PRETIVM General Workplace Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

A. Workplace Inspection

• Is access to the work site clear? <br><br><br>

  Yes

  No

  N/A

• Is housekeeping adequate?

  Yes

  No

  N/A

• Is lighting adequate for the task being performed?

  Yes

  No

  N/A

• Has a Risk Assessment been completed for the task(s) being performed?

  Yes

  No

  N/A

• What Type of Risk Assessment has been completed?

  FLHA

  JHA

  Verbal

  Other

• Have hazards been addressed and suitable controls put in place?

  Yes

  No

  N/A

• Is the worker(s) aware of an elevated avalanche hazard that effects work activity?

  Yes

  No

  N/A

• Is the employee(s) wearing suitable PPE for the task?

  Yes

  No

  N/A

• Is a permit required for the task being performed? e.g. Ground disturbance? Hot Work? Confined Space?

  Yes

  No

  N/A

• What permit has been issued?

  Select Ground Disturbance Hot Work Confined Space Other

  • Ground Disturbance
  • Hot Work
  • Confined Space
  • Other

• Has the permit been filled out adequately with supervisor signature?

  Yes

  No

  N/A

• Are the risk controls identified on the permit in place?<br>

  Yes

  No

  N/A

• If rigging equipment is being used, has it been inspected and is it suitable for the task?

  Yes

  No

  N/A

• Softeners used as required?

  Yes

  No

  N/A

• Proper rigging techniques used?

  Yes

  No

  N/A

• If mobile equipment is being used, has the operator completed a Pre-Operation Inspection?

  Yes

  No

  N/A

• Any deficiencies noted?

  Yes

  No

  N/A

• Is there a spill kit available?

  Yes

  No

  N/A

• Have portable equipment and/or hand tools been inspected and in good working order?

  Yes

  No

  N/A

• Electrical Cords inspected and in good condition?

  Yes

  No

  N/A

• Pneumatic/hydraulic hose connections properly secured?

  Yes

  No

  N/A

• Angle grinder has appropriate guarding and adequate disc for the job? Discs stored properly?

  Yes

  No

  N/A

• Any modified or home made tools?

  Yes

  No

  N/A

• Is adequate barricading/signage placed for any open holes or hazards created in the work area?

  Yes

  No

  N/A

• Have ladders and/or scaffolding been inspected and secured?

  Yes

  No

  N/A

• Description of Positive Findings

Positive

• Description:

• List any unsafe conditions:

Unsafe Condition

• Condition:

• Check if corrective action was implemented immediately

• What is the Corrective Action Required?

• Responsible person:

• Date required by:

  Date

• Entrances and exits clear?

  Yes

  No

  N/A

• Exit signage in place?

  Yes

  No

  N/A

• Is there a current evacuation plan/map for the building posted?

  Yes

  No

  N/A

• Is Noise Level within acceptable range? 0-85db?

  Yes

  No

  N/A

• Proper hearing protection warn by exposed workers?

  Yes

  No

  N/A

• Ventilation adequate?

  Yes

  No

  N/A

• Is a system in place to control smoke, dust, or exhaust fumes?

  Yes

  No

  N/A

• Is the lighting adequate?

  Yes

  No

  N/A

• Housekeeping in good order?

  Yes

  No

  N/A

• Tools, equipment, and materials being stored safely?

  Yes

  No

  N/A

• Storage of disposal waste adequate?

  Yes

  No

  N/A

• Sanitation - lunchroom and washroom facilities are clean and sanitary?

  Yes

  No

  N/A

• Storage of flammable materials in suitable cabinets?

  Yes

  No

  N/A

• Storage of oil, grease, and lubricants adequate with suitable spill containment?

  Yes

  No

  N/A

• MSDS available and current?

  Yes

  No

  N/A

• All electrical outlets have plate covers and accessible?

  Yes

  No

  N/A

• Access to electrical panels is unobstructed?

  Yes

  No

  N/A

• Electrical cords are in good condition?

  Yes

  No

  N/A

• Adequately stocked first aid kits available?

  Yes

  No

  N/A

• Eyewash station(s) available?

  Yes

  No

  N/A

• Expiry Date:

  Date

• Fire Extinguishers available, mounted, accessible, and monthly inspections completed?

  Yes

  No

  N/A

• Description of Positive Findings:

Positive

• Description of Unsafe Conditions:

Condition:

• Check box if a corrective action was implemented immediately?

• What is the corrective action required?

• Responsible person:

• Date required by:

  Date