Sections

Safety and Housekeeping Audit Information

Name of Auditor

Date of Audit

Unit Audited

Posting Requirements

OSHA Poster Posted

Emergency Phone Numbers Posted

Hearing Protection Signs

Eye Protection Sign

Head Protection Sign

Foot Protection Sign

Reflective Gear Sign

Add Pictures Here.
Safety Program

Daily Safety/ Job Briefing Conducted & Documented

Safety Manuel, Forms and Rulebook Accessible

MSDS Complete and Accessible

Chemical Inventory Complete & Current

Assured Grounding Form Current

PPE Hazard Assessment Accessible

Add Pictures Here.
Railroad Training Compliance

RWP Training - All Employees

Contractor Orientation - All Employees

Holland/OSHA Training - All Empoyees

Add Pictures Here.
Emergency Equipment

First Aid Kit - Fully Stocked and Up-to-Date (no expired materials)

Eyewash Available and Location Marked

Warning Triangle

Flares or Fusees ( for night time accidents)

Add Pictures Here.
Fire Protection/Prevention Program

Fire Extinguisher Location Marked

Secure Fire Extinguisher In Cab (mounted and fixed)

Secure Fire Extinguisher in Work Area (mounted and fixed)

Monthly Fire Extinguisher Inspection Current and Marked on Back Of Tag

Yearly Extinguisher Inspection Current (From beginning year to expiration year)

Used Rags Disposed of Off Unit or In Approved oily Rag Storage Can

Flammable Liquids stored in Approved Safety Cabinets/Cans

Add Pictures Here.
Personal Protective Equipment

Steel-Toed Work Boots on All Personnel (Minimum Height of 6" from top of Heel, All Leather, Defined Heel & Lace up Only. NO SLIP ONS)

Safety Glasses Worn Outside of Unit at All Times

Hearing Protection Worn Outside of Unit (as required)

Safety Reflective Vest Worn Outside Vehicle at All Times By Employees and Visitors Alike.

Head Protection Worn Outside of Unit.

ANSI Approved Laser Safety Goggles Available and Stored Properly.

ANSI Approved Laser Safety Goggles Worn At All times by trained Employees Servicing or Maintaining Laser Equipment.

Add Pictures Here.
Power Tools - General

Double-Insulated Tools (No Frays In Cords, No Cracks in Case and In Good Condition)

Other Tools - (Assured Grounding Tested and in Good Working Condition)

Extension Cords (Assured Grounding Tested and IN Good Working Condition)

Grinders, etc. And All Other Equipment With Guards have Original Guards Mounted on Them.

Add Pictures Here.
LockOut/TagOut & Hazcom

Unit LOTO Procedures Available On Unit

Unit LOTO Kit Available and Fully Stocked with Locks, Tags etc.

All Paints and Materials stored In LAbeled And Approved Containers.

Extra Haz-Com Labels Stored On Unit

Add Pictures Here.
DOT Compliance

Hours Of Service (Logs) For Each Driver Are Current and Complete

Daily Inspections Documented

Annual Inspection Document On Unit

Copy Of FMCSR Regulations On unit

No Apparent Log Or Hours of Service Violations

License Plates and insurance Card (Cab Card) On Unit and Current.

Add Pictures Here.
Vehicle Equipment

Driving Lights, Turning Signals, Braking Lights and Operating Lights Are All Operable.

Windshield Wipers & Defrost Operate

No Cracks In Windshield

Brakes, Steering, Horn Fully Operate

Seat Belts Operate And Are Used

No Apparent oil or fluid Leaks

Add Pictures Here.
Hand Tools & Equipment

All Hand Tools In Good Condition

Add Pictures Here.
Safety and Housekeeping

Cab Of Unit Clean and Organized

Work Area of Unit Clean, Organized and CLear Of Tripping Hazards

Ladders, Platforms, Handrails and steps Are In Safety and Operable Condition

Add Pictures Here.

New Items

Safety Behavior Of Personnel

Employees follow Safe Lifting Practices At All Times

Employees Never Foul A Track Until On-Track Safety Is Clearly Established

Defensive driving Techniques Are Practiced For All On-Road Driving

LOTO is Utilized For All Maintenance Which Could Exposed Employees To Hazardous Energies.

Employees Walk Cautiously On Ballast and NEVER On Rail

Employees Always Wear Seat Belts While In Transit

Employees Are Diligent About Wearing THeir Personal protective Equipment.

Employees Never Place Themselves In "The Line Of Fire" of Tools Equipment, Materials, etc.

Employees Use Ergonomically Correct body Postures When Working At Video Display Terminals/Computers.

Employees Select And Use The Correct Tools For The Job At Hand.

When Grinding, Workers Wear A Face Shield and Safety Goggles.

Employees Can Easily Obtain am MSDS For A Chemical WHen Asked.

Employees Clearly Demonstrate Their Knowledge Of Safety Rules.

Employees Use Proper Three Point Contact While Ascending and Descending Ladders and Stairs. They Require The Same Of Visitors.

Smart Fields

General

Condition OF Floors

Condition Of Walls

Condition Of Ceiling

Condition Of Buffet Area

Cleanliness Of Refrigerator

Condition Of Lockers

Light Fixture Working

Light Fixture Clean

Mission Sign

Measurable Objectives Sign

Availability Of Confidential Information

Condition OF AC's

Truck Cab

Condition Of Dash

Condition Of Floors

Condition OF Windows

Condition Of Radios

Storage Areas

Organization

Tidiness

Cabinets/Bins Labeled

Camera/Laser Storage

Anti-Static Bags

Tool Room

Light Fixture Working

Light Fixture Clean

Mission Sign

Measurable Objectives Sign

Availability Of Confidential Information

Condition Of AC's

Window Condition

Electrical Cabinets

UPS

Condition Of Tools

Condition Of Toll Cabinets

Computer Cabinet

Door Condition

Cleanliness

Air Filter System

Operating Temperature

Work Station

Condition Of Monitors

Condition Of Keyboard Mouse

Condition Of Printer

Manuals/CDs

Customer Area

Neat and Tidy

Free Of Clutter

Receptacles Working

Seat and Table Clean

Employee Grooming

In Company Approved Uniform

Neat And Tidy Appearance

Condition Of PPE

Rank Employee On A Scale From 0 to 5 (0 being the worst )
Employee well represents Holland to Customers
Person Making The Corrections

Date Of Corrections
Select date
Add Comments:

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.