Pennzoil Lube Health and Safety Inspection Report

• Date and Time

• Location

Self-Safety Inspection Checklist

• Spills promptly cleaned up or contained with non-combustible absorbent materials?

  Yes

  No

  N/A

• Storage neat, stable, and orderly?

  Yes

  No

  N/A

• Bathrooms, wash facilities, lunchrooms, locker rooms, maintained in a clean and sanitary condition?

  Yes

  No

  N/A

• Floors, steps, ramps, and other walking surfaces free of any trip hazards and maintained in a good condition free of any spills or hazards that could cause slips or falls?

  Yes

  No

  N/A

• Vehicle exhausts hose and/or collection system in good condition and used?

  Yes

  No

  N/A

• Portable fire extinguishers at assigned areas, accessible, and visible?

  Yes

  No

  N/A

• Portable fire extinguishers in operational condition with current inspection tag?

  Yes

  No

  N/A

• Combustible materials kept clear from heating equipment and other heat producing equipment?

  Yes

  No

  N/A

• Proper eye protection worn at all times in shop areas?

  Yes

  No

  N/A

• Respirators maintained in a clean and operable condition. Respirators properly stored when not in use in a sealed container?

  Yes

  No

  N/A

• Means of egress unobstructed and free of trip hazards?

  Yes

  No

  N/A

• First aid kits readily accessible and properly stocked?

  Yes

  No

  N/A

• Emergency showers/eye washes readily accessible, clean, and operational and appear to be properly maintained?

  Yes

  No

  N/A

• Electrical cords free from damage, properly used, third prong used and grounded?

  Yes

  No

  N/A

• Electric motors, tools, and other equipment free of accumulation of dirt, oil, waste and debris?

  Yes

  No

  N/A

• Ground fault circuit interrupters operational and provided in shop and wash bay areas?

  Yes

  No

  N/A

• Utility work lights in good condition and guard properly around light bulbs?

  Yes

  No

  N/A

• All guards provided on equipment pulleys, gears, sprockets, pinch points, and points of operation to prevent physical contact?

  Yes

  No

  N/A

• Hoses, extension cords, utility lights, tools, and other equipment not being used stored at assigned areas to help prevent trip hazards?

  Yes

  No

  N/A

• Are all hand tools and equipment maintained in a good condition and free of any defects?

  Yes

  No

  N/A

• Are all power tools and equipment maintained in a good condition and free of any defects?

  Yes

  No

  N/A

• Are the working rests on abrasive wheel grinders within 1/8-inch of the wheel?

  Yes

  No

  N/A

• Are spark shields provided on the bench grinders in place?

  Yes

  No

  N/A

• Grinding wheels in good condition free of chips, cracks, grooves, defects, and does not wobble when operated?

  Yes

  No

  N/A

• Are all air tools and equipment maintained in a good condition and free of any defects?

  Yes

  No

  N/A

• Are lifts, hoists, and jacks clean and in good working condition?

  Yes

  No

  N/A

• Lift hoses, connections, controls, lift cylinders, and other components free of any leaks or other defects?

  Yes

  No

  N/A

• Lift safety locks engaged and functional?

  Yes

  No

  N/A

• Vehicles positioned properly on lifts and jacks?

  Yes

  No

  N/A

• Jack safety stands being used when portable jacks are used?

  Yes

  No

  N/A

• Wheels chocks placed in front and back of tires when jacks are being used?

  Yes

  No

  N/A

• Equipment maintained and serviced according to manufacturers guidelines.

  Yes

  No

  N/A

• Are chains, slings, and hooks being inspected by the operator (daily) before use and maintain in operable condition?

  Yes

  No

  N/A

• Service pits covered or guarded when not in use?

  Yes

  No

  N/A

• No leaks or dripping of combustible or flammable liquids?

  Yes

  No

  N/A

• Combustible and flammable liquids used, dispensed, and stored away from ignition sources?

  Yes

  No

  N/A

• Flammable and combustibles properly stored in safety cabinets?

  Yes

  No

  N/A

• All compressed gas cylinders secured/chained and valves capped?

  Yes

  No

  N/A

• Spray room/booth, exhaust system duct work, and other equipment clean from accumulation of deposits of combustible materials?

  Yes

  No

  N/A

• Are all ladders maintained in good condition, joints between steps and side rails tight, and all hardware and fittings securely attached and moveable parts operating freely without binding or undue play?

