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ProAmpac
Brett Ishman

ProAmpac

Safety and Risk Assessment

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Free ProAmpac Checklist

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Information

  • Department / Area / Machine #

  • Document No.

  • Conducted on

  • Prepared by

  • Location

  • Personnel

Departmental Inspections & Meetings

  • Weekly Safety meeting or safety talk performed by Supervisor or Lead

  • Housekeeping / safety inspection completed for previous month?

Housekeeping

  • Housekeeping Pics

  • Cleanliness of floor?

  • Area free of trash?

  • Are there misc. items / parts placed in nooks, cranny's, cubby holes that looks like CLUTTER?

  • Personal belongings put away? (Coats, purses, lunch boxes, shoes, etc.)

  • Racks and shelves organized?

  • Racks and shelves are properly labeled?

  • Walkways and passages clear to walk?

  • Brooms, mops, etc... Stored correctly when not in use?

  • Desks, carts, tables, toolbox & counters clean?

  • Any excessive dust noticed? (Special enfaces on combustible dust)

  • Are cords and hoses out of aisles and walkways?

  • Empty pallets, crates, or boxes removed from area before they become "clutter"?

  • Any pallets or skids leaning on it's side or standing on end?

  • Area around trash cans, bins, dumpsters, scrap bins is clean?

  • Do carts, racks or shelves that have protruding objects that could injure someone?

  • Drains, sinks or drinking fountains clean and free of spills?

  • Pics of "Clutter" or poor Housekeeping.

(PPE) Personal Protective Equipment

  • PPE Pics

  • Employees wearing safety glasses at all times?

  • Employees wearing gloves when exposed to cuts, scrapes, burns or chemical hazards?

  • Arm/wrist protectors worn as required?

  • Employees wearing face shield during grinding, sanding or other operations when required?

  • Face shield or splash goggles worn during chemical operations? (Splash Hazard into eyes)

  • Hearing Protection worn properly by employees when required?

  • Condition of PPE? (Clean & sanitary condition)

  • PPE properly stored when not being used?

Electrical

  • Electrical Pics

  • Breaker box cover / door is closed when not in use?

  • Electrical panels, Breaker boxes, Disconnect boxes unobstructed? ( 3 ft clearance)

  • Electrical panels and devices labeled and secured? (Panel covers have all screws in place)

  • Are GFCI outlets being used properly or needed in this area?

  • Cover plates or switch plates in place?

  • Extension cords in good condition?

  • Extension cords NOT used on a permanent basis?

  • Extension cords not used across aisle ways or walk ways.

  • A quick (random) inspection was performed.

Machinery & Machine Guarding

  • Machine Pics

  • Is the current guard(s) effective?

  • Type of guard(s)?

  • Is the Light curtain working properly?

  • Potential for employee to reach (Over, Under, Around, Through) the guard?

  • E-stop properly labeled (Emergency Shut-off)?

  • Pinch Points labeled?

  • Caution / Warning signs in place?

  • Are all gates, grates, fencing, pin guards, etc in place to prevent employee from entering a hazardous area or nip point.

  • Are moving parts guarded (chains, belts, shafts, rotating/reciprocating parts, pinch points, etc.)?

  • Are bench grinders secured to bench or table, or is pedestal secured to floor.

Hand and Power Tools

  • Tool Pics

  • Power or Pneumatic Tools free from damage (switches and guards)?

  • Cords or hoses free from holes, damage, frays or exposed wiring?

  • Cord plug is equipped with ground plug....electrical?

  • Hand tools free from damage ( handles, shaft, head, etc.)?

  • Safety guards in place? (Grinders, sanders, etc.)

  • Grinders have handles in place and free from damage?

  • A quick (random) inspection was performed.

( Crane/Hoist ) - Lifting Devices / Lifting Components

  • Properly stored when not in use?

  • Properly tagged or labeled?

  • Is tag / label legible?

  • Is Crane / Sling inspections being documented in log book?

  • A quick (random) inspection was performed.

Emergency / First Aid

  • Clear access to fire extinguishers?

  • Are fire extinguishers properly mounted?

  • Are fire extinguisher signs in place?

  • Fire extinguisher inspections current?

  • Access to Emergency fire exits?

  • Access to First Aid items / kit?

  • Emergency Pics

Eye Wash Station

  • Eye Wash Pics

  • Accessible or clear path?

  • Are adequate signs marking the location?

  • Clean (Free from dust, dirt or other debris)?

  • Expiration date ok or last inspection ok?

  • Continuous flow unit has adequate flow or water pressure?

  • Caps or covers in place when not in use?

  • A quick (random) inspection was performed.

Chemicals

  • Chemical Pics

  • All chemical containers labeled?

  • Are labels legible?

