Multi-Color EHS Audit (ver. 3)

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• City

• Location
  Address

Previous Audit Summary

• A. Have all non-conformances from the EHS audit been completed by due date?

  Yes

  No

  N/A

• Please review open items from previous EHS audit.

• Have you reviewed open items from previous EHS audit?

  Yes

  No

  N/A

Safety Committee/Recognition

• A. Does the location have a designated safety coordinator?

  Yes

  No

  N/A

• Name of designated safety coordinator.

• B. Does the location have an established safety committee? If yes, answer the following questions:

  Yes

  No

  N/A

• How many members, management and production?

• How often do they meet?

• Does the safety coordinator lead and facilitate the meetings?

  Yes

  No

  N/A

• Are internal safety inspections conducted and documented at least monthly?

  Yes

  No

  N/A

• Do supervisors participate in and document daily safety inspections?

  Yes

  No

  N/A

• C. Does the site have a written incident/near miss investigation procedure?

  Yes

  No

  N/A

• D. Are accident investigations reviewed by the Plant Manager?

  Yes

  No

  N/A

• E. Are root cause analyses conducted and a follow-up system implemented for any recommendations pending?

  Yes

  No

  N/A

• F. Does the facility have a safety suggestion program?

  Yes

  No

  N/A

• G. Does the facility have a formal safety recognition program? (29 CFR 1904.35)

  Yes

  No

  N/A

• H. Does the facility discipline program include actions for safety infractions and is this process documented?

  Yes

  No

  N/A

Notice of Act (1903.2)

• A. Is Notice of Act posted in a conspicuous place or places where notices to associates are customarily posted?

  Yes

  No

  N/A

Recordkeeping (1904)

• A. Are OSHA logs maintained at the site for the previous 5 years, plus the current year? (Note: OSHA 200 logs do not need to be maintained, but must be on file). AUDITOR NOTE: Ask to see all logs and confirm updated and current copy of OSHA Form 300.

  Yes

  No

  N/A

• B. Are one page supplemental reports (i.e. 301 or state FROI's) available for each OSHA 300 log entry?

  Yes

  No

  N/A

• C. Is the certified OSHA Form 300A Summary kept on file for 5 years plus the current year? AUDITOR NOTE: A "certified copy" is a hard copy signed by the highest ranking site official.

  Yes

  No

  N/A

• D. Do questionable entries that have been removed from the OSHA 300 log have written justification for non-recordability?

  Yes

  No

  N/A

• E. If the facility utilizes the services of "Borrowed Servants" (any temporary associate that receives direct supervision from MCC), are these contract associates being logged on the OSHA 300 log?

  Yes

  No

  N/A

• F. Are any incidents identified on the OSHA Form 300 first aid injuries?

  Yes

  No

  N/A

• G. Are work-related recordable injuries/illnesses recorded within 7 calendar days of receiving information that a recordable case occurred?

  Yes

  No

  N/A

• H. Is the previous year's summary of the OSHA log (Form 300A) posted from February 1 to April 30 for the preceding year?

  Yes

  No

  N/A

• I. Is the previous year's summary of the OSHA log signed by the highest ranking company official working at the facility, or the immediate supervisor of the highest ranking company official working at the establishment?

  Yes

  No

  N/A

• J. After reviewing annual hearing records, are all recordable hearing losses recorded as required? Work-related hearing shifts averaging 10 dB or more at 2000, 3000, and 4000 hertz in either ear when compared to the associate's baseline AND the associate has an average hearing threshold level [at 2000, 3000, and 4000 hertz] greater than or equal to 25 dB when compared to audiometric zero.

  Yes

  No

  N/A

• K. Has a procedure been established for associates to report injuries and illnesses and has this procedure been communicated to all associates?

  Yes

  No

  N/A

• L. Does the facility ensure all work related injuries treated by an outside medical facility are submitted to the TPA/Insurance?

  Yes

  No

  N/A

• M. Does the facility have a First Aid log? If yes, has the facility filed FROI’s for work related cases that included services paid to outside medical providers?

  Yes

  No

  N/A

Training

• A. Is new associate EHS training conducted?

  Yes

  No

  N/A

• B. Is annual training completed and documented for all OSHA and EPA standards that affect or this facility is responsible to uphold?

  Yes

  No

  N/A

Employee Exposure & Medical Records (1910.1020)

• A. Does the facility have documentation that associates are informed at the time of employment and annually thereafter?

  Yes

  No

  N/A

• Of their right to access exposure and medical records?

  Yes

  No

  N/A

• Where they are located?

  Yes

  No

  N/A

• The job title responsible for maintaining and providing access to the records?

  Yes

  No

  N/A

• Does the facility have a standard medical record release authorization form?

  Yes

  No

  N/A

• B. Is there a file system to ensure that: (Physically verify file system)

  Yes

  No

  N/A

• Medical records are maintained for at least the duration of employment plus 30 years?

  Yes

  No

  N/A

• Exposure records, including chemical lists or SDS’s, (Industrial Hygiene monitoring, noise surveys, etc.) are maintained for at least 30 years?

  Yes

  No

  N/A

• C. Does the facility have a copy of the standard and appendices available for associates upon request?

  Yes

  No

  N/A

• D. Are associates personally notified of their monitoring results? [Are OSHA substance specific materials, (i.e. lead, asbestos, hex chrome, formaldehyde, etc.) monitoring results provide to associate in writing?]

  Yes

  No

  N/A

Hazard Communication and Chemical Management (1910.1200)

• A. Is a current written Hazard Communication (HazCom) program in place?

