Title Page
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Location
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Month
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Building
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Year
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Prepared by
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INSTRUCTIONS:
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1. Answer "Yes", "No", "N/A", “Help” for the questions below.
2. Add photos and notes by clicking on the paperclip icon.
3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
4. Complete audit by providing digital signature.
5. Share your report by exporting as PDF, Word, Excel or Web Link. -
Response Guideline:
Y = Satisfactory Conditions Exist
N = Unsatisfactory - Corrective Measures are required
NA = Not applicable to facility or area reporting
HELP = Need advice from Safety Compliance / Facility Manager
EXTERIOR-BUILDING & GROUNDS-Above Ground storage Tanks (AST's)
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1 The exterior of building is free of trash and debris (weeds and trash)
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2 Above Ground Storage Tanks (AST) and pad area is free of signs of staining, spills
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3 AST's are visually inspected for rust, leaks or any other defects-check fluid levels
FIRE EXTINGUISHERS, EMERGENCY EXITS
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4 Each fire extinguisher is readily and easily accessible, fully charged and mounted on bracket
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5 Fire extinguishers inspected monthly (by Foley Employee) and inspector name (initials) and date recorded on tag
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6 Aisles, floors, walkways (Exit Egress for Building Emergency Evacuation) are clear of obstructions
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6a Emergency Exit lights are tested and lights are working
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7 Emergency Response Plan (ERP) posted on bulletin boards (Bldg. Evacuation, Severe Weather)
PERSONAL PROTECTIVE EQUIPMENT
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8 Safety Glasses and Hearing Protection available for visitors, employees while in shop area
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9 Eye protection worn at all times while in shop hazard areas
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10 Hearing protection worn in noise hazard areas (>85 db)
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11 Protective Footwear (Workboots) worn where required
ENVIRONMENTAL STORAGE - Flammables, Cylinders
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12 All storage containers (tanks, drums, etc.) are clearly marked "Used Oil", "Used Antifreeze", etc.
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13 All "Secondary Containers" are properly labeled (GHS labels) with contents
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14 All Red Oily Waste Containers (Combustible / Flammable materials) are closed and emptied every night
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15 Used Oil Filters are completely drained and disposed of properly
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16 Small Parts Washers (red solvent tanks) lids are closed when not in use
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17 Flammable liquids, such as gasoline, diesel, kerosene, are kept in approved metal safety cans
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18 Compressed cylinders are stored upright, secured and caps in place
HAND AND POWER TOOLS, EQUIPMENT, MACHINE GUARDS
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19 Hoses and extension cords are stored properly when not in use to prevent trip hazards in work areas
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20 Electrical power and extension cords are free of visible signs of damage, have grounding plug-no exposed wiring
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20a Continuity and Resistance Testing (MSHA) and Assured Equipment Grounding Testing has been conducted
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21 Fixed machinery (grinders, chop saws, etc.) are securely anchored to prevent tipping
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21a Grinder Rest (1/8") and Tongue Guard (1/4") are adjusted properly
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22 Each grinding / cutting station has face shield available and Foley sign / gauge
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23 Each grinder displays no excessive wheel wear or visible defects.
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24 Machine guards are in place (as original equipment from manufacturer) and functioning properly
ELECTRICAL / DISTRIBUTION PANELS
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25 Electrical panels (breaker, distribution box) are accessible and have a minumum of 36" clearance
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26 Electrical panel doors are closed at all times
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27 Electrical junction boxes are free of unprotected or exposed knockouts - covers are in place
SAFETY EQUIPMENT, MISCELLANEOUS
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28 Plumbed eyewash stations are accessible, have a minimum of 36" clearance…weekly inspection tag up to date
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28a Fixed/self contained (green) eyewash stations are inspected weekly. Third party vendor quarterly inspection current
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29 Eyewash bottles are located in each hazard area (danger of flying particles, chemicals)-exp date checked
CHAINS, SLINGS, BLOCKING, CRIBBING
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30 Chains, slings and other lifting devices are inspected-have legible ID tag
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31 Synthetic (nylon) slings are free of defects and ID tag legible
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32 Jack stands, blocking and cribbing are in good working order-free of defects
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32a Jack stands are marked with capacity
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33 Portable step ladders are industrial strength-fiberglass, aluminum, metal
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34 Ladder manutacturer's capacity rating sticker is legible
OTHER ITEMS
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Monthly shop cranes inspected
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Are there other items that was not mentioned above?
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Other Items: (Click "Add Item")
Item
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Please specify item
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Compliance?
Completion
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Visual Inspection Completed by
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Manager's Signature
