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?
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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 (number and 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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All chemical bottles are clearly labelled as per WHMIS (GHS) - product identifier, hazard symbols, 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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Correct stacking heights on bins (safe stacking, not leaning or potential to fall over)
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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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General condition of wiring (extension cords, 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
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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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Lockout provisions available and procedures posted
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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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Are there any extension cords replacing permanent wiring?
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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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- 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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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
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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
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Oily rags container in good working condition (lid opens/closes)
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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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Flammables cabinet - must be grounded and only contain flammable substances. Free from rags, cardboard and other combustible materials?
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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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Spill kits are accessible - ensure emergency contact numbers , ID sign and inventory list posted, verified?
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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
ACCESS / EGRESS
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Route and exits are clearly marked/lighted
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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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Adequate means of emergency egress?
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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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Exits 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
FIRST AID KITS
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Names of qualified first-aid providers are posted and clearly visible? (not torn, damaged or unlegible)
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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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Names and phone numbers of emergency facilities are posted and clearly visible? (not torn, damaged or unlegible)
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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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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
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Instructions for accident reporting sticker (form 82)
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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
EQUIPMENT - SHIPPING
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Shipping forklift daily inspections completed?
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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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Seat belts worn on forklifts (randomly audit)
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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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Wheel chocks are available and in good working condition (not damaged/broken)
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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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Shipping office area houskeeping
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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
WASTE DISPOSAL
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Recyclables are being disposed of properly?
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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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Waste bins being emptied regularly?
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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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Dies stacked properly?
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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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All dies stacks are stable and secure (2 Dies High MAXIMUM)
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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, Face shield if grinding)
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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 Inspector Signature
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JHSEC Member