  Yes

  No

  N/A

• B. Does the facility have a documented process whereby chemical materials are evaluated for safety / environmental considerations prior to purchasing?

  Yes

  No

  N/A

• C. Is there evidence where associates are made aware of new hazards brought into the workplace? AUDITOR NOTE: see "Chemical Alerts" in Master documents for a method of handling.

  Yes

  No

  N/A

• D. Is an accurate site list of chemical materials available?

  Yes

  No

  N/A

• E. Are Material Safety Data Sheets available for all items on the facility hazardous chemical list? (To verify, check a representative number).

  Yes

  No

  N/A

• F. Are containers of hazardous chemicals labeled, tagged, or marked with a chemical identity and appropriate hazard warning?

  Yes

  No

  N/A

• G. Is there a process to ensure SDSs are available to associates on all shifts?

  Yes

  No

  N/A

• H. Are information and training records available for each associate affected by the HazCom standard? AUDITOR NOTE: Some operations, choose to perform Hazcom standard training annually. Verification of the refresher portion of this question is a random review of refresher training documentation.

  Yes

  No

  N/A

• I. Are all contractors required to submit a list of all chemicals and corresponding SDS’s prior to bringing them on MCC property?

  Yes

  No

  N/A

• J. Has the location conducted a chemical inventory and kept it on file at least annually?

  Yes

  No

  N/A

Noise & Hearing (1910.95)

• A. Has an initial noise survey been completed and kept updated for any major equipment or process changes?

  Yes

  No

  N/A

• B. If needed, is there a written Noise Exposure Program?

  Yes

  No

  N/A

• C. Are all high noise areas posted (continuous 85 dBA and above)?

  Yes

  No

  N/A

• D. Are all associates who are exposed to noise levels above 85 dBA required to wear hearing protection?

  Yes

  No

  N/A

• E. For facilities requiring hearing protection has the hearing protector attenuation been evaluated for specific noise environment in which the protector will be used?

  Yes

  No

  N/A

• F. Are these associates given annual audiometric tests which are compared to their baseline? If associates refuse the test, is a waiver form completed? Check documentation.

  Yes

  No

  N/A

• G. Are new associates receiving audiometric tests? (Within 6 months of hire date or within one year if a mobile test van is used.) Temporary employees follow the same protocol but it can be a shared effort between the agency and the host employer. Any shared responsbility needs to be determined before the temporary associate starts work.

  Yes

  No

  N/A

• H. Are associates advised in writing, within 21 days, of audiometric test or retest results if hearing loss is indicated, or the STS is not persistent?

  Yes

  No

  N/A

• I. Does the facility hearing test provider(s) provide an OSHA recordable hearing loss exception report? NOTE: Is this provider analyzing audiograms to determine potential OSHA recordability?

  Yes

  No

  N/A

• J. Is the Hearing Conservation Standard posted in the facility?

  Yes

  No

  N/A

• K. When audiometric testing is conducted, by outside contractor or at facility, are they meeting the following requirements:

  Yes

  No

  N/A

• Are there records indicating the audiometer has an exhaustive calibration at least every two years?

  Yes

  No

  N/A

• Are the records indicating the audiometer is calibrated at least annually?

  Yes

  No

  N/A

• Is the audiometer checked before each day’s use?

  Yes

  No

  N/A

• Is the person conducting audiometric tests properly certified?

  Yes

  No

  N/A

• Have background noise checks been conducted on hearing booth?

  Yes

  No

  N/A

• L. Is training provided to associates that are exposed to noise levels above 85 dBA TWA?

  Yes

  No

  N/A

Personal Protective Equipment (1910.132)

• A. Has a Personal Protective Equipment (PPE) hazard assessment of the workplace been completed?

  Yes

  No

  N/A

• B. Is there a formal certification that the assessment has been completed?

  Yes

  No

  N/A

• C. Has initial training been conducted and retraining as required for associates to identify the need for PPE, what PPE is necessary, how to use the PPE, the limitations, and proper care, maintenance and disposal of the PPE.

  Yes

  No

  N/A

• D. Does the PPE Training include a written certification that it was performed and understood and does it include the name of each associate trained, date trained, and subject certified?

  Yes

  No

  N/A

Respiratory Protection (1910.134)

• A. Have all chemical requirements and need for respirators been reviewed for this site?

  Yes

  No

  N/A

• B. If respirators are used (required or voluntary), does the site have a written Respiratory Program?

  Yes

  No

  N/A

• C. Are there tasks that require air purifying cartridge respirator or supplied air respirator? If yes:

  Yes

  No

  N/A

• What types of respirators are used in this facility?

  Yes

  No

  N/A

• What tasks require these types of respirators?

  Yes

  No

  N/A

• Have respirator users received medical fitness evaluation and are these evaluations documented? (Note: Medical clearance must be done before fit tests)

  Yes

  No

  N/A

• Are users receiving appropriate (annual) fit tests and are these tests documented?

  Yes

  No

  N/A

• D. Where filtering face piece respirators (dust masks) are used on a voluntary basis, does the facility provide respirator users with information contained in Appendix D of the standard? AUDITOR NOTE: These must be completed annually and copies kept until new forms are completed)

  Yes

  No

  N/A

• E. Have users been instructed and trained in the proper use of the respirator, and is this training documented? (any type of respirator including dust mask and required or voluntary)

  Yes

  No

  N/A

Emergency Action/Fire Prevention Plan (1910.38 & 39)

• A. Does the site have a written Emergency Action or Fire Safety Plan?

