Periodic Inspection 108.1 Appendix 1

• Inspection Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

1.0 - Previous inspection

• 1.1 - Has the last inspection been reviewed?

  Yes

  No

  N/A

• 1.2 - Are there no outstanding actions?

  Yes

  No

  N/A

2.0 Production Area

• 1- Trash cans, Hoppers, CES & Recycling Containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Waste properly segregated?

  Yes

  No

  N/A

• C- Is there hazardous waste in containers?<br>

  No

  Yes

• 2- Supply Cabinets & Flammable Cabinets

  Completed

  Not Completed

• A- Are containers labeled & readable?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are containers upright & closed when no it use?

  Yes

  No

  N/A

• 3- Equipment

  Completed

  Not Completed

• A- Are there any leaks?

  No

  Yes

• B- Have leaks been labeled?

  Yes

  No

  N/A

• C- Is Weld curtain properly functioning?

  Yes

  No

  N/A

• D- Are there any oils on the floor?

  No

  Yes

• E- Is welding exhaust duct work near the point of welding?

  Yes

  No

  N/A

• F- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

• 4- Misc.

  Completed

  Not Completed

• A- Have any new chemicals been brought into the area?

  No

  Yes

• B- Is cardboard being used on floor in place of matting?

  No

  Yes

• 5- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing PPE?

  Yes

  No

  N/A

3.0 - Maintenance

• 1- Trash Cans, Hoppers, & Recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Is waste properly segregated?

  Yes

  No

  N/A

• C- Is there Hazardous waste in containers?

  No

  Yes

• D- Are signs adequate?

  Yes

  No

  N/A

• 2- Oil Drums, Waste Drums

  Completed

  Not Completed

• A- Are drums labeled?

  Yes

  No

  N/A

• B- Are drums closed when not in use?

  Yes

  No

  N/A

• C- Are drums in good condition?

  Yes

  No

  N/A

• D- Are there any full waste containers to be removed?

  Yes

  No

  N/A

• 3- Supply Cabinets & Flammable Cabinets

  Completed

  Not Completed

• A- Are containers labeled & readable?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are containers upright & closed when not in use?

  Yes

  No

  N/A

• 4- Equipment

  Completed

  Not Completed

• A- Are there any leaks?

  No

  Yes

• B- Have leaks been labeled?

  Yes

  No

  N/A

• C- Is there any oils on the floor?

  No

  Yes

• D- If you have a grinder is it working properly and machine guard in place?

  Yes

  No

  N/A

• 5- Waste Satellite Area (Generator Room)

  Completed

  Not Completed

• A- Do drums/containers have accurate complete labels affixed?

  Yes

  No

  N/A

• B- Are drums/containers in good condition & closed when not in use?

  Yes

  No

  N/A

• C- Are signs posted?

  Yes

  No

  N/A

• D- Is emergency equipment available & working?

  Yes

  No

  N/A

• E- Is there more than 55 gallons?

  Yes

  No

  N/A

• F- Are drums located only in designated areas?

  Yes

  No

  N/A

• G- Are full drums dated within one day?

  Yes

  No

  N/A

• H- Are there full waste containers to be removed?

  Yes

  No

  N/A

• I- What are the contents & weight of the full drum?

  Yes

  No

  N/A

• 6- Hazardous Materials & Flammable Storage Area

  Completed

  Not Completed

• A- Are accurate, complete labels affixed?

  Yes

  No

  N/A

• B- Are storage cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are aisles open?

  Yes

  No

  N/A

• D- Are containers closed when not in use?

  Yes

  No

  N/A

• E- Are warning signs posted for PPE or special hazards?

  Yes

  No

  N/A

• F- Are materials stored only in approved areas?

  Yes

  No

  N/A

• G- Is Secondary containers in good condition?

  Yes

  No

  N/A

• H- Is spill response equipment available?

  Yes

  No

  N/A

• 7- Exterior

  Completed

  Not Completed

• A- Check all storm water outfalls for indications of any discharges.

  Safe

  At Risk

  N/A

• B- Any leaks, spills, debris or improperly stored material?

  No

  Yes

• C- Orders or noise at property line?

