PMP Safety Compliance Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 PMP Main Office

• Select date

  Date

1.1 Emergency Equipment

• 1.1.1 Are emergency exit signs installed and functioning correctly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.1.2 Are emergency exit doors working correctly and free of obstructions?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.1.3 Are fire extinguishers in place accessible and in good working order?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.1.4 Is first aid kit in the lunch room stocked up, accessible and in good working order?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.1.5 Is a list of First Aid Attendants posted by the first aid station?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.1.6 Is emergency lighting system installed and functioning correctly? Test each light for operation by flicking the switch located on the side of the box.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

1.2 Safety postings

• 1.2.1 Are current OHS Committee minutes posted and available?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.2.2 Are photographs of current members of the OHS Committee posted in the lunch room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.2.3 Is a current copy of the Health & Safety Policy posted ?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.2.4 Is a current copy of the Harassment Policy posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.2.5 Are the Hazard Reporting & Incident Reporting procedures posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.2.6 Are the core safety rules posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.2.7 Is a copy of the PMP Safety Manual available for employees?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

1.3 General Facility

• 1.3.1 Are guest passes and PPE available and in good condition? Check with Reception.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.3.2 Are hallways & walkways clear of obstructions and debris?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.3.3 Are stairwells, stair treads, hand rails & landings in good condition and clear of obstructions and debris?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.3.4 Does the ventilation seem adequate?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.3.5 Is lighting adequate for the area? Are any bulbs burnt out?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.3.6 Is break room clean?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 1.3.7 Are restrooms clean and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• Inspector signature to verify audit complete

  Sign

• Health & Safety Manager signature.

  Sign

2.0 Engineering Office

• Select date

  Date

2.1 Emergency Equipment

• 2.1.1 Are emergency exit signs installed and functioning correctly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.1.2 Are emergency exit doors operating correctly and free of obstructions?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.1.3 Is the AED in proper location, unobstructed and functioning?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.1.4 is the first aid station clearly marked, unobstructed & stocked up?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.1.5 Are fire extinguishers in place, unobstructed and in good working order?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.1.6 Is emergency lighting system installed and functioning correctly? Test each light for operation by flicking the switch located on the side of the box.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.1.7 Is a list of First Aid Attendants posted by the first aid station?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

2.2 Safety Postings

• 2.2.1 Are current OHS Committee minutes posted and available?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.2.2 Are photographs of current members of the OHS Committee posted in the lunch room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.2.3 Is a current copy of the Health & Safety Policy posted ?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.2.4 Is a current copy of the Harassment Policy posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.2.5 Are the Hazard Reporting & Incident Reporting procedures posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.2.6 Are the core safety rules posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.2.7 Is a copy of the PMP Safety Manual available for employees?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

2.3 General Facilities

• 2.3.1 Are guest passes and PPE available and in good condition? Check with Reception.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.3.2 Are hallways & walkways clear of obstructions and debris?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.3.3 Are stairwells, stair treads, hand rails & landings in good condition and clear of obstructions and debris?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.3.4 Does the ventilation seem adequate?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.3.5 Is lighting adequate for the area? Are any bulbs burnt out?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.3.6 Is break room clean?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 2.3.7 Are restrooms clean and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• Inspector signature to verify audit complete

  Sign

• Area Supervisor/ Manager Signature of acknowledgment.

  Sign

3.0 Planning Offices

• Select date

  Date

3.1 Emergency Equipment

• 3.1.1 Are emergency exit signs installed and functioning correctly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.1.2 Are emergency exit doors operating correctly and free of obstructions?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.1.3 Is the first aid station clearly marked, unobstructed & stocked up?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.1.4 Are fire extinguishers in place, unobstructed and in good working order?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.1.5 Is emergency lighting system installed and functioning correctly? Test each light for operation by flicking the switch located on the side of the box.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.1.6 Is a list of First Aid Attendants posted by the first aid station?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