  • Chemical spill kits available near by?

  • Chemicals used and/or stored in an approved containers?

  • Aerosol cans have lids/caps in place when not in use?

  • Flammable materials stored properly in flammable proof cabinet? (Ie:Acetone, Paint, etc.)

  • Flammable drums properly grounded / bonded to prevent sparks during transferring process?

  • Waste or spent chemicals properly labeled and stored ready for pick-up?

  • Adequate number of fire extinguishers in place?

  • Are there items that have the potential to catch fire or possibility to cause a fire.

Welding

  • Are welding screens safely in place around welding work areas?

  • Are welding screens clean or free from excessive dust?

  • Are welding gas bottles secured to rack, cart or fixture to prevent it from falling?

  • Are caps in place on bottles not being used?

  • Hoses and/or cords free from defects?

  • Is a respirator, PAPR or Supplied air welding hood needed?

  • A quick (random) inspection was performed.

Ladders (Fixed or Portable)

  • Stored or secured correctly while not in use?

  • Ladders free from defects or damage?

  • Properly labeled or identified?

  • A quick (random) inspection was performed.

Walking & Working Surfaces

Slip, Trip & Fall

  • Elevated work levels (Over 4 feet high) have guardrails or railing at the proper height of 42" with mid-rail at approx 21"?

  • Are fall arrest (Harness, Lanyard, Clips, Hooks) inspected?

  • Last documented inspection date.

  • Any observed Slip Hazards?

  • Any observed Trip Hazards?

  • Any observed Fall Hazards?

  • Slip, Trip Hazard Pics

  • Spills or leaks?

  • Cords or hoses across aisle ways or walk ways?

  • Misc. items obstructing aisle ways?

  • Any holes in floor have been reported to Supervisor or Maintenance to be fixed?

Forklift Operators

  • Daily operator inspection card filled out?

  • Was operator wearing seatbelt?

  • Traveling at an appropriate speed?

  • Honking horn in appropriate locations? (Corners, blind spots, etc...)

Environmental

Waste & Waste Reduction (Hazardous, Non-Haz, Universal)

  • Drums have lids and/or caps in place when not in use?

  • Waste drums properly labeled?

  • Waste drum storage area labeled?

  • Waste satellite accumulation areas properly labeled?

Pollution Prevention

  • BMP's include: Good Housekeeping, Preventive Maintenance, SOP's, Spill Prevention, Training, Inspections

  • Are BMP's (Best Management Practices) observed to prevent pollution?

Recycling

  • Are good recycling practices taking place?

  • Are recycling containers labeled?

Water Conservation

  • Any leaks or drips noticed?

Energy Conservation

  • Are lights turned off when applicable? (ie: natural light is plentiful or motion sensors are used)

  • Excess machinery, electrical devices are unplugged breakers turned off when not being utilized?

Waste water

  • Any observations of unauthorized items being disposed of down the drain?

Storm Water

  • Storm water drain access is clear and free from debris?

Secondary Containment

  • Is secondary containment being used?

  • Free from cracks, holes, etc?

  • Describe the type of secondary containment.

Unsafe acts observed?

  • Unsafe Acts?

For this area/dept, How many accidents have occurred since the last assessment?

  • Clinic Visit Injuries

  • First Aid Only

  • Report Only (No clinic visit needed)

  • Property Damage

  • Near Misses

Are there Risk controls that have failed or need to be enhanced in order to prevent future injuries?

  • PPE (Besides Safety Glasses & Steel Toes)

    • Safety Glasses
    • Full Suit
    • Gloves
    • Hearing Protection
    • Steel Toed Boots
    • Bump cap / Hard Hat
    • Hood
    • Faceshield
    • Welding Gear
    • Respirator, PAPR, SAR

  • Engineering Controls

    • Guard Rails
    • Preventive Maintenance
    • Gated Access
    • Machine Guards
    • Cranes
    • Forklift / Powered Industrial Truck
    • E-Stop, pumps, sensors, monitors
    • Secondary Containment

  • Administrative Controls / Work Practice Controls

    • Work Instructions
    • SOP's
    • Training
    • Safety Meeting
    • Two Way Radios
    • Inspections/Audits
    • R2A2 (Roles, Responsibilities, Accountability, Authority
    • Housekeeping
    • Decontamination

  • Communication Controls

    • 2 Person Checklist
    • Maps
    • Signs / Posters
    • Meetings
    • Training / Awareness
    • Investigations
    • Other Visual communications
    • Verbal Communication from Supervisor/Lead

  • Additional comments on control failures.

Review

  • Overall review?

  • Supervisor or Lead signature

  • EHS Manager signature

ProAmpac
Brett Ishman

ProAmpac

Safety and Risk Assessment

Use this Template
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.

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