  Yes

  No

  N/A

• B. Does this site have a Fire Protection Plan?

  Yes

  No

  N/A

• C. Does the facility have an emergency alarm system whereby all associates can be notified of the emergency?

  Yes

  No

  N/A

• D. Have associates been trained on the elements of the Emergency Action/Fire Protection Plan, including those who have the responsibility of assisting in the safe and orderly evacuation of associates?

  Yes

  No

  N/A

• E. Is there a means to assure that all associate alarm systems are maintained in operating condition?

  Yes

  No

  N/A

• F. Is there a procedure for ensuring the adequacy and reliability of emergency alarms in the workplace? Auditor Note: A Supervised system (panel controlled alarm) must be checked annually; an Unsupervised system (manual alarm) must be checked every two months.

  Yes

  No

  N/A

• G. Are all the fire extinguishers charged and within the expiration date? Are fire extinguishers and hoses inspected and documented monthly?

  Yes

  No

  N/A

• H. Are the fire extinguisher inspection tags marked every month?

  Yes

  No

  N/A

• I. Is the facility using a supervisor "tag" or similar notification system for fire protection equipment impairments?

  Yes

  No

  N/A

• J. Has the location conducted fire drills on each shift at least once per year?

  Yes

  No

  N/A

• K. Is an updated evacuation plan posted in each area of the facility, identifying evacuation routes, and the location of each fire extinguisher?

  Yes

  No

  N/A

• L. Does the location have a designated reorganization point and are associates aware of the location of the reorganization point in the event of an emergency evacuation?

  Yes

  No

  N/A

• M. Are all exits clearly marked and lit?

  Yes

  No

  N/A

• N. Are all emergency aisles kept clear of debris?

  Yes

  No

  N/A

• O. Is the Sprinkler Main easily accessible?

  Yes

  No

  N/A

• P. Is the Sprinkler Main Valve chained open?

  Yes

  No

  N/A

• Q. Are all sprinkler heads free and clear?

  Yes

  No

  N/A

• R. Has the local fire department toured the facility for a pre-fire orientation? When?

  Yes

  No

  N/A

Fire Extinguishers (1910.157)

• A. Are portable fire extinguishers provided for associate use?

  Yes

  No

  N/A

• B. Are portable extinguishers properly mounted and identified?

  Yes

  No

  N/A

• C. Are fire extinguishers and hoses inspected and documented monthly?

  Yes

  No

  N/A

• D. Are fire extinguishers serviced annually by an outside firm, tagged with dates and identities of the person and/or firm performing service?

  Yes

  No

  N/A

• E. Have all associates been trained annually on the principles of fire extinguisher education and the hazards involved?

  Yes

  No

  N/A

Flammable and Combustible Liquid Storage (1910.106)

• A. Are flammable/combustible liquids stored in UL/FM approved cabinets?

  Yes

  No

  N/A

• B. Are large (drum) quantities of flammable or combustible liquids or gases stored in properly designated rooms?

  Yes

  No

  N/A

• C. Are safety containers used to transfer flammables?

  Yes

  No

  N/A

• D. Are the containers holding flammable/combustible liquids properly bonded and grounded?

  Yes

  No

  N/A

• E. Are all gas cylinders stored properly? (Auditor's Note: See notes in audit workbook)

  Yes

  No

  N/A

Confined Space Entry/Rescue (1910.146)

• A. Has the facility developed a Confined Space Entry Program that includes: list of confined spaces, specific entry procedures, procedure for atmospheric monitoring, procedure for pre-entry checks, role of entrants & standby attendant, entry permits, and procedure for rescue.

  Yes

  No

  N/A

• B. Have procedures been developed to conduct a pre-entry review with contractors? Copies of contractor employee training records? Discuss entry program to be followed? Review specific entry procedures for space to be entered? All aspects of the entry and required compliance to do the entry?

  Yes

  No

  N/A

• C. Are the confined space/permit space areas appropriately labeled?

  Yes

  No

  N/A

• D. Are contractor Confined Space entry tags/permits utilized for only one shift and filled out appropriately? (Verify by checking a representative number of completed permits).

  Yes

  No

  N/A

• E. Are contractor Confined Space Entry tags/permits being retained by the facility for one year and has the facility conducted an annual review of the confined space program to ensure that proper procedures are being followed?

  Yes

  No

  N/A

• F. Are employees trained annually about how to recognize a confined space and knowledge that MCC employees will not enter any confined space, with records kept on file?

  Yes

  No

  N/A

Lockout/Tagout (1910.147)

• A. Does the facility have a current written Energy Control (Lockout/Tagout) Program? a. Have procedures been developed, documented and utilized for control of hazardous energy. b. Do the energy control procedures clearly and specifically outline the scope, purpose, authorization, rule & techniques to be used. c. Is there a specific statement of the intended use. d. Are there steps for shutting down, isolating, blocking & securing machine. e. Are there steps for placement, removal & transfer of lockout / tagout devices.

  Yes

  No

  N/A

• B. Are there individual written procedures for multi-energy source machines/processes? Do procedures include a verification to ensure that all energy sources have been de-energized?

  Yes

  No

  N/A

• C. Are individual written procedures for multi-energy source machines/processes reviewed annually or prior to the next assigned lockout when it is over a year old?

  Yes

  No

  N/A

• D. Are lockout devices available and used in all cases where lockout is possible?

  Yes

  No

  N/A

• E. Are lockout devices and tags singularly identified within the facility by specific color, shape or size?

  Yes

  No

  N/A

• F. Are lockout devices and tags not used for other purposes such as out-of-service?