  No

  Yes

• D- Signs of visible emissions?

  No

  Yes

• E- Check transformers for discharges.

  Safe

  At Risk

  N/A

• 8- Misc.

  Completed

  Not Completed

• A- Have any new chemicals been brought into the are?

  No

  Yes

• B- Is cardboard being used on the floor in place of felt matting?

  No

  Yes

• 9- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessable?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

4.0 - Quality Area

• 1- Trash hoppers, trash cans & recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Is the area neat and clean?

  Yes

  No

  N/A

• C- Waste properly segregate?

  Yes

  No

  N/A

• D- Are signs adequate?

  Yes

  No

  N/A

• E- Is there Hazardous waste in hoppers/cans?

  No

  Yes

• 2- Supply cabinets & flammable cabinets.

  Completed

  Not Completed

• A- Are accurate & complete labels affixed?

  Yes

  No

  N/A

• B- Are all containers in an upright position

  Yes

  No

  N/A

• C- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• D- Are aisles open?

  Yes

  No

  N/A

• E- Are containers closed when not in use?

  Yes

  No

  N/A

• F- Are containers in good condition?

  Yes

  No

  N/A

• G- Are warning signs posted for PPE or special hazards?

  Yes

  No

  N/A

• H- Are materials stored only in approved areas?

  Yes

  No

  N/A

• I- Is area neat and clean?

  Yes

  No

  N/A

• 3- Lab

  Completed

  Not Completed

• A- Is lab neat and clean?

  Yes

  No

  N/A

• B- Are all containers properly labeled?

  Yes

  No

  N/A

• C- Are recyclables & wastes properly segregared?

  Yes

  No

  N/A

• 4- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

5.0 - Shipping Area

• 1- Trash hoppers, trash cans & recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Is the area neat and clean?

  Yes

  No

  N/A

• C- Waste properly segregated?

  Yes

  No

  N/A

• D- Are signs adequate?

  Yes

  No

  N/A

• E- Is there Hazardous waste in hoppers/cans?

  No

  Yes

• 2- Supply cabinets & flammable cabinets

  Completed

  Not Completed

• A- Are accurate & complete labels affixed?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are aisles open?

  Yes

  No

  N/A

• D- Are containers closed when not in use?

  Yes

  No

  N/A

• E- Are containers in good condition?

  Yes

  No

  N/A

• F- Are warning signs posted for PPE or special hazards?

  Yes

  No

  N/A

• G- Are storage racks properly labeled?

  Yes

  No

  N/A

• 3- Docks

  Completed

  Not Completed

• A- Are the drains & docks free of debris?

  Yes

  No

  N/A

• B- Is the area neat and clean?

  Yes

  No

  N/A

• C- Any trucks leaking oil or antifreeze?

  No

  Yes

• D- Have all leaks and spills been reported to the Environmental Manager?

  Yes

  No

  N/A

• E- Are dock chains properly in place?

  Yes

  No

  N/A

• 4- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

• 5- Exterior

  Completed

  Not Completed

• A- Walk exterior of building to determine if there are leaks spills or improperly stored materials.

  Safe

  At Risk

  N/A

• B- Is the area neat and clean?

  Yes

  No

  N/A

• C- Are there any visible sign of emissions?

  No

  Yes

• D- Check all dock stands for any sign of leakage

  Safe

  At Risk

  N/A

• E- Check Dok Loks for any signs of leakage

  Safe

  At Risk

  N/A

• 6- Forklifts, stock chases, chargers & other equipment

  Completed

  Not Completed

• A- Are there any leaks on forklifts, stock chasers, etc.?

  No

  Yes

• B- Are there any emissions?

  No

  Yes

• C- Is the equipment stored properly or parked in the correct area?

  Yes

  No

  N/A

6.0 - Outside Perimeter

• 1- Trash hoppers, trash cans & recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Is the area neat and clean?

  Yes

  No

  N/A

• C- Waste properly segregated?

  Yes

  No

  N/A

• D- Are there any open containers?

  No

  Yes

• 2- Oil drums, waste drums & exhaust drums

  Completed

  Not Completed

• A- Are drums labeled?

