Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Pass or Fail
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Did the equipment pass the safety checklist
Lock-out/Hazardous Energy Control
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Are all sources of energy clearly labeled (i.e. E1, P1, etc.)?
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Hazardous energy placard (e-PLAC standard) posted (for any dual source equipment)?
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Lockable electrical and/or air lines/valves within 6 1/2 ft from the floor?
Confined Space
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Labeled and numbered?
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Evaluated for permit/non-permit required?
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Potential hazard(s) identified?
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Recorded on Plant's Confined Space Log?
Electricity
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All wiring meets Inteva Controls standards?
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Properly Fused?
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Limit Switches Functional?
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Light curtains and safety mats function correctly?
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Ground fault interrupts required/installed?
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Voltage marked?
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Panels have proper clearances?
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Arc flash and shock label posted NFPA70E?
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Non-custom equipment NRTL (i.e. UL) listed and labeled?
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Are the electrical cords/extensions safe? Routed Safety? Less than 20 feet and protected?
Controls
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Anti tie down/anti repeat circuitry verified?
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Stop controls function properly and are accessible?
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Cycle stops - Are yellow and stop upon completion of a cycle?
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Master stops- Are red and stops machine?
Ergonomics
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Meet height requirements?
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Meet lifting guidelines?
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Cycle time identified?
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Within operator posture limitations?
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Within operator force limitations?
Compressed Air
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Hand held max 30 PSI and vented?
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Mechanical brakes on air cylinders operate correctly?
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Properly labeled?
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Valves labeled including operating pressure and what valve initates?
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Muffler on exhaust?
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Does not create a safety hazard when de-energized?
Water Lines
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Properly labeled? (utilities labeled every 40 feet)
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Incoming/Drain?
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Back flow preventer(s) installed if required?
Gas Lines
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Properly labeled? (utilities labeled every 40 feet)?
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Direction of flow identified?
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Pressure identified?
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Proper exhaust?
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Proper safety valves including lockout?
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Safety instructions in place?
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Training plan written for implementation?
Hydraulics
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Proper plumbing?
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Valves labeled including operating pressure and what valve initiates?
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Clearly labeled gages, preferably within operating range?
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Does not create a safety hazard when de-energized?
Steam
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Properly labeled? (utilities labeled every 40 feet)?
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Direction of flow identified?
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Pressure identified?
Chemicals
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Approved through Hazardous Material Control Committee?
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Material Safety Data Sheets provided with 100% disclosure and all ingredients within 5% of actual?
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Safe Use Instructions provided?
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Storage area provided?
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Properly labeled?
Maintenance
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System prints provided and current?
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Electrical?
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Pneumatic?
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Hydraulic?
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Water, Gas, Steam, Etc?
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Ventilation?
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Lubrication?
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Coolant/Quench?
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Preventative maintenance sheets have been provided?
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Preventative maintenance frequency have been provided?
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Maximo identification number is affixed to the equipment?
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Maintenance has been trained on proper use/operation per instructions?
Work Place Organization plan implemented
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Tools in marked spots?
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All required equipment in designated locations?
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Skip/hopper/rack locations designated- visually marked?
Guarding
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Are guards free from burrs, sharp edges, and sharp corners?
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does guarding safely contain all material within the guarded area in case of mechanical failure?
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Do guards contain coolant or lubricant splash?
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Do guards permit proper visibility where necessary?
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Do guards avoid creation of a hazard or interfering normal operation of equipment?
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Are easy open barrier guards which cover pinch points interlocked?
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Are guards hinged whenever possible and designed in such a manner that neither counter balance not any other mechanical aids are required to open/hold/close them?
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Do all barrier guards installed eliminate all pinch points?
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Are all drive unit apparatuses such as belts, cylinders, chains, sprockets, gears, and shafts totally enclosed?
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Are all shear, crush, pinch, and coupling drive flanges completely guarded?
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Are all turnover or rollover fixtures adequately guarded to stop access?
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Where suspended counterweights are used and not guarded by location, are they enclosed?
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Does light curtain installation conform to proper "safe distance" requirements?
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Has light curtain application been entered into preventive maintenance tracking system?
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Is proper mechanical guarding in place to prevent reaching around light curtains and into unsafe area?
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Are robot to hard guarding distances adequate per ANSI R15.06, generally 18" from restricted space to guard?
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Does the control safety circuit meet all requirements outlined in Inteva Standards?
Ventilation Requirements
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Ventilation required/installed?
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Fire detection required/installed?
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Fire suppression system required/installed?
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Exhaust ventilation required/installed?
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Proper filters available/installed?
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Mist collector's required/installed?
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Dust collector's required/installed?
Platforms, Ladders, and Steps
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Do treads have non-slip surfaces?
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Are hand rails provided?
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Are mid rails provided?
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Toe boards, 4" high (above 48" elevation)?
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Is a safety gate at fixed ladder/platform entrance/exit?
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Are serviceable components accessible without climbing?
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Are platform railings 42" high?
General
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Proper lighting?
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All sharp and protruding points have been eliminated or protected?
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Personal protective equipment identified?
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Emergency eyewash and safety shower installed?
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Floor openings guarded or covered?
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Walking surfaces are free from obstacles and posted load requirements?
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Audible operator signals provided on conveyors, assembly lines, transfers?
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Is a Safety fence/barrier provided?
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Are operating noise levels <80 dBA, including documentation?
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Operators are protected from hot/cold temperatures?
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Operators instructions have been provided to the department?
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Operators have been trained on proper use/operation?
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Are safety signs installed?
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Service personnel compliant with NFPA70E (letter of compliance signed)?
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Service personnel have reviewed Vandalia contractor guidelines?
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Safe work procedures/placard(s) are posted on the Machinery/Equipment?
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Brass tag number is affixed to the equipment?
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Fall Hazards identified and eliminated or protected?
Additional Notes
Owner of Action Items
Signatures of Auditors
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