  Yes

  No

  N/A

• G. Do all authorized associates use tags and individual locks?

  Yes

  No

  N/A

• H. Do lockout and tagout devices indicate the identity of the associate applying the device(s)? Are the tags legible and understandable?

  Yes

  No

  N/A

• I. Do LOTO locks have single keys?

  Yes

  No

  N/A

• J. Do all tags have dates? (Dates are not required when picture tags are used.)

  Yes

  No

  N/A

• K. Have all associates who lock or tag out equipment (Authorized) received documented training on the purpose, procedures, and function of the Lockout / Tagout Program & verification?

  Yes

  No

  N/A

• L. Have all associates who operate equipment in an area where lockout/tagout is being performed (Affected) received documented training on the purpose and use of the energy control procedure?

  Yes

  No

  N/A

• M. Is there retraining provided for all authorized associates whenever there is a change in job assignment, change in machine, equipment or processes or change in energy control procedures?

  Yes

  No

  N/A

• N. Is a periodic inspection of the Energy Control specific procedures being conducted and documented at least annually? NOTE: Unless its subsidiary EHS management has specified a different number, each department of a facility that performs lockout/tagout shall conduct at a minimum at least two periodic inspections per month. Subsidiaries that do not have multiple departments that perform lockout/tagout should conduct a minimum of two periodic inspections per month at each facility.

  Yes

  No

  N/A

Electrical Safety-Related Work Practices (1910.331-.335)

• A. Has documented training been provided to those qualified associates facing a higher than normal risk of an electrical accident?

  Yes

  No

  N/A

• B. Has documented training on general electrical safety been provided for all other unqualified associates?

  Yes

  No

  N/A

• C. Are all panels and breakers accurately and clearly marked to indicate purpose?

  Yes

  No

  N/A

• D. Is a minimum of 36" clearance maintained in front of all electrical panels?

  Yes

  No

  N/A

• E. Are all cabinets and boxes intact with all knockouts and covers in place?

  Yes

  No

  N/A

• F. Are flexible extension cords being used properly (Temporary use only)?

  Yes

  No

  N/A

• G. Is MCC Electrical Safety Program being used (PPE, Permits, Training, etc.)?

  Yes

  No

  N/A

• H. Is the voltage and ARC Flash labels on each panel?

  Yes

  No

  N/A

• I. Does the facility have appropriate PPE for performing high voltage work? Verify that the required PPE meets requirements: e.g. 100 cal suits.

  Yes

  No

  N/A

• J. Has the facility PPE matrix been updated with high voltage PPE requirements: e. g. high voltage gloves, face-shields, head protection and especially 100 cal suits.

  Yes

  No

  N/A

• K. Is facility electrical PPE (gloves, sleeves, blankets, etc.) subjected to periodic electrical tests conforming with Tables I - 5 and I - 6 ? Auditor Note: Reference 29 CFR 1910.137 (b) (2) (viii) and (xii).

  Yes

  No

  N/A

• L. Are these required tests certified by the employer to include the identity of the equipment that passed the test and the date of the test? Reference 29 CFR 1910.137 (b) (2) (xii).

  Yes

  No

  N/A

Powered Industrial Trucks (1910.178), Scissor Lift (1910.29), and Aerial Lifts (1910.67)

• A. Does the PIT training program include formal classroom instruction (i.e. lecture, discussion, interactive computer learning, video tape, written material), and practical training (demonstrations performed by the trainer and practical exercises by the trainee)?

  Yes

  No

  N/A

• Does the training program include an evaluation of the operators performance in the workplace?

  Yes

  No

  N/A

• Does the training program include the specific hazards of operating the particular type of forklift, including manufacturers operating instructions?

  Yes

  No

  N/A

• Does the training program include reviewing the requirements of the OSHA standard (29 CFR 1910.178)?

  Yes

  No

  N/A

• Are the training and evaluations certified? (must include operator name, date of training, date of evaluation, name of instructor)

  Yes

  No

  N/A

• Was the training provided by persons who have the knowledge, training, and experience to conduct this training and evaluation?

  Yes

  No

  N/A

• B. Have current forklift operators been determined to be competent to operate a PIT, as demonstrated by successful completion of an evaluation program?

  Yes

  No

  N/A

• C. Is an evaluation of each operators performance conducted at least every three years?

  Yes

  No

  N/A

• D. Does the facility truck loading and unloading procedures require the use of trailer stabilizing jacks(jack stands)?

  Yes

  No

  N/A

• E. On those PIT’s that are equipped with seat belts, does the facility require the operators to wear seat belts?

  Yes

  No

  N/A

• F. Are pre-shift forklift checks being conducted? (Only required prior to use on that shift.)

  Yes

  No

  N/A

• G. Is air released on air-ride suspended trailers before the trailer is loaded? Is this included in the written dock procedures?

  Yes

  No

  N/A

• H. Does the facility retrain associates if the operator is involved in an accident or near-miss incident, or the operator was observed operating the vehicle in an unsafe manner, or is assigned to operate a different type of vehicle?

  Yes

  No

  N/A

• I. Is the forklift in good working order? (load backrest, seat belt, propane tank installed correctly, testing laboratory approval sticker, nameplates/stickers legible, etc.)

  Yes

  No

  N/A

• J. Are areas where forklifts travel identified with markings on the floor, signs, etc.?

