Municipal

• Facility Location
  Address

• Department/Division

• Date & Time of Audit

  Date

• Auditor:

• Audit Participants:

1.0 Previous inspection

• Has the last audit been reviewed?

  Yes

  No

  N/A

• Have previous monthly inspections been reviewed?

  Yes

  No

  N/A

• Are there no outstanding abatements?

  Yes

  No

  N/A

2.0 Departmental Policies & Training

• Accident & Injury forms available?

  Yes

  No

  N/A

• Arc Flash Policy present?

  Yes

  No

  N/A

• Hazardous Communication Policy present?

  Yes

  No

  N/A

• Bloodborne Pathogen Policy present?

  Yes

  No

  N/A

• Cranes/Hoists Policy present?

  Yes

  No

  N/A

• EAP/Means of Egress Policy present?

  Yes

  No

  N/A

• Electrical Safety Policy present?

  Yes

  No

  N/A

• Fall Protection Policy present?

  Yes

  No

  N/A

• Fire Protection Policy present?

  Yes

  No

  N/A

• Forklift Policy present?

  Yes

  No

  N/A

• Hazardous Communication Policy present?

  Yes

  No

  N/A

• Hearing Conservation Policy present?

  Yes

  No

  N/A

• Machine Guarding Policy present?

  Yes

  No

  N/A

• Material Handling & Ergonomics Policy present?

  Yes

  No

  N/A

• LO/TO Policy present?

  Yes

  No

  N/A

• Have annual equipment LO/TO audits been performed and documented?

  Yes

  No

  N/A

• Have annual personnel LO/TO audits been performed and documented?

  Yes

  No

  N/A

• Permit Required Confined Space Policy present?

  Yes

  No

  N/A

• Has hands-on employee training been performed and documented?

  Yes

  No

  N/A

• Portable Hand and Power Tools Policy present?

  Yes

  No

  N/A

• PPE, PPE Grid & Hazard Assessments present?

  Yes

  No

  N/A

• Respiratory Protection Policy present?

  Yes

  No

  N/A

• Are voluntary respirator forms maintained for affected employees?

  Yes

  No

  N/A

• Roadway Safety Policy present?

  Yes

  No

  N/A

• Stairway & Ladder Policy present?

  Yes

  No

  N/A

• Trenching & Shoring Policy present?

  Yes

  No

  N/A

• Has hands-on employee training been performed and documented?

  Yes

  No

  N/A

• Welding & Hot Work Policy present?

  Yes

  No

  N/A

• Policy/revision dates within 3 years?

  Yes

  No

  N/A

• Are any additional policies maintained?

  Yes

  No

  N/A

• List additional policies.

• Are additional policies recommended?

  Yes

  No

  N/A

• List recommended policy and justification.

• Is the OSHA Worker's Rights poster posted and current?

  Yes

  No

  N/A

• Is the NCDOL Wage and Hour poster posted and current?

  Yes

  No

  N/A

• Is OSHA 300 log posted & current as required?

  Yes

  No

  N/A

3.0 Electrical

• Is clear access to panels provided?

  Yes

  No

  N/A

• Have arc flash requirements been met?

  Yes

  No

  N/A

• Are extension cords used properly?

  Yes

  No

  N/A

• Are lamp holders/guards in place?

  Yes

  No

  N/A

• Are openings in panels properly sealed?

  Yes

  No

  N/A

• Are circuits properly used?

  Yes

  No

  N/A

• Are receptacles in good condition?

  Yes

  No

  N/A

• Are there no broken plugs, sockets or switches?

  Yes

  No

  N/A

• Are no power leads crossing walkways?

  Yes

  No

  N/A

• No frayed or damaged leads?

  Yes

  No

  N/A

• No strained leads?

  Yes

  No

  N/A

• Portable power tools in good condition?

  Yes

  No

  N/A

• Where required, are emergency shutdown procedures in place?

