Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Section A.1 Walking/Working Surfaces

  • A.1 All interior walkways are properly identified and kept clear.

  • A.2 All exterior walkways are cleared and in good repair.

  • A.3 All floor holes, floor openings, hatchways, manholes, wall openings, and skylights are properly guarded.

  • A.4 Non-slip mats, gratings, false floors, and other like materials are used in areas where slipping is a danger.

  • A.5 All mats, gratings, etc., are in good repair.

  • A.6 All railings and toe boards meet specifications and are in good repair.

  • A.7 All open sided floors, platforms and runways four feet or more above ground or floor level are properly guarded with toe boards installed.

Section B. Illumination

  • B.1 All lighting in work and storage areas is adequate and in good repair.

  • B.2 All lighting in non work areas (drives, passageways, exits, parking lots, shop perimeter, etc.) is adequate and in good repair.

  • B.3 Emergency lighting and exit signs are routinely checked and properly maintained.

  • B.4 All temporary lighting are checked for adequacy, capacity, and proper guarding.

Section C.1 Stairs and Stairways

  • C.1 All stairways are clear of waste/stored materials, adequately illuminated, and have handrails and/or guardrails. Treads and risers are in good repair with non slip surfaces.

Section D. Ladders & Scaffolds

  • D.1 All ladders are maintained in good condition. Damaged ladders are removed from service and tagged as such until replaced/repaired.

  • D.2 All portable ladders are equipped with safety feet.

  • D.3 Precautions are taken to prevent the use of metal ladders where there is a possibility of electrical shock.

  • D.6 Chains or self-closing gates in use at top of all FVL's.

  • D.4 All fixed vertical ladders (FVL) extend at least 36" above the landing and provide at least 3" toe clearance.

Section E. Life Safety

  • E.1 Location and easy accessibility of at least two fire emergency exits (minimum requirement) for each work area, with special attention to high hazard areas (i.e. chemical storage).

  • E.2 Each fire emergency exit is properly marked and illuminated.

  • E.3 The exit route to and beyond the fire doors must be clear and unobstructed.

  • E.4 Fire emergency doors will not be locked from inside. Each is to be equipped with panic or other simple types of release device.

  • D.5 All FVL ≥ 20' in length equipped with cage that extend at least 36" above landing and starts not more than 7' from bottom of ladder, OR are equipped with centerline fall protection.

  • E.5 First Aid supplies are accessible, kept sanitary and stocked.

  • E.6 Site first aid kits contain bloodborne pathogen protective equipment (gloves, etc.).

  • E.7 AED's are accessible, have applicable pad, batteries and accessories, kept sanitary and up-to date.

  • E.8 Eyewash Stations and Emergency Showers are inspected and tested on a regular basis and are placed according to risk.

  • E.9 Emergency Contact information (i.e. fire, ambulance, plant contact list) is located near phones and conspicuously posted.

  • E.10 Alarms systems are maintained and inspected on a regular basis.

  • E.11 Blanket and stretcher is accessible to all employees.

Section F. Fire Suppressioin

  • F.1 All portable fire extinguishers are readily accessible and properly located. Records show servicing is up‑to‑date.

  • F.2 All portable fire extinguishers are inspected monthly for condition.

  • F.3 Fire suppression has been reviewed for its adaptability to the fire risk presented in the immediate area.

  • F.4 Where fire control systems are used, which are a danger in themselves, appropriate warnings are posted.

  • F.5 All potential sources of fire and/or explosion from gases, vapors, fumes, dusts, and mists are inspected for fire safety.

Section G. Electrical Wiring, MCC/PLC Rooms and Equipment

  • G.1 Clearly identified MCC entrances as DANGER and restricted to authorized persons.

  • G.2 Extension cords and other temporary wiring are examined for breaks, fraying, or other defects.

  • G.3 Electrical equipment operating between 50 and 600 volts is protected against accidental contact by an approved cabinet or other enclosure.

  • G.4 Insulation mats and protective gear are provided in all areas where an employee may be exposed to a shock hazard.

  • G.5 Sufficient access and working space is provided and maintained around all electrical equipment including access to disconnecting devices.

  • G.6 In battery rooms, provision has been made for diffusion of gases to prevent the accumulation of an explosive mixture.

  • G.7 Wall openings into MCC/PLC rooms, through which electrical or control lines pass, are to be adequately sealed for prevention of fire penetration.

  • G.8 Extraneous combustible/flammable materials are not stored in MCC/PLC rooms.

