Title Page
-
Conducted on
-
Prepared by
-
Shift
Inspection Items
GENERAL INSPECTION / HOUSEKEEPING
-
Aisle/walkways are clear and unobstructed?
-
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
-
Floors are clean and free of obstructions or tripping hazards?
-
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
-
Lights and light fixtures are working and in good order with proper illumination?
-
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
-
Garbage & Recycling bins (number and location adequate)
-
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
-
Work stations and barriers are free from sharp edges and protrusions? (i.e. nails, strapping, panels, etc.)
-
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
-
All chemical bottles are clearly labelled as per WHMIS (GHS) - product identifier, hazard symbols, etc.?
-
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
-
Racking and shelving in good condition, secured from tipping and in good location? (not obstructing aisles or limiting worker movement)
-
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
-
Exhausts functioning properly to prevent fumes or smoke in work areas?
-
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
-
High voltage and control panels closed and secured
-
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
-
Control panel identified and accessible (1M clearance)
-
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
-
General condition of wiring (extension cords, fans, etc.)
-
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 equipment protected from the elements
-
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
-
Lockout provisions available and procedures posted
-
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
-
Are there any extension cords replacing permanent wiring?
-
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
-
Emergency exit signs are in good working order and illuminated ?
-
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
-
Is there any equipment showing exposed wiring (welding machines, fans, etc.)
-
undefined
- 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
-
Fire extinguishers and hoses are properly identified and secured on bracket?
-
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 extinguishers are accessible (not blocked by dies) and inspected monthly (check tags)?
-
if missing, indicate specific area/location and extinguisher number
-
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
-
Oily rags container in good working condition (lid opens/closes)
-
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
-
Flammables cabinet - must be grounded and only contain flammable substances. Free from rags, cardboard and other combustible materials?
-
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
-
Spill kits are accessible - ensure emergency contact numbers , ID sign and inventory list posted, verified?
-
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
EQUIPMENT - MACHINES
-
Pre-start checks/inspections are being completed?
-
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
-
All machine guards are present and in good condition (safety interlocks)
-
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
EQUIPMENT - CRANES
-
Pre-start safety checks/inspections are being completed?
-
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
-
Remote pendant is in good working condition?
-
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
EQUIPMENT - PEDESTAL GRINDERS
-
Pre-start safety checks/inspections are being completed?
-
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
-
Work rest 3mm from grinding wheel?
-
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
-
Work rest is in a position above the centre line of the grinding wheel?
-
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
-
Names of qualified first-aid providers are posted and clearly visible? (not torn, damaged or unlegible)
-
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
-
Names and phone numbers of emergency facilities are posted and clearly visible? (not torn, damaged or unlegible)
-
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
-
Contents of first-aid kit(s) are inspected, re-stocked & signed-off?
-
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
WASTE DISPOSAL
-
Recyclables are being disposed of properly?
-
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
-
Waste bins being emptied regularly?
-
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
-
Dies stacked properly?
-
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
-
All dies stacks are stable and secure (2 Dies High MAXIMUM)
-
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)
-
Employees wearing appropriate eye protection? (CSA safety glasses with side shields, Face shield if grinding)
-
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
-
Employees wearing appropriate foot protection? (CSA approved, Green patch)
-
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:
-
Indicate any other issue not previously mentioned
JOB OBSERVATION / PERFORMANCE NOTES: (at least one)
-
undefined
EMPLOYEE INTERVIEW / WORKER CONCERNS:
-
Indicate name of employee interviewed
-
Does the employee know what to do in an evacuation?
-
Inform employee of nearest evacuation and meeting points. Notify Supervisor.
-
Does the employee know hazards of their job? Please indicate
-
Inform employee of specific job related hazards. Notify Supervisor
Supervisor/JHSEC Inspector Signature
-
Supervisor or JHSEC Member