  Yes

  No

  N/A

• K. Are all LP tanks stored properly? (Auditor's Note: See notes in audit workbook)

  Yes

  No

  N/A

• L. Is the storage area properly marked? (i.e. DANGER - Flammable Propane - No Smoking)

  Yes

  No

  N/A

• M. Is an emergency wash station located within 10 seconds walking of the forklift battery charging station? (ANSI Z258.1 - Emergency Wash Stations)

  Yes

  No

  N/A

• N. Do all PITs have the blue safety lights installed?

  Yes

  No

  N/A

• Auditor Note: A scissor lift is a mobile scaffold for which the platform only moves vertically. An aerial lift is any vehicle-mounted work platform that can move vertically and/or horizontally.

• O. Is there a lift inspection that must be completed prior to use? Are the inspections documented and filed?

  Yes

  No

  N/A

• P. Is specific lift training completed for associates using the lifts, to include fall protection training?

  Yes

  No

  N/A

• Q. Is fall protection worn and attached to the boom or basket when working from an aerial lift?

  Yes

  No

  N/A

Medical and First Aid (1910.151)

• A. Does the facility have an emergency response team?

  Yes

  No

  N/A

• If no, does the location have at least two associates per shift trained/certified in first aid and CPR?

  Yes

  No

  N/A

• B. Is outside emergency responose help within 4 minutes of the facility?

  Yes

  No

  N/A

• C. Does this location have a written plan on responding to a medical emergency?

  Yes

  No

  N/A

• D. Are the phone numbers of emergency response organizations posted in a prominent area?

  Yes

  No

  N/A

• E. Does the facility have an Emergency "Red" bag to be used by trained team members during an emergency requiring medical attention more than first aid?

  Yes

  No

  N/A

Automatic External Defibrillators (1915.87 Appendix A)

• A. Does the facility provide an automated external defibrillator (AED)?

  Yes

  No

  N/A

• B. Are their trained designated employees for use of the AED on all shifts?

  Yes

  No

  N/A

• C. Is the AED located so they can be utilized within three to five minutes of a report or accident?

  Yes

  No

  N/A

• D. Do you have an inspection, testing and PM program developed in accordance with the manufacturers instructions?

  Yes

  No

  N/A

Blood borne Pathogens (1910.1030)

• A. Does the facility have associates, who are required by their job duties, to have potential exposure to blood borne pathogens?

  Yes

  No

  N/A

• B. Does the location have a written Exposure Control Plan that includes Exposure Determination?

  Yes

  No

  N/A

• C. Is there an annual review process to ensure the facility exposure control plan is current?

  Yes

  No

  N/A

• D. Are the containers used for disposal of contaminated sharps closable, puncture-resistant, and leak-proof on sides and bottom?

  Yes

  No

  N/A

• E. Are the containers used for disposal of contaminated materials red in color or labeled with the biohazard symbol?

  Yes

  No

  N/A

• F. Are the containers used for disposal of contaminated materials and sharps located as close as feasible to the immediate area of discovery?

  Yes

  No

  N/A

• G. Have Hepatitis B vaccinations been offered and documented to all associates with potential occupational exposure free of charge?

  Yes

  No

  N/A

• H. Do you have established guidelines to offer the vaccine to new associates within 10 days of their initial assignment?

  Yes

  No

  N/A

• I. Was the mandatory Vaccine Declination, found in Appendix A of the Standard, used?

  Yes

  No

  N/A

• J. Is annual training provided by, and documented by a person knowledgeable in all elements of the standard?

  Yes

  No

  N/A

Eyewash/Shower Stations (ANSI Z358.1)

• A. Are eyewash and shower stations located at least 10 seconds walking time from the location of all potential chemical hazards?

  Yes

  No

  N/A

• B. Is a drain, mat, or other water collection device provided under the stations to prevent creating a slip hazard if the stations are used?

  Yes

  No

  N/A

• C. Have all associates been trained on the location and proper use of emergency wash stations, as well as what to do if an associate must use the station?

  Yes

  No

  N/A

• D. Are eyewash and shower stations tested monthly, with the date of the test maintained on a card at the stations?

  Yes

  No

  N/A

• E. Are eyewash outlet heads protected from airborne contaminants with removable covers/caps?

  Yes

  No

  N/A

• F. Are the emergency wash stations clearly identified with a highly visible sign?

  Yes

  No

  N/A

• G. Is the space around the stations (48" in front, 30" wide) clear of debris and obstruction?

  Yes

  No

  N/A

Walking-Working Surfaces - Ladders (29 CFR 1910.23 and 29 CFR 1910 Appendix D)

• A. Does this facility use fall protection for any work at least 4 ft. above a lower level?

  Yes

  No

  N/A

• B. What types of fall protection equipment or devices are used?

  Yes

  No

  N/A

• C. Have any fixed ladders been installed (new or replacement) since 1/1/2018?

  Yes

  No

  N/A

• If yes, does it extend more than 24 feet?

  Yes

  No

  N/A

• If yes, does it have a ladder safety system or personal fall protection system?

  Yes

  No

  N/A

• D. Do all fixed ladders installed prior to 1/1/2018 have a cage, well, ladder safety system or personal fall arrest system?

  Yes

  No

  N/A

• E. Are pre-use inspections being completed on portable ladders?

  Yes

  No

  N/A

• F. Does the location routinely complete a Ladder Inspection Checklist for each ladder?

  Yes

  No

  N/A

• G. Are mechanisms used to keep ladders stationary when being stored?

  Yes

  No

  N/A

• H. Is any ladder with structural defects immediately tagged "Do Not Use" and taken out of service or replaced? (1910.145 and 1910.22(d))

  Yes

  No

  N/A

• I. Are each of the portable ladders in the location individually numbered?

