Title Page
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Conducted on
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Prepared by
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Location
Emergency Equipment/Egress
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Are electrical panels, eyewash<br>stations, spill clean up equipment, first aid<br>cabinets, exit doors & pathways accessible and free from obstruction?
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Are Fire extinguisher in place and inspected, not<br>blocked
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Safety light work correctly- Perform check
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Is there Evacuation plan posted (EAP)?
Personal Protective Equipment
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Is required PPE accessible in department
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Proper PPE worn by all employees: gloves, ear<br>protection, face shields, Glasses, special<br>equipment required by job ( When Required)
Hazardous Materials
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Flammable/combustible materials stored properly;<br>lids closed, used rags in containers
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Flammables grounded when transferred to other containers?
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Secondary containers labeled
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Food grade and non-Food Grade chemicals<br>separated
General
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Hand tools properly stored, used & in good<br>condition
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Barrier guards in place.
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Shelving/mezzanines marked for capacity
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Compressed gas cylinders properly stored
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ladders in good condition
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Fall protection required?
Housekeeping
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Hoses put away when not in use
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Aisles/work areas properly lit
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Walkways free of debris; cardboard, scrap, parts,<br>spider webs present, no leaning pallets etc.
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Master Cleaning Schedule Up To Date
Lockout Procedure
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Machine specific procedures posted on all<br>required equipment (SOP)
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Provisions for lockout provided on all machines
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Employees knowledgeable of requirements for<br>affected employee: cannot start equipment,<br>cannot help with service, cannot remove lock (Please speak with workers in that area)
Machine Guarding
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Any damaged guarding
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Equipment guards in place & used