Title Page

  • Conducted on

  • Prepared by

  • Location

Fall Protection

  • Are fall protection devices or fall protection areas going to be inspected?

  • Scaffolding not properly adjusted sides to ends of unit to prevent falls (i.e. bridges more than 6" from unit

  • Fall protection harness not being worn, or proper fall protection device not in place, while working more than 4 feet above the floor

  • Protective chains/gates are not in place at mezzanine/scaffolding loading areas and other access points. All other handrails meet requirements.

  • Employees working below an object that could call/employees operating a hoist or scaffolding without clearing the area

  • Scaffolding and hoist controls not functioning properly

  • Items set on scaffold or on top of units that re heavy and not secured (i.e..air conditioners, saws, and drills

Powered Equipment

  • Were deficiencies found with powered equipment during this audit?

  • Powered industrial equipment guard defective

  • Powered industrial equipment guard missing

  • Powered industrial equipment left running unattended

  • Powered industrial equipment being serviced without being locked out

  • Unsafe work practices while operating saw/power equipment

  • Power equipment brake failure on saw motor

  • Power equipment failure to return to home position

  • Saw/machinery not properly secured/anchored

  • No push stick evident

  • Poor housekeeping at/or around and saw/machinery area

  • Failure to use a staple gun in the correct manner

  • Staple gun safety defeated

Material Handling and Storage

  • Will material handling and storage elements be inspected in this audit?

  • Daily forklift inspections complete

  • Pallets/materials/misc. items not being stored safely

  • Hopper safety latches not being utilized

  • Items stored on racks not secure

  • Items stored on racks protruding into aisle/walkway

  • Items stored on mezzanines not secure

  • Pole stops or other devices used to secure material not in place

Personal Protective Equipment (PPE)

  • Will PPE compliance be inspected during this audit?

  • Is all other task specific PPE being worn?

  • Employees/vendors not wearing eye protection when in the plant

Work Practices

  • Were improper work practices observed in this audit?

  • Employees running in the facility

  • Employees jumping from unit to floor

  • Employees throwing scrap into hoppers more than 6 feet away

  • Failure to use utility knives correctly

  • Employees carrying items 25 pounds on or over their head

  • Hopper safety latches not being utilized

  • Non-compliant air blowers being used

Cranes and Hoists

  • Were safety elements of cranes and hoists inspected during this audit?

  • Hoists being used beyond capacity limits

  • Crane pendant damaged

  • Crane controller functions illegible

  • Crane pendant missing warning tag

  • Employees walking/working under a suspended load


  • Was electrical safety done during this audit?

  • Frayed, cut or damaged electrical cords being used

  • Electrical cabinet doors open

  • Electrical cabinet obstructed

  • Items being stored in electrical area

  • Missing knockout on or inside electrical panel/receptacle

  • Damaged electrical cabinet/receptacle

  • Electrical cords being used as permanent wiring

  • Improper use or RPT (power strip)

  • Electrical cords run through wall holes/doorways

  • Exposed battery terminals

  • Broken strain relief

  • Breaker boxes/transformers in defective condition

  • Improper storage in/on electrical equipment

Fire Protection

  • Was fire protection inspected during this audit?

  • Fire extinguisher obstructed

  • Fire extinguisher not properly mounted

  • Fire extinguisher sign not present

  • Fire extinguisher sign obscured

  • Fire extinguisher missing

Exit Routes/Emergency Planning

  • Were exit routes and emergency planning components inspected?

  • Obstructed exit door, interior/exterior

  • Emergency exit light not illuminated

  • Emergency exit light damaged

Hazcom/Chemical Storage

  • Was Hazcom/chemical storage inspected?

  • Improper storage on flammable cabinet

  • Improper storage of flammable liquids

  • Unmarked/illegible chemical container

  • Flammable cabinet door(s) left open and unattended

Walking/Working Surfaces

  • Were walking/working surfaces inspected during this audit

  • Housekeeping - General

  • Excessive water on floor

  • Ladder damaged

  • Excessive combustible debris or dust accumulation

  • Improper use of a ladder

  • Ladder not secured properly

Compressed Gases

  • Was compressed gas storage inspected during this audit?

  • LP tank/cylinder not properly secured

  • Gas cylinders improperly stored without protective caps

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