Information

  • Monthly Environmental / Health / Safety Inspection

  • Client / Site

  • Conducted on

  • Performed by: (First & Last Name)

1 - Housekeeping

  • 1.1 Work areas are clean and organized?

  • 1.2 All walking and working surfaces are clear of debris and obstructions?

  • 1.3 Dust Abatement. Work surfaces and facilities are free from dust accumulation?

  • 1.4 Restrooms and break rooms are clean and sanitary? No trash accumulation, no leaks or standing water, lighting is adequate and functional?

  • 1.5 General Signage. Is there missing or faded signage? Does the space require new signage that indicates hazards?

2 - Tools

  • 2.1 Tools are stored properly after use?

  • 2.2 Tools are in good condition and used properly?

  • 2.3 All equipment guards are in place and in good condition?

  • 2.4 Air wands have approved tips?

3 - PPE - Personal Protective Equipment

  • 3.1 PPE is worn properly?

  • 3.2 Required PPE available for employees at the site?

  • 3.3 PPE is in good condition and suitable for the job?

4 - Fire Extinguishers

  • 4.1 Extinguishers are accessible / free from blockage?<br>

  • 4.2 Charged and Serviced? Monthly Inspection card is current?

  • 4.3 Extinguishers are are well marked / easily located?

  • 4.4 Extinguishers are in good repair?

  • 4.5 The proper extinguishing agent is available for the potential fire hazard? (CO2, Water, Foam, Chemical?)

5 - Emergency Exits

  • 5.1 All emergency exits are accessible and free from obstruction?

  • 5.2 Clearly marked and visible from all vantage points in the area? Signage is adequate to met the need?

  • 5.3 Exit doors open outwards?

  • 5.4 Doors have the correct opening device?

  • 5.5 Exit lanes are at least 4 feet wide?

6 - Emergency Lighting

  • 6.1 Adequate lighting available and operational?

7 - First Aid / Medical Equipment

  • 7.1 Trauma Kits accessible and free from obstructions? Properly maintained and serviced?

  • 7.2 AED unit(s) accessible and free from obstructions? Properly maintained and serviced?

  • 7.3 First Aid cabinets accessible and free from obstruction? Materials stocked?

  • 7.4 Eye wash stations accessible and free from obstructions? Properly maintained and serviced? Tested?

8 - Hazardous Materials

  • 8.1 Labeled properly?

  • 8.2 Flammables / Chemicals / Gas stored properly in appropriate and approved storage devices?

  • 8.3 Gas cylinders properly stored and in good condition?

  • 8.4 Gas turned off when not in use?

  • 8.5 Spill kits available? Properly stocked with materials required to respond to spills?

9 - Fall Protection

  • 9.1 Handrails installed on all areas 6 feet or higher?

  • 9.2 Handrails installed on all stairs?

  • 9.3 Handrails meet standard 42", mid-rail, and toe board specifications?

  • 9.4 Ladders are in good condition and secure? Rust, damage to rungs or supports? Securely fastened at all control points?

  • 9.5 Fixed ladders have provide cage above 6 feet?

  • 9.6 Harnesses are available and in proper working condition?

10 - Hoists / Cranes / Come-a-Longs

  • 10.1 Inspected and in good condition?

  • 10.2 Rated for capacity?

  • 10.3 Supporting structure rated for capacity?

  • 10.4 Safety latch on hook and in proper working condition?

11 - Electrical

  • 11.1 MCC's labeled properly?

  • 11.2 MCC doors closed and in good condition?

  • 11.3 Three (3) foot clearance in front of all MCC's?

  • 11.4 Cords and cables stored properly? Good condition?

  • 11.5 GFCI's installed for all components within 6' of a water source?

12 - Guarding

  • 12.1 All moving equipment guarded?

  • 12.2 Drive shafts, sprockets, pulleys and chains?

  • 12.3 Hazardous areas clearly marked? Signage in good condition?

  • 12.4 Confined spaces / High traffic areas / Lockout areas properly guarded?

13 - Corrective Action Requests

  • 13.1 Did the audit result in any findings? If YES, enter CAR numbers pulled for each finding in the text field in section 13.2

  • Section 13.2

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.