3.2 Safety Posting

• 3.2.1 Are current OHS Committee minutes posted and available?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.2.2 Are photographs of current members of the OHS Committee posted in the lunch room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.2.3 Is a current copy of the Health & Safety Policy posted ?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.2.4 Is a current copy of the Harassment Policy posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.2.5 Are the Hazard Reporting & Incident Reporting procedures posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.2.6 Are the core safety rules posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.2.7 Is a copy of the PMP Safety Manual available for employees?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

3.3 General Facilities

• 3.3.1 Are guest passes and PPE available and in good condition?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.3.2 Are hallways & walkways clear of obstructions and debris?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.3.3 Are stairwells, stair treads, hand rails & landings in good condition and clear of obstructions and debris?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.3.4 Does the ventilation seem adequate?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.3.5 Is lighting adequate for the area? Are any bulbs burnt out?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.3.6 Is break room clean?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 3.3.7 Are restrooms clean and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• Inspector signature to verify audit complete

  Sign

• Operations Manager Signature of acknowledgment.

  Sign

4.0 Machine Shop East

• Select date

  Date

4.1 Emergency Equipment

• 4.1.1 Are emergency exit signs installed and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.1.2 Are emergency exit doors clear of obstructions and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.1.3 is the first Aid station clearly marked, stocked with supplies and accessible?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.1.4 Is there a list of first aid attendants posted near the first aid station?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.1.5 Are emergency lights installed and functioning properly? Test each light by flicking the switch on the side.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.1.6 are fire extinguishers in their proper locations, unobstructed and in good working order?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.1.7 Are emergency contact cards placed at each public employee phone?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.1.8 Is the MSDS book in its proper location?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

4.2 Inspections

• 4.2.1 Are overhead crane inspections being completed once per shift? Check logbooks to confirm.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.2.2 If forklift is being used in this department is it being inspected each morning? Check logbook to confirm.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

4.3 General facility

• 4.3.1 Are painted walkways clear of obstructions and in good condition?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.2 Does ventilation seem adequate in this department?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.3 Is overhead lighting adequate? Are there any burnt out bulbs?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.4 Is task lighting adequate at work stations? Are any bulbs burnt out?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.5 Are electrical panels & disconnects accessible?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.6 Is good housekeeping being practiced in the break room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.7 Are restroom facilities clean?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.8 Are stairs to planning office clear of obstructions?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.9 Decibel levels marked on all entrances to this department?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.10 do all machines in this department have an easily accessible and functioning E Stop button?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.11 Is lockout tag out station accessible? Are there adequate amount of locks & tags?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.3.12 Are controlled products ( chemicals ) being stored appropriately?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

4.4 Safety Posting

• 4.4.1 Are current OHS Committee minutes posted and available?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.4.2 Are photographs of current members of the OHS Committee posted in the lunch room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.4.3 Is the Health & Safety Policy up to date and posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.4.4 Is a current copy of the Harassment Policy posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.4.5 Are the Hazard Reporting & Incident Reporting procedures posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.4.6 Are the core safety rules posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.4.7 Is a copy of the PMP Safety Manual available for employees?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

4.5 Safe Work Practices

• 4.5.1 Is required PPE being used by all employees?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.5.2 Are all machine guards being used as intended?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.5.3 Are forklifts being operated safely and being parked in a safe location when not in use?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.5.4 Are overhead cranes being operated safely and being parked in the designated crane park locations?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.5.5 Is all rigging being stored in an acceptable manner?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 4.5.6 Are hand tools and power tools being operated in a safe manner?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• Inspector signature to verify audit complete

  Sign

• Department Supervisor signature of acknowledgment.

  Sign

5.0 Welding

• Select date

  Date

5.1 Emergency Equipment

• 5.1.1 Are emergency exit signs installed and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.1.2 Are emergency exit doors clear of obstructions and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.1.3 is the first Aid station clearly marked, stocked with supplies and accessible?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.1.4 Is there a list of first aid attendants posted near the first aid station?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.1.5 Are emergency lights installed and functioning properly? Test each light by flicking the switch on the side.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.1.6 are fire extinguishers in their proper locations, unobstructed and in good working order?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.1.7 Are emergency contact cards placed at each public employee phone?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.1.8 Is the MSDS book in its proper location?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

