Title Page
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Conducted on
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Prepared by
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Shift
Inspection Items
GENERAL INSPECTION / HOUSEKEEPING
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Aisle/walkways are clear and unobstructed?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Floors are clean and free of obstructions or tripping hazards? Ergo matting in no damaged or missing?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Lights and light fixtures are working and in good order with proper illumination?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Garbage & Recycling bins (Item in the bins and 5S location adequate)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Work stations and barriers are free from sharp edges and protrusions? (i.e. nails, strapping, panels, etc.)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Racking and shelving in good condition, secured from tipping and in good location? (not obstructing aisles or limiting worker movement)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Exhausts functioning properly to prevent fumes or smoke in work areas?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
ELECTRICAL POWER SYSTEMS - ESA CHECKS
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High voltage and control panels closed and secured
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Control panel identified and accessible (1M clearance)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Electrical equipment protected from the elements
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Emergency exit signs are in good working order and illuminated ?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Is there any equipment showing exposed wiring (welding machines, fans, etc.)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
FIRE PROTECTION
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Fire extinguishers and hoses are properly identified and secured on bracket?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Fire extinguishers are accessible (not blocked by dies) and inspected monthly (check tags)?
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if missing, indicate specific area/location and extinguisher number
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
FIRST AID KITS (IN PANEL STORAGE AREA)
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Contents of first-aid kit(s) are inspected, re-stocked & signed-off?
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
STACKING AND STORAGE
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Blanks/Panels stacked properly on wooden pallets? (not leaning or tilting and in designated area)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Parts stacked properly on metal skids? (metal cones on all corners in place and not leaning or tilting)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
PERSONAL PROTECTIVE EQUIMENT (PPE)
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Employees wearing appropriate eye protection? (CSA safety glasses with side shields)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
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Employees wearing appropriate foot protection? (CSA approved, Green patch)
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What is the hazard class rating?
- Hazard Class A - permanent disability, loss of life or body part and/or extensive loss of structure, equipment and/or material
- Hazard Class B - serious injury/illness or property damage that is disruptive but less severe than class 'A'
- Hazard Class C - non-disabling injury/illness or non-disruptive property damage
ADDITONAL ITEMS NOTED/CHECKED:
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Indicate any other issue not previously mentioned
JOB OBSERVATION / PERFORMANCE NOTES: (at least one)
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EMPLOYEE INTERVIEW / WORKER CONCERNS:
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Indicate name of employee interviewed
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Does the employee know what to do in an evacuation?
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Inform employee of nearest evacuation and meeting points. Notify Supervisor.
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Does the employee know hazards of their job? Please indicate
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Inform employee of specific job related hazards. Notify Supervisor
JHSEC/Supervisor Inspector Signature
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JHSEC Member/Supervisor
