Information

  • Document No.

  • Department Audit

  • Plant Location

  • Conducted on

  • Prepared by

  • Signature

Confined Space Program

  • Spaces labeled?

  • Evaluate CS rescue equipment as listed on the log - App B

  • Evaluate CS entry and rescue ropes

  • Evaluate CS Atmospheric Monitoring Devices as listed on the log - App C

  • Other

Contractor Safety Program

  • Evaluate all programs/policies related to the scope of work being performed.

  • Review of equipment/tools being used.

  • Review (current day) self inspection audits

  • Review orientation records

  • Other

Emergency Response and Action Plan

  • External and Internal locations posted

  • Evacuation maps posted in facility (including revision dates)

  • Evaluate emergency exit signs/lights

  • Egress - exit access, the exit, and the exit route<br>Aisle way and exit routes are not blocked and clearly labeled

  • Exit doors - hinged, open in the direction of travel, not blocked

  • Evaluate Emergency Response Equipment (suits, boots, SCBAs, etc.)

  • Other

Electrical Safety Related Work Practices

  • Exposed wiring

  • Improper use of SO cords (wrapped cords, doorways, walls, etc...)

  • 110 panel labeling current and correct (including revision date)

  • Equipment (buckets, cans, disconnects) labeled

  • CO2 fire extinguisher (immediately inside or outside door) and emergency lighting in panel rooms

  • 3 foot clearance in front of electrical panels

  • GFCI used in wet areas

  • Clean rubber mats and/or rubber sole shoes being utilized at panels

  • Missing covers or knock outs

  • Broken or unsecured conduit/conditions of cable tray

  • Sub stations over 600 volts locked

  • No storage of non essential electrical equipment in MCC panel rooms

  • MCC panel rooms limited access (proper training for authorized personnel)

  • Arc Flash Protection (PPE) available to employees / conditions

  • Hot glove test (evaluate process from few employees)

  • Other

Ergonomic Program

  • Ergonomic improvements on floor

  • Stretching program and place and in use

  • Knife sharpening program

  • Other

Fall Protection and Protection Program

  • Evaluate harness & lanyards (good condition, proper storage, etc...)

  • Designated anchor points - locations

  • Rail car fall protection systems

  • Safety swing gates in place and operational

  • Ladder storage and usage

  • Other

Fire Prevention

  • Fire sprinkler system operational

  • Sprinkler main valve locked in open position

  • Fire extinguisher (annual and monthly) inspection tag

  • Oil storage area clean

  • Flammable and combustible stored properly

  • Sprinkler heads at least 18 inches from material

  • No smoking signs in applicable places

  • Fire alarms panels are functional

  • Flammable cabinets in good shape and orderly

  • Boiler permits posted / current

  • Other

Hot Work Permit Program

  • Verify with MTC employees - Hot Work classification map

  • Designated Welding Area posting

  • Welder condition (welders and leads) - production areas

  • Other

Chemical Handling and Storage

  • Eyewash and shower available & operational - correct activation handle

  • Labeling per Hazcom Program

  • Designated bulk chemical storage areas (compatible chemicals / clean and orderly)

  • Piping labeled and identified

  • Chemical specific SOPs have been developed for receiving, handling, PPE, mixing and storage. SOPs are made available to employees.

  • SDS books - updated

  • Other

Industrial Hygiene

  • H2S monitor required postings or markings

  • Carbon Dioxide "in use" postings

  • Radiation signs markings/postings

  • Evaluate Respirators and cartridges (proper storage)

  • Verify all monitoring equipment is working properly (any used for quarterly monitoring)

  • Other

Counter Balances, Chains and Chain Hoists

  • Chain in good shape and stamped

  • Cable in good shape and rated

  • Identified rating on hoist and structure

  • Safety chain or cable in place correctly on all balances (including wizard motors)

  • Safety clip on hoist hook

  • Cable clamp installed properly

  • Other

Lockout Tag-out

  • Lockable valves

  • Lockout procedures posted at drive or available

  • Yellow out of service lock / tag process in place

  • Other

Machine Guarding

  • Shaft key ways smooth

  • No set screws protruding above lock collar

  • Shafts not extended more than one half diameter

  • Auger guarding that requires a tool to remove or interlock that shuts equipment down when lid is raised

  • Incline conveyor guarding (cross under, work stations, etc... guarded to 8 feet)

  • Sprockets and chains totally enclosed (6' 8" & unless work station)

  • Pulley belt drives totally enclosed (6' 8" & unless work station)

  • Coupling guards covered with safety devices

  • Dual handle controls on scissor type devices

  • Safety shield in place, tongue guard (1/4 inch) and tool rest (1/8 inch) on grinders proper adjusted and mounted securely in place

  • Other

Personal Protective Equipment

  • Evaluate employee PPE - based off of PPE check list

  • Randomly inspect PPE for any defects

  • Other

Knife Handling Program

  • Evaluate transportation of knives (including whizards, air knives, skinner blades) following program

  • Designated location for storage of skinning blades (new/used)

  • Other

PIT Program

  • Evaluate driving at safe distance and speed

  • Cautions/warning signs posted

  • Randomly evaluate PIT license

  • Evaluate daily pre shift inspections

  • SOP for fueling/battery charging -posted in designated locations

  • Loading dock policy posted in load out areas

  • Evaluate PIT for working lights, horns, fire extinguisher, etc

  • Other

Rail car, tanker, hopper safety program

  • Evaluate pedestrian warning systems

  • Blue light / flag system in place

  • Other

Vertical Reciprocating Conveyor

  • Evaluate freight lifts (doors, limit switches, etc...)

  • Other

Walking Surfaces, Fixed Stairs, Stairways

  • Floors clean and without obstructions

  • Floor openings that drop more than 4 feet have handrails and toe boards

  • Fixed stairs a minimum of 22 inches unless egress.

  • Fixed stair angle less than 50 degrees

  • Stair railing between 30 and 34 inches

  • Stairwells over 88 inches wide need center handrail

  • Stair treads slip resistant and uniform in height and tread

  • Industrial railing 42 inches with 21 inch intermediate and 4 inch toe board

  • Floor drain covers securely in place

  • All floor openings greater than 2 inch by 2 inch have covering

  • Other

Maintenance shops

  • Welding curtain available

  • Housekeeping

  • Air regulators for bench air hoses set at 30 pounds or less

  • Safety shield in place, Tongue guard (1/4 inch) and tool rest (1/8 inch) on grinders proper adjusted and mounted securely in place.

  • Drill presses, fixed grinders, etc... Securely anchored

  • Oxygen and fuel cylinders separated by fire resistant wall or 25 feet apart

  • Compressed cylinders properly secured and capped

  • Welder condition (welders and leads)

  • Torch cart condition (back flow regulators, gauges)

  • Hand tools in safe condition

  • Other

Roof

  • No signs of smoking

  • Leading edge warning system (fall protection)

  • Stairs, cross overs, ladder conditions

  • Fan covers, skylights and general guarding in place

  • Housekeeping (build up of product, extra equipment, lighting, etc...)

  • Roof access limited (authorized only, locked)

  • Other

Exterior Facility Grounds

  • Housekeeping (scrap material, chemical storage, closed doors, etc...)

  • Accumulation locations

  • Bulk chemical wash / storage areas

  • Fuel storage locations (housekeeping, signs of smoking, etc...)

  • Locking glad hand, jack stands and wheel chocks (dock locks)

  • Other

Other (Misc)

  • Any other possible hazardous conditions found

  • Other

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.