  Yes

  No

  N/A

• Are ladder rungs, steps, and side rails free from oil, grease, and other foreign materials?

  Yes

  No

  N/A

• Exterior area free of any slip, trip and fall hazards?

  Yes

  No

  N/A

• Dumpster area clean and free of any slip hazards such as oil spills?

  Yes

  No

  N/A

• Seatbelts worn all times when driving?

  Yes

  No

  N/A

• Shop employees are not wearing any rings, jewelry, watches, or torn or loose clothing?

  Yes

  No

  N/A

• Employees with long hair contained under a hat or hair net?

  Yes

  No

  N/A

• Floors: clean, dry, free from debris, clutter<br>and trip hazards

  Yes

  No

  N/A

• Signs are posted when floors are wet (e.g.,<br>when floors are washed, spills)

  Yes

  No

  N/A

• Furniture/office equipment secure from<br>tipping; appropriate for work being done

  Yes

  No

  N/A

• Doors are not blocked

  Yes

  No

  N/A

• Walkways and parking lots are free from<br>snow, ice, water, grease, etc

  Yes

  No

  N/A

• Lighting levels adequate; work areas free<br>from glare

  Yes

  No

  N/A

• Air quality adequate

  Yes

  No

  N/A

• Temperature and humidity adequate

  Yes

  No

  N/A

• Noise levels appropriate, signs indicting<br>hearing protection required where noise<br>levels are high

  Yes

  No

  N/A

• Workers trained in use of personal<br>protective equipment (PPE)

  Yes

  No

  N/A

• Step/ladders have non‐slip surfaces and<br>are in good condition. Secured when<br>stored

  Yes

  No

  N/A

• Step/ladders are positioned and secured<br>safely when in use (observe worker)

  Yes

  No

  N/A

• Work done above 3m follows “Working<br>from Heights” policy and procedures

  Yes

  No

  N/A

• Racks and platforms loaded only within<br>the limits of their capacity

  Yes

  No

  N/A

• A safety data sheet (SDS) for each product<br>is available and accessible (ask worker)

  Yes

  No

  N/A

• WHMIS training: Safe use and storage of<br>hazardous substances (ask worker

  Yes

  No

  N/A

• PPE is available and worn (observe)

  Yes

  No

  N/A

• PPE is maintained (ask worker)

  Yes

  No

  N/A

• Training in PPE use and care (ask worker)

  Yes

  No

  N/A

• Clear access to electrical panels (24 Inches around) and no<br>combustible material stored/posted<br>within 24 inches around

  Yes

  No

  N/A

• Defective tools are tagged and removed<br>from service

  Yes

  No

  N/A

• Manufacturers’ manuals available for all<br>tools and machinery

  Yes

  No

  N/A

Health and Safety Bulletin Board "Postings"

• Occupational Health and Safety Act and<br>Regulations

  Yes

  No

  N/A

• Policies: Health and Safety; Violence<br>and Harassment

  Yes

  No

  N/A

• “Prevention Starts Here” poster

  Yes

  No

  N/A

• WSIB “In Case of Injury” poster

  Yes

  No

  N/A

• Name of health and safety<br>representative

  Yes

  No

  N/A

• Workplace Inspection Report (Monthly)

  Yes

  No

  N/A

• JHSC Meeting Minutes (Monthly unless otherwise stated)

  Yes

  No

  N/A

• First aid certificates are posted and valid

  Yes

  No

  N/A

Fire protection and warning systems

• Emergency lighting; adequate lighting,<br>tested and record of annual inspection

  Yes

  No

  N/A

• Fire exit doors: in good repair, unlocked<br>and free from obstruction (both sides)

  Yes

  No

  N/A

• Fire/emergency alarm systems<br>operational; fire exit signs lit

  Yes

  No

  N/A

• Fire and evacuation plan is posted

  Yes

  No

  N/A

• Workers know the plan (ask a worker)

  Yes

  No

  N/A

Security

• Emergency numbers for internal and<br>external contacts are easily available

  Yes

  No

  N/A

• Visitor/contractor rules are in place

  Yes

  No

  N/A

• Safety measures are in place for anyone<br>working alone (ask worker)

  Yes

  No

  N/A

• Working with money: Safe procedures and<br>emergency procedures are in place

  Yes

  No

  N/A

• Training on workplace violence and<br>harassment (ask worker)

  Yes

  No

  N/A

NOTES

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