  • G.9 Disconnects are labeled to show what they control.

  • G.10 Methods of release - Rescue hook (or similar) is available and employees have been trained in methods of release.

  • G.11 Metering Equipment - Metering equipment is appropriately rated for circuits being tested.7

  • G.12 Insulated Tools - Site has at least one set of insulated tools.

Section H. Pressure

  • H.1 All piping systems are identified by appropriate coding or markings to show what they contain.

  • H.2 Pressure Vessels are inspected as required.

Section I. Housekeeping & Sanitation

  • I.1 Outlets for non-potable water are clearly marked to indicate that the water is not for human use or consumption.

  • I.2 Receptacles for waste are adequate in design (i.e. metal with lids) and number. They are leak-proof, well maintained, and serviced regularly.

  • I.3 Restrooms and locker rooms are kept clean and free from debris. Adequate receptacles with lids for waste are provided and not allowed to overflow.

  • I.4 Gender shared toilets shall be equipped with a lock capable of being locked form the inside.

  • I.5 The lunch room is adequate in size, clean, well‑maintained, and physically separated from areas offering the risk of exposure to toxic materials.

  • I.6 All food is properly stored, refrigerated where appropriate, and handled under acceptable sanitary practices.

  • I.8 Microwaves and refrigerators are maintained in sanitary and safe operational condition.

  • I.9 Hand washing and shower facilities are kept clean and provided with adequate amounts of soap and hand drying materials.

  • I.10 Vending machine areas are maintained in a good sanitary condition and ground tested unless provided with a GFCI connection.

  • I.11 There is no accumulation of dust and other product material within the plant.

  • I.12 There is no accumulation of water, oil, or process compounds on floor surfaces.

Section J. Material Handling & Storage

  • J.1 All slings used in material handling are in good condition with no evidence of excessive wear or visible defects.

  • J.2 All wire ropes and wire rope slings are in good condition with no evidence of mechanical damage, bumps, broken strands, or other visible defects.

  • J.3 All hooks when in use and originally equipped with safety latches shall be in good working order with the latches in place.

  • J.4 Cranes and hoists are in good operating condition, have a regular maintenance schedule, and have no visible defects. Inspection records are properly maintained and proper operating procedures are followed. Load ratings are present. Grade 80 chains are used.

  • J.5 Pre-use inspections - Daily pre-use checks by operators.

  • J.6 Periodic inspections - Inspections done in accordance with OEM specs or regulatory requirements are conducted and documented.

  • J.7 All conveyor systems are in good operating order with no visible defects. There is adequate clearance from aisles and walkways. Stopping devices are adequate in number and location.

  • J.8 All material is stored so as to prevent fire or risk of personal injury.

  • J.9 All commodities are stored, handled and piled with due regard for their fire characteristics.

  • J.10 Outside storage areas are in good condition. Weeds and grass do not obstruct materials or signs.

  • J.11 Hoisting and trolley beams are load rated with rating clearly marked for the operator to see.

Section K. Hand & Portable Powered Tools

  • K.1 All hand and portable power tools are in good operating condition, are equipped with ground wires, and have no defects in wiring.

  • K.2 All portable equipment have necessary guarding devices.

  • K.3 All compressed air equipment used for cleaning operations is regulated at 30 p.s.i. or less.

  • K.4 Trigger locks are absent on hand held tools.

Section. L Machine GGuarding

  • L.1 Pinch points have adequate guarding.

  • L.2 Guarding is designed with ergonomics in mind.

  • L.3 Autostart systems are identified by signage and have audible or visual alarms to warn employees in the area.

Section M. Hazardous Environment.

  • M.1 All dangerous gases, liquids, and other materials are properly labeled and stored.

  • M.2 Protective clothing is worn by employees when hazardous materials are being used.

  • M.3 All flammable material areas are posted with "No Smoking" signs.

  • M.4 All areas where caustics or corrosives are used have been provided with eye fountains and deluge showers.

  • M.5 SDS's are available to employees working with hazardous materials.

  • M.6 Fuel dispensing areas are properly bermed, have posted "No Smoking" signage and adequate fire suppression.

  • M.7 Areas where noise exceeds 85 dBa are marked conspicuously with signage.

  • M.8 Confined space labeling - Labels affixed to all confined spaces.

  • M.9 Rescue equipment - Does the site have rescue equipment available to facilitate a confined space rescue?