  Yes

  No

  N/A

4.0 Fire Protection

• Evacuation routes posted and understood by all employees?

  Yes

  No

  N/A

• Annual drill accomplished and documented as required?

  Yes

  No

  N/A

• Extinguishers in place and clearly marked for type of fire?

  Yes

  No

  N/A

• Extinguisher locater signs present & visible?

  Yes

  No

  N/A

• Are monthly inspections current?

  Yes

  No

  N/A

• Extinguisher annual service dates current?

  Yes

  No

  N/A

• Extinguishers are properly mounted?

  Yes

  No

  N/A

• Extinguishers are within 75' of flammables?

  Yes

  No

  N/A

• Extinguishers clear of obstructions?

  Yes

  No

  N/A

• Adequate exit signs present & illuminated?

  Yes

  No

  N/A

• Exit doors open easily from inside?

  Yes

  No

  N/A

• Emergency exit lighting operable?

  Yes

  No

  N/A

5.0 Signage

• Eyewash/shower signs present?

  Yes

  No

  N/A

• Doors are properly labeled along exit routes?

  Yes

  No

  N/A

• PPE signage present where needed?

  Yes

  No

  N/A

• High voltage/arc flash labels present?

  Yes

  No

  N/A

• NFPA signs where necessary?

  Yes

  No

  N/A

• No smoking signs posted where applicable?

  Yes

  No

  N/A

• Confined Spaces are labeled appropriately?

  Yes

  No

  N/A

6.0 Walking Working Surfaces

• Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• Entry and walkways kept clear?

  Yes

  No

  N/A

• Walkways adequately and clearly marked?

  Yes

  No

  N/A

• Intersections kept clear of boxes etc?

  Yes

  No

  N/A

• Stair and risers kept clear?

  Yes

  No

  N/A

• Stairs structurally sound and at proper pitch?

  Yes

  No

  N/A

• Are liquid spills removed quickly?

  Yes

  No

  N/A

• Are railings, handrails, handholds & guardrails in place and in good condition?

  Yes

  No

  N/A

• Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• Are footpaths in good condition?

  Yes

  No

  N/A

• Area well lighted?

  Yes

  No

  N/A

• Door swings adequate & safe?

  Yes

  No

  N/A

• Furniture in good condition?

  Yes

  No

  N/A

• Loading area clean and tidy?

  Yes

  No

  N/A

7.0 Work Benches

• Clear of trash?

  Yes

  No

  N/A

• Tools not in use kept in place?

  Yes

  No

  N/A

• No damaged hand tools in use?

  Yes

  No

  N/A

• No damaged power tools in use?

  Yes

  No

  N/A

• Work height correct for the type of work and the employee?

  Yes

  No

  N/A

• No sharp edges?

  Yes

  No

  N/A

8.0 Trash and Rag Management

• Bins located at suitable points around site?

  Yes

  No

  N/A

• Bins emptied regularly?

  Yes

  No

  N/A

• Oily rags and combustible refuse in covered metal continers?

  Yes

  No

  N/A

9.0 Storage

• Materials stored in a neat & organized manner?

  Yes

  No

  N/A

• Shelves are properly loaded?

  Yes

  No

  N/A

• Storage designed to minimize lifting problems?

  Yes

  No

  N/A

• Pathways are kept clear?

  Yes

  No

  N/A

• Ladders used properly for accessing?

  Yes

  No

  N/A

• General condition of shelving good & not damaged?

  Yes

  No

  N/A

10.0 Machines

• Are they kept clean?

  Yes

  No

  N/A

• Area around machines kept clean & clear?

  Yes

  No

  N/A

• Guards in good condition?

  Yes

  No

  N/A

• Starting & stopping devices within easy reach of operator?

  Yes

  No

  N/A

• Drip pans on floor to prevent spillage?

  Yes

  No

  N/A

• Adequate work space?

  Yes

  No

  N/A

• Is lighting adequate?