  Yes

  No

  N/A

• B- Are drums closed when not in use?

  Yes

  No

  N/A

• C- Are drums in good condition?

  Yes

  No

  N/A

• D- Are any full waste containers to be removed?

  No

  Yes

• 3- Grounds & parking lots

  Completed

  Not Completed

• A- Are there cigarette butts on the ground?

  No

  Yes

• B- Are there trash, paper, cans, etc on the ground?

  No

  Yes

• C- Are there any metal stored outside?

  No

  Yes

• D- Any signs of leaks?

  No

  Yes

• 4- Waste Satellite Area

  Completed

  Not Completed

• A- Are there any satellite areas?

  Yes

  No

  N/A

• B- Do drum/containers have accurate, complete labels affixed?

  Yes

  No

  N/A

• C- Are signs posted?

  Yes

  No

  N/A

• D- Are drums/containers in good condition and closed when not in use?

  Yes

  No

  N/A

• E- Are drums located only in designated areas?

  Yes

  No

  N/A

• F- Are there any full waste containers to be removed?

  No

  Yes

• 5- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

7.0 - General Waste Accumulation

• 1- Trash hoppers, trash cans, & recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Waste properly segregated?

  Yes

  No

  N/A

• C- Is there hazardous waste in containers?

  No

  Yes

• 2- Oil drums, waste drums & exhaust drums

  Completed

  Not Completed

• A- Are drums labeled?

  Yes

  No

  N/A

• B- Are drums closed when not in use?

  Yes

  No

  N/A

• C- Are drums in good condition?

  Yes

  No

  N/A

• D- Are there any waste containers to be removed?

  No

  Yes

• 3- Hazardous materials and flammable storage areas (Not Waste Areas)

  Completed

  Not Completed

• A- Are accurate complete labels affixed?

  Yes

  No

  N/A

• B- Are storage cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are aisles open?

  Yes

  No

  N/A

• D- Are containers closed when not in use?

  Yes

  No

  N/A

• E- Are warning signs posted for PPE or special hazards?

  Yes

  No

  N/A

• F- Are materials stored only in approved areas?

  Yes

  No

  N/A

• G- Is secondary containment in good condition?

  Yes

  No

  N/A

• H- Is spill response equipment in good condition?

  Yes

  No

  N/A

• 4- Equipment

  Completed

  Not Completed

• A- Are there any leaks?

  No

  Yes

• B- Have leaks been labeled?

  Yes

  No

  N/A

• 5- Solid Waste Area

  Completed

  Not Completed

• A- Are containers and compactors in good condition?

  Yes

  No

  N/A

• B- Is the area neat and clean?

  Yes

  No

  N/A

• C- Is there recyclable or hazardous waste in container?

  No

  Yes

• D- Are signs adequate?

  Yes

  No

  N/A

• 6- Waste area

  Completed

  Not Completed

• A- Are any waste containers full and ready to be recycled?

  No

  Yes

• B- Do drums/containers have accurate and complete labels affixed?

  Yes

  No

  N/A

• C- Are signs posted?

  Yes

  No

  N/A

• D- Are drums/containers in good condition and closed when not in use?

  Yes

  No

  N/A

• E- Are all drums located in designated areas?

  Yes

  No

  N/A

• F- Are drums, buckets, or containers w/fluids on spill containment structure?

  Yes

  No

  N/A

• G- Are there any chemicals that do not belong?

  No

  Yes

• 7- Misc

  Completed

  Not Completed

• A- Have any new chemicals been brought into the area?

  Yes

  No

  N/A

• 8- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

8.0 - Rework Area

• 1- Trash cans, hoppers, CES & recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Waste properly segregated?

  Yes

  No

  N/A

• C- Is there hazardous waste in containers?

  No

  Yes

• 2- Supply cabinets & flammable cabinets

  Completed

  Not Completed

• A- Are containers labeled and readable?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are containers upright & closed when not in use?

  Yes

  No

  N/A

• 3- Equipment

  Completed

  Not Completed

• A- Are there any leaks?

  No

  Yes

• B- Have leaks been labeled?

  Yes

  No

  N/A

• C- Is there any oils on the floor?

