Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Marcus Level 4

Passenger Elevator

  • Does it work?

  • Do the lights work?

  • Is it clean?

Fourth Floor Entryway

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

  • Is stair A clean and well lit?

Visiting Scholar Office

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

Fourth Floor Lab Common Area

  • Do the double doors work?

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

Conference Room 4107

  • Do the Lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is it clean?

Fourth Floor Men's Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • Is the floor free of any puddles or hazards?

Fourth Floor Ladies' Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • Is the floor free of any puddles or hazards?

Fourth Floor Grad Student Area

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the emergency exit clear of any obstruction?

  • Is Stair C clean and well lit?

Lab 4120 (Muhannad Bakir)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 4120 Hood #1 Controller Image

  • Lab 4120 Hood #2 Controller Image

  • Lab 4120 Hood #3 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Lab 4124 (Oliver Brand)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 4124 Hood #1 Controller Image

  • Lab 4124 Hood #2 Controller Image

  • Lab 4124 Hood #3 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Lab 4126 (Farrokh Ayazi)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 4126 Hood #1 Controller Image

  • Lab 4126 Hood #2 Controller Image

  • Lab 4126 Hood #3 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Marcus Level 3

Third Floor Entryway

  • Do the Lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

  • Is Stair A clean and well lit?

MRSEC office

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

Third Floor Lab Common Area

  • Do the double doors work?

  • Do the lights work?

  • Does the HVAC work?

  • Are the Ceiling tiles in good condition?

  • Is the area clean?

Conference Room 3108

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

Third Floor Men's Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • Is the floor free of puddles or other hazards?

Third Floor Ladies Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is it clean?

  • Is the floor free of puddles or other hazards?

Third Floor Grad Student Area

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the emergency exit clear of any obstruction?

  • Is stair C clean and well lit?

Lab 3120 (Tony Kim)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 3120 Hood #1 Controller Image

  • Lab 3120 Hood #2 Controller Image

  • Lab 3120 Hood #1 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Lab 3121 (Gabe Kwong)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 3121 Hood #1 Controller Image

  • Lab 3121 Hood #2 Controller Image

  • Lab 3121 Hood #3 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Lab 3126/3127 (Wilbur Lam)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition

  • Do the fume hoods work properly?

  • Lab 3126/3127 Hood #1 Controller Image

  • Lab 3126/3127 Hood #2 Controller Image

  • Lab 3126/3127 Hood #3 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Shared Lab Spaces

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Marcus Level 2

Second Floor Entrway

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

  • Is stair A clean and well lit?

Gallery Landing

  • Do the lights work?

  • Does the HVAC work?

  • Is it clean?

Second Floor Lab Common Area

  • Do the double doors work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

Conference Room 2107

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is it clean?

Second Floor Men's Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • is it clean?

  • Is the floor free of puddles or other hazards?

Second Floor Ladies' Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • Is the floor free of puddles or other hazards?

Second Floor Shared Rest Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • Is the floor free of any puddles or hazards?

Second Floor Grad Student Area

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the emergency exit clear of any obstruction?

  • Is Stair C clean and well lit?

Lab 2122/2124 (Bara Cola)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 2124 Hood #1 Controller Image

  • Lab 2124 Hood #2 Controller Image

  • Lab 2124 Hood #1 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Lab 2123/2125 (Michael Filler)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 2125 Hood #1 Controller Image

  • Lab 2125 Hood #2 Controller Image

  • Lab 2125 Hood #3 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Lab 2126/2129 (Eric Vogel)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the fume hoods work properly?

  • Lab 2126 Hood #1 Controller Image

  • Lab 2126 Hood #2 Controller Image

  • Lab 2126 Hood #3 Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Marcus First Floor

Gallery

  • Do the lights work?

  • Does the HVAC work?

  • Do the glass doors work?

  • Is the gallery clean?

Kitchen and Common Area

  • Do the lights work?

  • Does the HVAC work?

  • Is the common area clean?

  • Is the kitchen clean?

  • Does the exterior door work properly?

Conference Room 1116-1118 *(Answer for all sections)

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Do the operable wall segments work properly?

  • Are all three sections clean?

IEN Headquarters

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

  • Do the gallery and exterior doors work properly?

Cleanroom Hallway

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

Cleanroom Staff Office

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Is the area clean?

Unfinished Hallway

  • Do the lights work?

  • Is the space free of any other problems?

Basement/Subfab

Southern Portion

  • Do the lights work?

  • Is the area free of any spills, unusual odors, or other hazards or problems?

  • Is equipment stored safely?

Workshop/Middle Section

  • Do the lights work?

  • Is the area free of any spills, unusual odors, or other hazards or problems?

  • Is equipment stored safely?

  • Are electrical panels free of obstructions?

Loading Dock

  • Do the lights work?

  • Do the roll-up doors work?

  • Does the dock leveler work?

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Chemical Storage and North Hallway

  • Do the lights work?

  • Are the materials in the chemical storeroom properly stored?

  • Are the halogenated and non-halogenated solvent systems operating properly (all lights green)

  • Is the area free of any spills, unusual odors, or other hazards or problems?

  • Is the exhaust drain viewport in the acid waste room dry?

  • Is the exhaust drain viewport in the chemical store room dry?

  • Is the exhaust drain viewport in the north hallway dry?

  • Is the exhaust drain viewport in the process chill water room dry?

Subfab Under the Cleanroom

  • Is the exhaust drain viewport on lateral 1 dry?

  • Is the exhaust drain viewport on lateral 2 dry?

  • Is the exhaust drain viewport on lateral 3 dry?

  • Is the exhaust drain viewport on lateral 4 dry?

  • Is the exhaust drain viewport on lateral 5 dry?

  • Is the subfab floor free of any spills or hazards?

Unisex Bathroom

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • is the floor free of puddles or other hazards?

Basement Men's Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • Is the floor free of any puddles or hazards?

Basement Ladies' Room

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the plumbing work?

  • Is it clean?

  • Is the floor free of any puddles or other hazards?

Characterization

  • Do the lights work?

  • Does the HVAC work?

  • Are the ceiling tiles in good condition?

  • Does the fume hood work properly?

  • Characterization Hood Controller Image

  • Is the area free of any spills, unusual odors, or other hazards or problems?

Back of the Building

  • Is Stair D clean and well lit?

  • Is there still room in the dumpster?

  • Is the tank farm and surrounding area clear and free of any hazards?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.