

  Yes

  No

  N/A

• 10.2- Chemical spills cleaned up immediately?

  Yes

  No

  N/A

• 10.3- Pesticides stored away from edible products? (Animal Feed)

  Yes

  No

  N/A

11.0- Operators and CMV

• 11.0- All operators DQF current?

  Yes

  No

  N/A

• Pre-employment DOT drug test, Medical card, and license

• 11.1- Supervisors have received 2 hours of training focused on alcohol misuse and controlled substances?

  Yes

  No

  N/A

• 11.2- Vehicle Maintenance files maintained?

  Yes

  No

  N/A

• 11.3- Annual Inspection performed?

  Yes

  No

  N/A

• 11.4- Pre-trip inspection performed to satisfy operator of safe operating conditions.

  Yes

  No

  N/A

• 11.5- Post trips inspection performed a d documented? (90 days)

  Yes

  No

  N/A

12.0- Ladder Safety

• 12.1- Do rolling stock ladders have their rubber stop?

  Yes

  No

  N/A

Recommendations:

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• Signature of inspector:

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• Signature of supervisor:

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