5.2 Inspections

• 5.2.1 Are overhead crane inspections being completed once per shift? Check logbooks to confirm.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.2.2 If forklift is being used in this department is it being inspected each morning? Check logbook to confirm.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

5.3 General facility

• 5.3.1 Are painted walkways clear of obstructions and in good condition?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.2 Does ventilation seem adequate in this department?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.3 Is overhead lighting adequate? Are there any burnt out bulbs?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.4 Is task lighting adequate at work stations? Are any bulbs burnt out?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.5 Are electrical panels & disconnects accessible?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.6 Is good housekeeping being practiced in the break room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.7 Are restroom facilities clean?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.8 Are stairs to planning office clear of obstructions?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.9 Decibel levels marked on all entrances to this department?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.10 do all machines in this department have an easily accessible and functioning E Stop button?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.11 Is lockout tag out station accessible? Are there adequate amount of locks & tags?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.3.12 Are controlled products ( chemicals ) being stored appropriately?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

5.4 Safety Posting

• 5.4.1 Are current OHS Committee minutes posted and available?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.4.2 Are photographs of current members of the OHS Committee posted in the lunch room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.4.3 Is the Health & Safety Policy up to date and posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.4.4 Is a current copy of the Harassment Policy posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.4.5 Are the Hazard Reporting & Incident Reporting procedures posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5..4.6 Are the core safety rules posted?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.4.7 Is a copy of the PMP Safety Manual available for employees?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

5.5 Safe Work Practices

• 5.5.1 Is required PPE being used by all employees?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.5.2 Are all machine guards being used as intended?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.5.3 Are forklifts being operated safely and being parked in a safe location when not in use?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.5.4 Are overhead cranes being operated safely and being parked in the designated crane park locations?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.5.5 Is all rigging being stored in an acceptable manner?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 5.5.6 Are hand tools and power tools being operated in a safe manner?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• Inspector signature to verify audit complete

  Sign

• Department Supervisor signature of acknowledgment.

  Sign

6.0 Machine Shop West

• Select date

  Date

6.1 Emergency Equipment

• 6.1.1 Are emergency exit signs installed and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.1.2 Are emergency exit doors clear of obstructions and functioning properly?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.1.3 is the first Aid station clearly marked, stocked with supplies and accessible?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.1.4 Is there a list of first aid attendants posted near the first aid station?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.1.5 Are emergency lights installed and functioning properly? Test each light by flicking the switch on the side.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.1.6 are fire extinguishers in their proper locations, unobstructed and in good working order?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.1.7 Are emergency contact cards placed at each public employee phone?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.1.8 Is the MSDS book in its proper location?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

6.2 Inspections

• 6.2.1 Are overhead crane inspections being completed once per shift? Check logbooks to confirm.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.2.2 If forklift is being used in this department is it being inspected each morning? Check logbook to confirm.

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

6.3 General facility

• 6.3.1 Are painted walkways clear of obstructions and in good condition?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.2 Does ventilation seem adequate in this department?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.3 Is overhead lighting adequate? Are there any burnt out bulbs?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.4 Is task lighting adequate at work stations? Are any bulbs burnt out?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.5 Are electrical panels & disconnects accessible?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.6 Is good housekeeping being practiced in the break room?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.7 Are restroom facilities clean?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.8 Are stairs to planning office clear of obstructions?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.9 Decibel levels marked on all entrances to this department?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.10 Do all machines in this department have an easily accessible and functioning E Stop button?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.11 Is lockout tag out station accessible? Are there adequate amount of locks & tags?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date

• 6.3.12 Are controlled products ( chemicals ) being stored appropriately?

  Yes

  No

  N/A

• What immediate corrective action was done to reduce risk or eliminate the hazard?

  Select Rearrange hazardous condition Repair Remove from service Lock out/tag out Retrain Redesign New tools/equipment

  • Rearrange hazardous condition
  • Repair
  • Remove from service
  • Lock out/tag out
  • Retrain
  • Redesign
  • New tools/equipment

• Who is responsible for corrective action if required?

  Management

  Supervisor

  Worker

  Committee

• Input target date for completion if known.

  Date