Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Ensure that the workplace is safe in the following areas:

  • AWAIR Safety Program Contains 5 elements; updated annually with goals and objectives.

  • Potential OSHA Citation:

  • Safety Committee MN: Regular Meetings? Documented Meetings? Management & employee equally represented?

  • Potential OSHA Citation:

  • Bloodborne Pathogens: Training? BBP clean up kits?

  • Potential OSHA Citation:

  • Chemical Hygiene: Employees trained, Properly labeled, Stored properly (25+ gallons flammable liquid inside cabinet), SDS readily available, PPE in use as required.

  • Potential OSHA Citation

  • Compressed Air Use: Not used for cleaning personnel/clothing, For cleaning equipment nozzle pressure reduced to 30 psi if dead ended (regulated or relief ports on nozzle), chip guarding/PPE in place.

  • Potential OSHA Citation:

  • Electrical Wiring & Equipment: Cords not used for permanent wiring? Damaged Cords? 3 feet clearance in front of panels?

  • Potential OSHA Citation:

  • Emergency Action Plan: Notification system, Maps developed/posted? Drills?

  • Potential OSHA Citation:

  • Employee Right To Know / GHS / SDS: Annual training? SDS available to employees? Labeling of Containers?<br>

  • Potential OSHA Citation:

  • Fall Protection and Elevated Surfaces: Fall protection available and in use above 4'? Guardrails in place where appropriate (mezzanine and other elevated surfaces)? PFAS in use when appropriate (order pickers, etc.)? Mezzanine labeled with load rating? Training? Equipment Inspections?

  • Potential OSHA Citation:

  • Fire Extinguishers: Training? Monthly inspection? Labeled? Not Blocked/Obstructed? Mounted properly?

  • Potential OSHA Citation:

  • First Aid & CPR: Trained personnel if no EMS Response within 4 minutes, Training every 2 years?<br>

  • Potential OSHA Citation:

  • Injury & Illness Record Keeping: OSHA 300 Log Accurate? Log posted (February 1 - April 30)? Posters?

  • Potential OSHA Citation:

  • Ladders: Trained on proper use, in good condition, labels are legible, being used properly (Extension Ladder - secured, set up at a 4:1 ratio, and extends 3' above access point. Step Ladder - spreader bars locked, personnel not standing above the second step from the top).

  • Potential OSHA Citation:

  • Lock Out Tag Out: Procedures developed for equipment? Authorized/Affected training? Procedures evaluated?

  • Potential OSHA Citation:

  • Machine Guarding: AUTO Interlocks? Light curtains? Two hand controls?

  • Potential OSHA Citation:

  • Overhead Cranes: Documented Inspections? Safety latch? Controls labeled? Limit switches tested?<br>

  • Potential OSHA Citation:

  • Permit Required Confined Space: Signs? Training? Rescue plan?<br>

  • Potential OSHA Citation:

  • Personal Protective Equipment: Trained, Proper Use, Hazard Assessments

  • Potential OSHA Citation:

  • Power Tools: In good condition, cords not damaged, guards/shields in use, proper PPE?

  • Potential OSHA Citation:

  • Powered Industrial Trucks: Classroom Training? Written Test? Hands on evaluation, every 3 years? Quarterly Monitoring for CO?

  • Potential OSHA Citation:

  • Respiratory Protection: Required Use (Trained, Medically Qualified, Fit Tested) Voluntary Use (Signed Form, Medically Qualified for Elastomeric APR)<br>

  • Potential OSHA Citation:

  • Rigging (Chains & Slings): Inspected? Rated? Good condition?<br>

  • Potential OSHA Citation:

  • Walking & Working Surfaces: Personnel exposed to a fall hazard are protected (4' trigger height, guardrail system, personal fall arrest system or safety net system). <br><br>

  • Potential OSHA Citation:

  • Woodworking Machines: Guards in place? Push Sticks? Anti restart?<br>

  • Potential OSHA Citation:

  • Additional observations: Air Quality, Combustible Dust, Ergonomics, Hot Work Permit Program, Servicing Rims & Wheels, Mechanical Power Presses, Lab Safety, Process Safety Management, Welding (weld fume, hex chrome), etc.
  • Describe the observation:

  • Observation finding:

  • Potential OSHA Citation:

ADDITIONAL SAFETY EFFORTS

  • Any examples of best practices, or pro-active safety efforts observed during the site visit (ergonomic improvements, pre-task planning, near miss reporting, safety suggestion system, perception surveys, incentive program, return to work program, etc.)?<br>

  • Summarize the observation:

  • Have there been any injuries or incidents since the previous jobsite inspection?<br>

  • Summarize the incident, results of the investigation and any corrective actions that were implemented:

STANDARD OF CARE:

  • The services performed by Marsh & McLennan Agency (MMA) on this project have been conducted with that level of care or skill ordinarily exercised by reputable members of the profession, practicing in the same locality under similar budget and time constraints. No other warranty is expressed or implied.

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