Information
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Client / Site
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Conducted on
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Prepared by
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Location
Ensure that the workplace is safe in accordance with the PREVENT General Industry Guide:
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AWAIR Safety Program<br>with 5 elements; updated annually with goals and objectives.
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Injury & Illness OSHA 300 Record Keeping<br>Log posted?<br>Log correct?<br>Posters?
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Safety Committee MN<br>Regular Meetings?<br>Documented Meetings?<br>Management & employee equally represented?
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Right To Know / GHS / SDS<br>Annual training?<br>SDS available to employees?<br>Labeling of Containers?<br>
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Bloodborne Pathogens<br>Training?<br>BBP clean up kits?
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Personal Protective Equipment - Proper Use
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Emergency Action Plan<br>Maps developed?<br>Drills?
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Lock Out Tag Out<br>Procedures?<br>Authorized training?<br>Procedures evaluated?
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Respiratory Protection (Voluntary & Required Use)<br>Medical evaluations?<br>Stored properly?<br>Appendix D if voluntary?<br>
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Powered Industrial Trucks<br>Classroom?<br>Test?<br>Behind the wheel, every 3 years?
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Fire Extinguishers<br>Training?<br>Monthly inspection?<br>Blocked?<br>Mounted properly?
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First Aid & CPR<br>with no EMS Response within 4 minutes<br>Training every 2 years?<br>
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Permit Required Confined Space Entry<br>Signs?<br>Training?<br>Rescue plan?<br>
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Walking & Working Surfaces <br>Fall Protection 4 feet vs. 6 feet<br>Guard rails?<br>PFAS?<br>Restraint?<br><br>
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Ladders<br>4:1 angle<br>Storage?<br>
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Machine Guarding<br>AUTO<br>Interlocks?<br>Light curtains?<br>Two hand controls?
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Woodworking Machines<br>Guards in place?<br>Push Sticks?<br>Anti restart?<br>
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Power Tools<br>Cords?<br>Guards/Shields?<br>Proper Use?<br>PPE?
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Overhead Cranes<br>Documenting Inspections?<br>Safety latch?<br>Controls labeled?<br>
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Chains & Slings<br>Inspected?<br>Rated?<br>
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Miscellaneous Hazards not discussed elsewhere:
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Additional Hazards: combustible dust, hot work permit program, servicing rims & wheels, mechanical power presses, lab safety, process safety management, stainless steel welding, and air quality.
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To the Best of Your Knowledge All Other Hazards are Controlled?