MONTHLY PRODUCT SAFETY AUDIT CHECKLIST Forming Manufacturing & Breakroom Ver. 1.0

• Location: Ripon Plant

• Document No.

• Add Area of Audit

  Area: Forming Manufacturing, Forming Breakroom

• Prepared by

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Conducted on

  Date

Area: Forming Manufacturing & Breakroom

• Exterior wall (18" white line) kept clean and free of obstruction<br>

  Safe

  At Risk

  N/A

• All necessary holes in walls, open-ended conduit, piping, etc., sealed to prevent pest or rodent nesting<br>

  Safe

  At Risk

  N/A

• Are cleaning schedules for all lines and break areas current, up to date and accurate?

  Safe

  At Risk

  N/A

• Lines cleared of previous product run materials and finished goods<br><br>

  Safe

  At Risk

  N/A

• All materials (raw materials, work in process, and finished goods) covered and identified<br>

  Safe

  At Risk

  N/A

• GMP's Compliant. Proper PPE being used. No personal items<br><br>

  Safe

  At Risk

  N/A

• Materials (cores, corrugated, etc) stored or elevated off of floor<br><br>

  Safe

  At Risk

  N/A

• All chemicals and compounds completely segregated from raw materials and product<br>

  Safe

  At Risk

  N/A

• All chemicals and secondary containers must be labeled and in proper location<br>

  Safe

  At Risk

  N/A

• Labels are marked out on re-used gaylords, new labels applied<br><br>

  Safe

  At Risk

  N/A

• Open ended hoses do not contact floor<br><br>

  Safe

  At Risk

  N/A

• Use the question list to "interview" at least 2 employees, include in your comments which questions were asked, the response given, and the position of the person asked.<br><br>

  Safe

  At Risk

  N/A

• Temporary or make-shift devices such as tape, cardboard, wire, etc., not used on equipment as a permanent fix<br>

  Safe

  At Risk

  N/A

• Machinery free of grease, dirt, and chipped paint that could come in contact with product<br>

  Safe

  At Risk

  N/A

• Walls and roof free of holes or cracks<br><br>

  Safe

  At Risk

  N/A

• No tears in insulation on ceiling or walls. No loose insulation tape. Painted surfaces not chipping or in need of scraping and/or re-painting

  Yes

  No

  N/A

• All entry into plant secured - check doors<br>

  Safe

  At Risk

  N/A

• No broken or damaged pallets<br>

  Safe

  At Risk

  N/A

• All aprons, gloves, etc are kept in designated area when not in use<br><br>

  Safe

  At Risk

  N/A

• Control of dust, condensation on overhead structures and pipes<br>

  Safe

  At Risk

  N/A

• No identified risk of items that can fall into the line/Product (nuts, bolts, screws, etc)

  Safe

  At Risk

  N/A

• No evidence of any physical contamination<br>

  Safe

  At Risk

  N/A

• No evidence of any chemical contamination<br>

  Safe

  At Risk

  N/A

• No evidence of any biological contamination<br>

  Safe

  At Risk

  N/A

• Other: Explain<br>

  Safe

  At Risk

  N/A

• Add media

  Media

• Add signature

  Sign

• Add signature

  Sign

• When Audit is complete, Email audit to cindy.goehring@polyone.com and charlene.frost@polyone.com