  Yes

  No

  N/A

Cranes/Hoists (1910.179)

• A. For cranes and hoists such as jibs, monorails or other overhead lifting equipment, has inspections been completed and documentation on file? AUDITOR NOTE: An annual inspection, periodic inspections should have documented load testing.

  Yes

  No

  N/A

• B. Are cranes/hoists operated by trained personnel?

  Yes

  No

  N/A

• C. Are operators making daily visual inspections prior to each use?

  Yes

  No

  N/A

• D. Are monthly inspections being conducted by a qualified inspector and are these inspection records on file?

  Yes

  No

  N/A

• E. Are the annual inspections completed by a qualified outside crane inspector with documentation?

  Yes

  No

  N/A

• F. Is there a PM program based on the crane/hoist manufacturer's recommendations?

  Yes

  No

  N/A

• G. Are synthetic slings and under-the-hook apparatus maintained in serviceable condition? NOTE: check for red indicator "wear" threads on synthetic slings.

  Yes

  No

  N/A

• H. Is the capacity of the crane/hoist clearly marked?

  Yes

  No

  N/A

Hot Work (1910.252)

• A. Is a formal Hot Work Program in place?

  Yes

  No

  N/A

• B. Are all Hot Work Permits retained for a minimum of 48 hours?

  Yes

  No

  N/A

• C. Is training completed and documented?

  Yes

  No

  N/A

Industrial Hygiene Sampling (1910.1029 Appendix B)

• A. Is industrial hygiene sampling done for any specific chemicals in the facility?

  Yes

  No

  N/A

• If yes, what chemicals are being monitored for?

  Yes

  No

  N/A

• If yes, do you have a monitoring plan in place?

  Yes

  No

  N/A

Chromium VI (1910.1026)

• A. Has the facility determined the 8 hour Time Weighted Average for each employee with the highest potential exposure to Chrome VI? EXAMPLE OF EXPOSURE: Welding on stainless steel with MIG or stainless steel welding rods. AUDITORS NOTE: If they have, then go to secondary list of chromium questions.

  Yes

  No

  N/A

Machine Guarding (1910.212)

• A. Are safeguards in place and meet the OSHA requirements?

  Yes

  No

  N/A

• B. Do the safeguards prevent workers hands, arms, and other body parts from making contact with dangerous moving parts?

  Yes

  No

  N/A

• C. Are the safeguards firmly secured and not easily removable?

  Yes

  No

  N/A

• D. Do the safeguards ensure that no objects will fall into the moving parts?

  Yes

  No

  N/A

• E. Do the safeguards permit safe, comfortable, and relatively easy operation of the machine?

  Yes

  No

  N/A

• F. Can the machine be oiled without removing the safeguard?

  Yes

  No

  N/A

• G. Are LOTO procedures followed before removing a guard?

  Yes

  No

  N/A

• H. Are all E-stops used for emergency stopping of hazardous machines, red? (1910.144)

  Yes

  No

  N/A

Laser Safety (ANSI Z136.1 - 2007)

• A. Does the facility have laser(s) and or laser equipment labeled by the manufacturer as a hazard class 2M, 3B, or 4? (This can be determined by looking at the manufacturer equipment labels.)

  Yes

  No

  N/A

• B. Are facility laser safety programs and employee training programs provided for Class 3B or Class 4 lasers and laser systems? Auditor Note: Employer and/or facility safety programs and employee training should be provided for laser systems containing embedded Class 3B and Class 4 lasers.)

  Yes

  No

  N/A

• C. Is there a designated individual as the Laser Safety Officer (LSO) with the authority and responsibility to effect the knowledgeable evaluation and control of laser hazards, and the implementation of appropriate control measures, as well as to monitor and enforce compliance with required standards and regulations.

  Yes

  No

  N/A

• D. For installed lasers, have manufacturers warning labels been maintained and are they visible to observers?

  Yes

  No

  N/A

• E. Have there been any injuries or laser related incidents and records maintained on these incidents?

  Yes

  No

  N/A

• F. Have appropriate medical examinations and medical surveillance program been completed?

  Yes

  No

  N/A

Asbestos (29 CFR 1910.1001, 1101)

• A. Does the facility have any known or suspected asbestos containing material? Was a survey completed and documentation kept to confirm?

  Yes

  No

  N/A

• B. Is there an asbestos plan or procedures developed explaining the location, management, method and responisbility for the asbestos containing material in the event of the material being disturbed or abatement is needed? Does the plan state that a certified outside contractor will be used to remove all asbestos continaing material when needed?

  Yes

  No

  N/A

• C. Are associates notified and trained annually on the location and managment of the asbestos containing material?

  Yes

  No

  N/A

Contractor Safety

• A. Are all associates responsible for monitoring on-site contractors aware of the written EHS Contractor Program?

  Yes

  No

  N/A

• B. Has a contractor safety packet been issued and a signed returned copy retained on file?

  Yes

  No

  N/A

Miscellaneous Items (General Duty Clause or other)

• A. Is the facility neatly organized?

  Yes

  No

  N/A

• B. Are the floors maintained and free of debris?

  Yes

  No

  N/A

• C. Does the facility use "wet floor" signs when needed?

  Yes

  No

  N/A

• D. Are aisle ways or doorways blocked?

  Yes

  No

  N/A

• E. Are exit signs appropriately placed?