  No

  Yes

• D- If you have a grinder is it working properly?

  Yes

  No

  N/A

• 4- Hazardous Materials ad flammable storage areas (not waste areas)

  Completed

  Not Completed

• A- Are accurate and complete labels affixed?

  Yes

  No

  N/A

• B- Are storage cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are aisles open?

  Yes

  No

  N/A

• D- Are containers closed when not in use?

  Yes

  No

  N/A

• E- Are warning signs posted for PPE or special hazards?

  Yes

  No

  N/A

• F- Are materials stored only in approved areas?

  Yes

  No

  N/A

• G- Is secondary containment in good condition?

  Yes

  No

  N/A

• H- Is spill response equipment available?

  Yes

  No

  N/A

• 5- Misc

  Completed

  Not Completed

• A- Is there anything that needs attention in the rework shop area?

  No

  Yes

• 6- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

9.0 - Compressor

• 1- Trash cans, hoppers, recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Waste properly segregated?

  Yes

  No

  N/A

• C- Is there hazardous waste in containers?

  No

  Yes

• 2- Oil drums, Waste drums

  Completed

  Not Completed

• A- Are drums labeled?

  Yes

  No

  N/A

• B- Are drums closed when not in use?

  Yes

  No

  N/A

• C- Are drums in good condition?

  Yes

  No

  N/A

• D- Are there any full waste containers to be moved?

  No

  Yes

• 3- Supply cabinets & flammable cabinets

  Completed

  Not Completed

• A- Are container labeled & readable?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are containers upright & closed when not in use?

  Yes

  No

  N/A

• 4- Equipment

  Completed

  Not Completed

• A- Are there any leaks?

  No

  Yes

• B- Have leaks been labeled?

  Yes

  No

  N/A

• C- Is there any oils on the floor?

  No

  Yes

• 5- Drains

  Completed

  Not Completed

• A- Are there warning signs affixed to all drains?

  Yes

  No

  N/A

• B- Are there any signs of dumping in drains?

  No

  Yes

• C- Are drains covered?

  Yes

  No

  N/A

• 6- Drum containers

  Completed

  Not Completed

• A- Are drums located only in designated areas?

  Yes

  No

  N/A

• B- Are full drums dated within one day?

  Yes

  No

  N/A

• C- Are there any full waste containers to be removed?

  No

  Yes

• D- What are the contents & weight of the full drum?

  Yes

  No

  N/A

• E- Are drums in good condition?

  Yes

  No

  N/A

• F- Are there any leaking drums?

  No

  Yes

• 6- Hazardous materials & flammable storage areas (Not Waste areas)

  Completed

  Not Completed

• A- Ae accurate and complete labels affixed?

  Yes

  No

  N/A

• B- Are storage cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are aisles open?

  Yes

  No

  N/A

• D- Are containers closed when not in use?

  Yes

  No

  N/A

• E- Are warning signs posted for PPE or special hazards?

  Yes

  No

  N/A

• F- Are materials stored only in approved areas?

  Yes

  No

  N/A

• G- Is secondary containment in good condition?

  Yes

  No

  N/A

• H- Is spill response equipment available?

  Yes

  No

  N/A

• 7- Misc

  Completed

  Not Completed

• A- Have any new chemicals been brought into the area?

  No

  Yes

• B- Is cardboard being used on the floor in place of felt matting?

  No

  Yes

• 8- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in good working condition?

  Yes

  No

  N/A

10.0 - Stockroom Area

• 1- Trash cans, hoppers, recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Waste properly segregated?

  Yes

  No

  N/A

• C- Is there hazardous waste in containers?

  No

  Yes

• D- Are signs adequare?

  Yes

  No

  N/A

• 2- Oil drums, Waste Drums

  Completed

  Not Completed

• A- Are drums labeled?

  Yes

  No

  N/A

• B- Are drums closed when not in use?

  Yes

  No

  N/A

• C- Are drums in good condition?

  Yes

  No

  N/A

• D- Ae there any full waste containers to be moved?

  No

  Yes

• 3- Supply cabinets & flammable cabinets

  Completed

  Not Completed

• A- Are containers labeled and readable?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are containers upright and closed when not in use?