Section N. Personal Protective Equipment

  • N.1 Suitable hard hats - Site is using suitable ANSI hardhats that are high-vis color and equipped with high-vis reflective material (e.g. tape, stickers).

  • N.2 Suitable foot wear - Site is using suitable ASTM footwear.

  • N.3 Suitable eye protection - Site is using suitable ANSI Z87 eye/face protection, including side shields.

  • N.4 Suitable Gloves - Site is using suitable gloves based on work requirements.

  • N.5 Suitable safety harnesses - Site is using suitable ANSI fall protection equipment.

  • N.6 Welding/burning protection -Site is using appropriate welding PPE.

  • N.7 Grinding protection - Site has grinding shields for use with fixed and portable grinders.

  • N.8 Personal Flotation -USCG approved life jackets are available when the risk of drowning exists. Life jackets must provide maximum protection available based on task being performed.

  • N.9 Suitable hearing protection - Hearing protection is readily available and used as required.

  • N.10 Suitable respiratory protection -Suitable respiratory protection is available and used as required.

  • N.11 High-visibility clothing (e.g. vests, shirts, coveralls) worn by all visitors, vendors and contractors, and employees.

  • N.12 Loose clothing, adornments and hair are suitably controlled/confined to prevent entanglement with any machinery or device.

  • N.13 First-aid supplies - Site has suitable first aid supplies in clean and sanitary condition.

  • N.14 Arc flash protection - Site has available AFP clothing and is fully compliant with arc flash protection.

Section O. Mobile Equipment & Traffic Management

  • O.1 Mobile equipment inspections are conducted prior to use.

  • O.2 Brake tests are conducted for all mobile equipment as defined by the OEM.

  • O.3 Operators manuals are present on all mobile equipment.

  • O.4 Seat belts on loaders and haul trucks are J386.

  • O.5 All mobile equipment is equipped with lights, horns, reverse warning devices.

  • O.6 Wheel chocks provided for vehicles that are on, or have the potential to be on, mine property.

  • O.7 What is the general condition of mobile equipment for cleanliness and mechanical condition?

  • 0.8 All roadways with two-way traffic are maintained with sufficient width to allow two largest vehicles to pass.

  • O.9 Speed limits and other road marking signs are posted and enforced.

  • O.10 Demarcated pedestrian walkways with physical barriers everywhere possible.

  • O.11 Designated parking zones established for different mobile equipment.

Section P. Hot Work

  • P.1 Welding operations are screened to prevent flash injuries.

  • P.2 Proper eye protection is being worn for the work being done.

  • P.3 All compressed gases are stored and used according to standards including valve protection, chains and stored with valves in off position.

  • P.4 Extra fire extinguishers are present for welding operations.

Section Q. Railroad Operations and Equipment

  • Q.1 Site has an appropriate number of wheel chocks and they are deployed close to the rail loading area.

  • Q.2 Trackmobiles are equipped with air brakes and are maintained functional at all times.

  • Q.3 Rail loading/unloading operations are equipped with fall protection equipment where required.

  • Q.4 Appropriate signage is posted at plant controlled crossings notifying of rail hazards.

Section R. Stockpile Operations

  • R.1 Appropriate signage for drawdown stockpiles is present and visible.

  • R.3 Dump point grade - Dump points are to have a slight uphill grade and be level side to side.

  • R.2 Dump point inspection - Dump points are inspected by Plant Manager (or designee) prior to start of dumping.

  • R.4 Drawdown stockpiles (covered) - Drawdown covered stockpiles where mobile equipment is used shall have overhead indicators of draw points.

Section S. Mining Operations and Equipment

  • S.1 Elevated roadways have adequate berms where required to mid-axle height of the largest vehicle that traverses the roadway.

  • S.2 Haulageways are maintained in good condition.

  • S.3 Mine signage is appropriate for conditions and operations.

  • S.4 Highwalls are appropriately sloped and/or scaled to remove loose/hanging materials or bermed to prevent access.

  • S.5 Floor conditions in the active face are acceptable for operations.

  • S.6 Dump points are sloped appropriately.

  • S.7 Sanitation facilities are provided and accessible where required.

  • S.8 Benches are adequately marked for safety regarding blasting/loading operations.

  • S.9 Dust control measures are adequate during haulage operations.

  • S.10 Blasting safety measures are in place and understood by all affected parties.

  • S.11 What is the general condition of material transfer equipment? (i.e. conveyor, crusher systems etc.)

  • Add signature

  • Add signature

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.