  Yes

  No

  N/A

• Noise level controlled?

  Yes

  No

  N/A

• No bending or stooping required?

  Yes

  No

  N/A

• Toe boards in place?

  Yes

  No

  N/A

• Operators have been trained and training is documented?

  Yes

  No

  N/A

• Are compressed gas cylinders secure & adequately separated as required?

  Yes

  No

  N/A

• Gauges present as needed/required?

  Yes

  No

  N/A

• Hoist inspections current?

  Yes

  No

  N/A

• Boiler/pressure vessel inspections current?

  Yes

  No

  N/A

• Ventilation adequate?

  Yes

  No

  N/A

11.0 Chemical Safety

• Right-to-Know complete & available to employees at all times?

  Yes

  No

  N/A

• SDS's all present?

  Yes

  No

  N/A

• Risk assessments completed for hazardous substances?

  Yes

  No

  N/A

• All containers labelled correctly?

  Yes

  No

  N/A

• Unused substances properly disposed of?

  Yes

  No

  N/A

• Do special storage conditions apply?

  Yes

  No

  N/A

• Have all employees been trained in the use of hazardous substances?

  Yes

  No

  N/A

• Is required PPE available?

  Yes

  No

  N/A

• Are eyewashes & drench showers easily accessed & working properly?

  Yes

  No

  N/A

12.0 Ladders

• Are all ladders industrial strength?

  Yes

  No

  N/A

• Are ladders in good condition?

  Yes

  No

  N/A

• Only non-conductive ladders used for electrical work?

  Yes

  No

  N/A

• Are ladders labeled legibly & used accordingly?

  Yes

  No

  N/A

• For extension ladders, are ropes, pulleys & treads in a good state of repair?

  Yes

  No

  N/A

13.0 First Aid

• Are first aid cabinets & contents clean & orderly?

  Yes

  No

  N/A

• No contents past the expiration date?

  Yes

  No

  N/A

• Cabinets clearly labeled?

  Yes

  No

  N/A

• Easily accessible?

  Yes

  No

  N/A

• Employees aware of location of cabinet?

  Yes

  No

  N/A

• Are AED's present?

  Yes

  No

  N/A

• Are pads & batteries current & in good working order?

  Yes

  No

  N/A

• Is AED clearly labeled?

  Yes

  No

  N/A

• Access to AED is clear and unobstructed?

  Yes

  No

  N/A

• Has employee training on AED use been performed and documented?

  Yes

  No

  N/A

14.0 Motorized Vehicles

• Seatbelt(s) in good condtion?

  Yes

  No

  N/A

• Horn operational?

  Yes

  No

  N/A

• Safety lights operational?

  Yes

  No

  N/A

• Employee training performed and documented?

  Yes

  No

  N/A

• Tires in good condition?

  Yes

  No

  N/A

• Back-up alarm and other safety features operational?

  Yes

  No

  N/A

• Seat(s) in good condition?

  Yes

  No

  N/A

• Pinch points guarded?

  Yes

  No

  N/A

• Proper fueling techniques followed?

  Yes

  No

  N/A

• If first aid kit or fire extinguisher is maintained on vehicle, have they been inspected and maintained accordingly?

  Yes

  No

  N/A

• Are proper mowing techniques followed while in traffic and on slopes?

  Yes

  No

  N/A

15 Additional Considerations

• PPE in good condition?

  Yes

  No

  N/A

• Restrooms & fountains clean?

  Yes

  No

  N/A

• Break-rooms clean?

  Yes

  No

  N/A

• Locker-rooms adequate & clean?

  Yes

  No

  N/A

• No slip, trip, or fall hazards observed?

  Yes

  No

  N/A

• Pesticides applied under appropriate license?

  Yes

  No

  N/A

• Public access areas (such as parks and playgrounds) maintained in safe condition?

  Yes

  No

  N/A

• Landscaping does not pose security issues?

  Yes

  No

  N/A