  Yes

  No

  N/A

• F. Does all compressed air lines have a safety nozzle that have a built in pressure reducer or relief device that reduces the air pressure in case the nozzle is dead ended? 30 psi or less

  Yes

  No

  N/A

• G. Are items in the plant stored and stacked securely to prevent falling, sliding, or collapsing? Items on top racks should be banded or shrink-wrapped for security from falling.

  Yes

  No

  N/A

• H. Are storage areas kept free from accumulation of materials that constitute hazards from tripping, fire, explosion, or pest harborage?

  Yes

  No

  N/A

• I. Are clearance limits marked for the proper height of stacked objects?

  Yes

  No

  N/A

• J. Is there an 18" clearance between the top of the racked or stacked material and the sprinklers?

  Yes

  No

  N/A

• K. Are rack columns anchored to the floor?

  Yes

  No

  N/A

• L. Are cross beams bolted to the uprights?

  Yes

  No

  N/A

• M. Are load ratings present on racking?

  Yes

  No

  N/A

• N. Is there a maintenance and inspection program for storage racks? The program should include keeping aisles clear and providing sufficient clearance for material handling equipment. Also, ensuring racks are properly aligned, plum, and level, per manufacturer’s instructions.

  Yes

  No

  N/A

Water: Pollution Prevention and Control (40 CFR...part 112 and parts 405-471)

• Does this facility have a water permit (NPDES)? Review permit

  Yes

  No

  N/A

• A. Is this facility in compliance with the requirements of this permit?

  Yes

  No

  N/A

• B. Does this facility have a Storm Water Pollution Prevention Plan?

  Yes

  No

  N/A

• Does this facility have a waste water discharge permit? Review permit

  Yes

  No

  N/A

• A. Is this facility in compliance with the requirements of this permit?

  Yes

  No

  N/A

• B. Are waste water analysis reports required and being submitted to local authorities?

  Yes

  No

  N/A

Air Permitting (40 CFR 70)

• Is this facility required to have a Title V or other permit per state or federal regulations? Review permit

  Yes

  No

  N/A

• A. Is this facility in compliance with the requirements of this permit?

  Yes

  No

  N/A

• B. Does the facility notify the local regulatory authority whenever new emission points are added or substantial changes to the facility’s process occur?

  Yes

  No

  N/A

Greenhouse Gas Reporting (40 CFR Part 98)

• Is this facility required to report based on the Greenhouse Gas Program?

  Yes

  No

  N/A

• A. Does this facility emit 25,000 metric tons or more of carbon dioxide equivalent per year?

  Yes

  No

  N/A

• B. Does the faciity have documentation of reporting annually by March 31 for emissions in the previous calendar year?

  Yes

  No

  N/A

Boilers and process heaters (40 CFR 65.149)

• Does this facility have a boiler or process heater?

  Yes

  No

  N/A

• A. Is the boiler permit current and displayed?

  Yes

  No

  N/A

• B. Does the facility have records of inspections and repairs?

  Yes

  No

  N/A

• C. Is this facility in compliance with the requirements of this permit or any other affiliated permit?

  Yes

  No

  N/A

Hazardous Waste Management (40 CFR 260-355)

• Does the facility have RCRA trained associates?

  Yes

  No

  N/A

• Does the facility have DOT trained associates and are they the only ones handling HW or signing manifests?

  Yes

  No

  N/A

• A. Has a hazardous waste determination been determined for wastes generated at this facility?

  Yes

  No

  N/A

• B. Is this facility a CESQG, SQG, or LQG?

  Yes

  No

  N/A

• C. Is the facility registered as a hazardous waste generator and does the registration list the correct waste streams?

  Yes

  No

  N/A

• D. Is the facility following the manifest system, with all shipments of hazardous waste documented on a uniform haz waste manifest and LDR?

  Yes

  No

  N/A

• E. Do you have the last three years of manifest plus current?

  Yes

  No

  N/A

• F. Are all hazardous waste containers properly labeled, dated, closed and maintained in good condition and inspected weekly?

  Yes

  No

  N/A

• G. Does the facility use a registered hazardous waste transporter to ship hazardous waste off-site?

  Yes

  No

  N/A

• H. Are all hazardous wastes stored on-site for no longer than the maximum accumulation time frames?

  Yes

  No

  N/A

• I. Are all personnel responsible for managing hazardous waste trained in hazardous waste handling and emergency response procedures?

  Yes

  No

  N/A

• J. Are all records pertaining to emergency preparedness, associate training, waste shipments, annual reports and required facility inspections maintained at the facility?

  Yes

  No

  N/A

• K. Are all hazardous wastes shipped off-site sent to a permitted hazardous waste facility?

  Yes

  No

  N/A

• L. Does the facility have a RCRA permit or interim status for all on-site treatment, storage or disposal units?

  Yes

  No

  N/A

• M. Has an audit of the current waste facility(s) been completed.

  Yes

  No

  N/A

• N. Is this facility completing all required reporting: annually or biannually?

  Yes

  No

  N/A

• O. Has the facility had any violations in the past 3 years?

  Yes

  No

  N/A

Universal Waste (40 CFR 273)

• A. Does the facility collect batteries, lamps, aerosols, or mercury containing equipment to send out as universal waste?

  Yes

  No

  N/A

• B. Is this waste sent out no more than one year from start date?

  Yes

  No

  N/A

• C. Is the waste labeled correctly, "Universal Waste, Lamps", "Used Lamps", or "Waste Lamps"?

  Yes

  No

  N/A

• D. Are broken lamps treated as hazardous waste?

  Yes

  No

  N/A

• E. Is proper documentation kept for the collection and transportation of the universal waste?