  Yes

  No

  N/A

• 4- Equipment decommissioned

  Completed

  Not Completed

• A- Are there any leaks?

  No

  Yes

• B- Have leaks been labeled?

  Yes

  No

  N/A

• C- Is there any oils on the floor?

  No

  Yes

• 5- Chemicals

  Completed

  Not Completed

• A- Are chemicals stored in correct manner?

  Yes

  No

  N/A

• B- Are there any chemicals on shelves?

  No

  Yes

• 6- Drums, containers

  Completed

  Not Completed

• A- Are accurate complete labels affixed?

  Yes

  No

  N/A

• B- Are storage cabinets in good condition with sufficient space so that materials can be safely moved?

  Yes

  No

  N/A

• C- Are aisles open?

  Yes

  No

  N/A

• D- Are containers closed when not in use?

  Yes

  No

  N/A

• E- Are warning signs posted for PPE or special hazards?

  Yes

  No

  N/A

• F- Are materials stored only in approved areas?

  Yes

  No

  N/A

• G- Is secondary containment in good condition?

  Yes

  No

  N/A

• H- Is spill response equipment available?

  Yes

  No

  N/A

• 7- Area

  Completed

  Not Completed

• A- Are aisles clear?

  Yes

  No

  N/A

• B- Are all parts up on shelf?

  Yes

  No

  N/A

• C- Is area clean?

  Yes

  No

  N/A

• 8- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

11.0 Office

• 1- Trash cans, hoppers, CES & recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Waste properly segregated?

  Yes

  No

  N/A

• C- Is there hazardous waste in containers?

  No

  Yes

• 2- Supply cabinets & flammable cabinets

  Completed

  Not Completed

• A- are cabinets labeled and readable?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are containers upright and closed when not in use?

  Yes

  No

  N/A

• 3- Chemicals and recyclables

  Completed

  Not Completed

• A- Are batteries disposed of properly?

  Yes

  No

  N/A

• B- Are printer toners disposed of properly?

  Yes

  No

  N/A

• C- Are electronics disposed of properly?

  Yes

  No

  N/A

• D- Is paper recycled?

  Yes

  No

  N/A

• 4- Misc

  Completed

  Not Completed

• A- Have any new chemicals been brought into the area?

  No

  Yes

• 8- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

12.0 - Break Room/ Janitor Area

• 1- Trash cans, hoppers, CES & recycle containers

  Completed

  Not Completed

• A- Are containers in good condition?

  Yes

  No

  N/A

• B- Waste properly segregated?

  Yes

  No

  N/A

• C- Is there any hazardous waste in containers?

  No

  Yes

• 2- Supply cabinets & flammable cabinets

  Completed

  Not Completed

• A- Are containers labeled and readable?

  Yes

  No

  N/A

• B- Are cabinets in good order with sufficient space so that materials can be safely removed?

  Yes

  No

  N/A

• C- Are containers upright and closed when not in use?

  Yes

  No

  N/A

• 3- Chemicals and recyclables

  Completed

  Not Completed

• A- Are there any chemicals stored in cabinets?

  No

  Yes

• B- Are there any improperly stored chemicals?

  No

  Yes

• 4- Drains

  Completed

  Not Completed

• A- Are there warning signs affixed to all drains?

  Yes

  No

  N/A

• B- Are there any signs of dumping in drains?

  No

  Yes

• C- Are drains covered?

  Yes

  No

  N/A

• 5- Misc

  Completed

  Not Completed

• A- Have any new chemicals been brought into the area?

  No

  Yes

• 6- Health & Safety

  Completed

  Not Completed

• A- Are fire exits accessible/not blocked?

  Yes

  No

  N/A

• B- Are fire extinguishers within inspection dates and easily accessible?

  Yes

  No

  N/A

• C- Is there water on the floor?

  No

  Yes

• D- Are workers wearing proper PPE?

  Yes

  No

  N/A

• E- Are electrical panels and machines in proper/safe working order?

  Yes

  No

  N/A

Sign Off

• Operations Manager

  Sign

• Auditor's signature

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