Title Page
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Client / Facility
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Conducted on
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Prepared by
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Location
PSSR
Information
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Equipment/Facility
- New equipment
- Modified equipment
- New facility
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Equipment name
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Location of Equipment
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Facility name
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PSSR Team Members
Lockout/Tagout
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Is the machine capable of being locked out?
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Has the equipment specific lockout/tag out procedure been developed?
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Are there any special lockout devices needed?
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Have they been ordered and distributed to the appropriate personnel?
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Have sanitation, production, and maintenance employees been properly trained on the lockout procedures?
Mechanical Hazards
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Are equipment disconnects and operating controls labeled?
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Are the start and stop controls within easy reach of the operator?
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Is there plant maintenance for the equipment?
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Are maintenance personnel trained to perform the plant maintenance?
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Can the machine be oiled without removing the safeguards?
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Is there more than one operator?
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Are separate controls provided?
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Are Emergency Stops working and accessible to the operator?
Machine Guarding
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Have all pinch points and points of operation been properly guarded?
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Have all chains and sprockets been properly guarded?
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Are there any exposed set screws, key ways, collars, etc?
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Have all pulleys and belts been properly guarded?
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Have augers (if present) been properly guarded?
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Are all machine guards securely attached?
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Are interlocks prohibited from being bypassed if applicable?
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Test all interlocks to ensure functioning properly if applicable?
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For saw blades, is only the length necessary to cut product exposed?
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Are all shafts ends covered with a non-rotating cap or cut down to a length of less than 1/2 the diameter of the shaft?
Electrical
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Is the machine wired according to code? (National Electric Code, National Fire Protection Association)
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Is the machine grounded?
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Is the power supply correctly fused and protected?
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Will additions or modifications require an Arc Flash analysis?
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Are all electrical connections secured, cords only the length necessary, conduit only used where required (no cords running through walls, under doors, etc)?
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Is there any temporary equipment S/O cord (allowed for only 90 days) if any follow up required?
Personal Protective Equipment (PPE)
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Has PPE Hazard Analysis been conducted for new jobs?
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Is required PPE available and issued to operators?
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Have operators been properly trained in the use and care of required PPE?
Noise
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Have appropriate measures been taken to safeguard workers against noise hazards?
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Has an area survey been conducted?
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If noise is above 85 dB, has noise reduction measures been considered?
Evacuation/Egress
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Have existing means of egress been obstructed or changed (at least 28")?
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Have exit routes been rerouted if necessary?
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Have employees been trained in new exit routes?
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Has the emergency evacuation drawing been updated?
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Is head room at least 7 feet high with no overhead obstructions below 6'8"?
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Have all emergency exits been designated by appropriate signage/lighting?
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Are new sprinkler systems operational and tested?
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Fire Extinguisher accessible and adequately marked?
Ventilation
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Does the new equipment generate hazardous vapors/gasses/fumes which will require additional ventilation?
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Has ventilation been installed?
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If ventilation has not been installed, have employees been instructed in temporary hazard abatement procedures?
Ergonomics
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Has an ergonomic audit (ergonomic job measurement system, ergonomic assessment) been conducted of the new/modified equipment?
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Have identified ergonomic hazards been corrected?
Confined Spaces & Hazardous Locations
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Has the new equipment created a hazardous location?
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What is the nature of the hazard?
- Flammable
- Toxic
- Extreme temperature
- Confined space
- Other
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Identify hazard
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Permit required for confined spaces?
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Are all hatches and other means of entry labeled as confined spaces?
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Have space specific entry procedures been developed?
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Have employees been trained on entry procedures?
Fall Protection
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The new equipment will not create a situation in which employees must work more than 4' above the floor and outside of a standard guard rail?
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Has appropriate fall protection equipment been provided to employees?
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Have employees been trained in the use of required fall protection equipment?
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No slip/trip/fall hazards created?
Hazard Communication
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The new equipment has not introduced any new hazardous chemicals into the facility?
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Have employees been trained in the hazards and protective measures for the new chemical?
Training
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Does the new/modified equipment require additional process training?
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Has the training been conducted?
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Have new training requirements forwarded to the Training Department?
Food Safety
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Is the new equipment designed and manufactured to be easily cleaned?
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Is there a standard operating procedure in place to break down the equipment for cleaning?
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Has USDA been notified of the addition and the start up of the equipment?
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Has the cleaning contractor been notified of the addition and the startup date of the equipment?
Air Permits
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Has equipment received the necessary air permits?
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Has the regulatory agency been notified of start up?
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Has a standard operating procedure been modified or created to control the equipment per regulations?
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Has an updated standard operating procedure been submitted to regulators for approval?
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Does the facility have spare/redundant critical equipment to keep equipment running within compliance standards?
Wastewater Compliance
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Has the equipment received the necessary wastewater permits and/or notifications?
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Has a standard operating procedure been modified/created to control the equipment to not impact wastewater?
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Is wastewater treatment operations prepared to handle the impact of this process change?
SPCC/Storm water
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Are secondary containment and/or storm water controls in place?
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Has the SPCC plan been updated, including site maps?
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Has a "best management practice" been created for this potential pollution source?
ISO 14001
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Are the necessary "Operational Controls" established and documented in the environmental management system?
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Have any new reporting requirements been added to the environmental calendar?
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Is the process change an Aspect or Significant Aspect?
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Has the training schedule been updated to include the process change?
Waste/Chemical Notification /Utilities
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Are the procedures in place to handle the waste (hazardous or non-hazardous) from the process change?
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Has notification to regulators occurred to address legal requirements?
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Are appropriate back flow connections installed to prevent contamination of potable water?
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Are the appropriate mechanical and procedural systems installed to minimize energy/water usage?
Completion
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Comments/Recommendations
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Safe and ready for commissioning/startup?
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Engineering
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Safety
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Quality
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Operations