  Yes

  No

  N/A

Used Oil (40 CFR 279)

• A. Does this facility follow the used oil generator rules?

  Yes

  No

  N/A

• B. Are drums/tanks kept in good condition and are labeled properly, "Used Oil"?

  Yes

  No

  N/A

• C. Is proper documentation kept for the collection and transportation of the used oil?

  Yes

  No

  N/A

Recycling

• A. Does the facility routinely review the industrial waste, the municipal solid waste, for reuse or recycling?

  Yes

  No

  N/A

Underground Storage Tanks (40 CFR 280)

• Does the facility have underground storage tanks?

  Yes

  No

  N/A

• A. Do the USTs have release detection?

  Yes

  No

  N/A

• B. Does the USTs have pressurized piping?

  Yes

  No

  N/A

• C. Does the USTs have suction piping?

  Yes

  No

  N/A

• D. Are repair, monitoring and all testing records kept for at least 1 year?

  Yes

  No

  N/A

• E. Are records kept for at least 5 years of calibration and maintenance of release detection equipment?

  Yes

  No

  N/A

• F. Are vendor performance claims and results of third-party evaluations kept for 5 years?

  Yes

  No

  N/A

• G. Do the USTs have corrosion protection?

  Yes

  No

  N/A

• H. Are there records for cathodic protection?

  Yes

  No

  N/A

• I. Does the UST have spill protection equipment, such as catchment basin?

  Yes

  No

  N/A

• J. Does the UST have overfill protection? Automatic shutoff? Alarm?

  Yes

  No

  N/A

• K. Have all required notifications been made to local, state or federal agencies, if required?

  Yes

  No

  N/A

Aboveground Storage Tanks (40 CFR 112)

• Does the facility have aboveground storage tanks?

  Yes

  No

  N/A

• A. Is there any evidence of possible corrosion or cracking of the tank?

  Yes

  No

  N/A

• B. When was the last third-party tank inspection completed?

  Yes

  No

  N/A

• C. Do the tanks have sufficient secondary containment? Large enough to hold contents of largest tank plus 25 year storm event.

  Yes

  No

  N/A

• D. Is the containment structure in satisfactory condition? Do you have record of regular inspections?

  Yes

  No

  N/A

• E. Does the facility have a Spill Prevention, Control and Countermeasure Plan?

  Yes

  No

  N/A

• F. Have all required notifications been made to local, state or federal agencies, if required?

  Yes

  No

  N/A

SARA Title III, Section 312 Tier II (40 CFR 370)

• Is the facility required to report?

  Yes

  No

  N/A

• Has the location submitted either copies of SDSs or a list of SDS chemicals to the State Emergency Response Commission (SERC), Local Emergency Planning Committees (LEPC), and local fire department by March 1st?

  Yes

  No

  N/A

SARA Title III, Section 313 (40 CFR 370)

• Is the facility required to report?

  Yes

  No

  N/A

• Has the location completed TRI (Toxic Release Inventory) reporting, based on the toxic chemicals that are manufactured, processed or used over the course of a calendar year in excess of the reporting quantity by July 1st?

  Yes

  No

  N/A

Hazwoper (Emergency Contingency Plan) (1910.120)

• A. Has the facility developed and implemented an Emergency Contingency Plan or HazWoper Plan anticipating chemical emergencies? For facilities relying on outside resources, the written plan should be in the 1910.38 Emergency Action Plan. The HazWoper plan must include the following: a. Pre-emergency planning with outside parties. b. Personal roles, lines of authority, training, and communication. c. Emergency recognition and prevention. d. Safe distances and places of refuge. e. Site security and control. f. Evacuation routes and procedures. g. Decontamination. h. Emergency medical treatment and first aid. i. Critique of response and follow-up. j. PPE and emergency equipment.

  Yes

  No

  N/A

• B. If the facility may have situations where they will not have a fully manned emergency team, does the facility Emergency Control Plan or HazWoper Plan have procedures in place to cover use of outside agencies?

  Yes

  No

  N/A

• C. Does the facility have an up to date list of team members?

  Yes

  No

  N/A

• D. Does the facility have at least one Hazmat team per operating shift?

  Yes

  No

  N/A

• E. Is there at least one individual per shift assigned as an Incident Commander?

  Yes

  No

  N/A

• F. Is there documented evidence of annual HazWoper refresher training being performed for all team members?

  Yes

  No

  N/A

• G. Is there adequate chemical emergency equipment available, is it maintained in good working order and are periodic inspections performed regularly and documented?

  Yes

  No

  N/A

• H. Does the facility HAZMAT team participate in a practice response drill at least annually?

  Yes

  No

  N/A

• I. Does the Hazmat Team conduct critique sessions after responding to a spill/drill and are these critique sessions documented? Are critiques complete and have all follow-up actions been completed?

  Yes

  No

  N/A

Security

• A. Are facility entrances/exits secure?

  Yes

  No

  N/A

• B. Are sensitive documents secure?

  Yes

  No

  N/A

• C. Are keys issued and documented properly?

  Yes

  No

  N/A

• D. Are key fobs issued and properly documented (specifically to contractors)

  Yes

  No

  N/A

• E. Does parking lot have adequate lighting?

  Yes

  No

  N/A

• F. Does the shipping department have a security cage?

  Yes

  No

  N/A

• G. Do all contractors go through contractor safety; with sign-offs?

  Yes

  No

  N/A

• H. Are there camera's in the facility (interior/exterior)?

  Yes

  No

  N/A

• I. Bomb threat protocol accessible?

  Yes

  No

  N/A