Safety and Compliance Binder Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• The daily and weekly checklist must be filled out in addition to this checklist.

• Items marked as "Blue Book" are checks that are included in the Environmental Binder. If an item is marked as Blue Book Only, please make any CAR notations in that binder.

1. All required documents are posted on the Safety Bulletin Board. SPPM 22.3

• Right to Access Medical Records posted?

  Yes

  No

  N/A

• Job Safety and Health posted?

  Yes

  No

  N/A

• Department of Labor Occupational Noise Exposure Standard posted?

  Yes

  No

  N/A

• Label Guide for Hazard Assessment posted? (Blue Book, Quarterly #1) EPM 8.11

  Yes

  No

  N/A

• Right to Know posted? (Blue Book, Quarterly #1) EPM 8.07

  Yes

  No

  N/A

• Emergency Response Plan posted?

  Yes

  No

  N/A

• OSHA 300 Log Annual Summary posted? (Feb 1-May 1).

  Yes

  No

  N/A

• Delta Safety Policy Statement posted?

  Yes

  No

  N/A

• Workplace Hazard Assessment posted?

  Yes

  No

  N/A

• Workers Compensation posted?

  Yes

  No

  N/A

2. Permanent Bulletin Boards contain the following documents: HRPM 1021

• Equal Employment Opportunity?

  Yes

  No

  N/A

• Family and Medical Leave?

  Yes

  No

  N/A

• Employee Polygraph Notice?

  Yes

  No

  N/A

• Equal Employment Policy Statement?

  Yes

  No

  N/A

• Naturalized Citizen Letter?

  Yes

  No

  N/A

• Minimum Wage?

  Yes

  No

  N/A

• Railway Labor Act?

  Yes

  No

  N/A

• Vietnam Veteran Era Letter?

  Yes

  No

  N/A

• Anti-Drug and Alcohol Misuse Prevention Policy Statement?

  Yes

  No

  N/A

• Anti-Drug and Alcohol Informational Materials? (e.g. posters and brochures)

  Yes

  No

  N/A

• Informative and Instructional Bulletins dated in upper right corner?

  Yes

  No

  N/A

• Personal items (e.g. selling and trading notices; 2 weeks max)?

  Yes

  No

  N/A

• Are personal items dated in the upper right corner?

  Yes

  No

  N/A

3. Inspect Ladders for Safety. SPPM 70.4

• Are ladders stable?

  Yes

  No

  N/A

• Are ladders free from damage?

  Yes

  No

  N/A

• Are ladders stored properly?

  Yes

  No

  N/A

4. Extension Cords are used for temporary applications only. SPPM 50.3

• Are they accessible and free of debris or trash?

  Yes

  No

  N/A

• Are they operational and free of damage?

  Yes

  No

  N/A

5. First Aid Kits. SPPM 44

• Are the First Aid Kits sealed?

  Yes

  No

  N/A

• Are all necessary materials and proper documentation inside?

  Yes

  No

  N/A

6. Emergency and SDS Management stickers are on each phone? (Blue Book, Monthly #7) EPM 8.13

• Do they have the proper Grid #?

  Yes

  No

  N/A

• Do they contain the Nearest Door information?

  Yes

  No

  N/A

• Yellow SDS sticker?

  Yes

  No

  N/A

• Red/White Emergency sticker?

  Yes

  No

  N/A

7. PMET Inspection - Lifting Equipment and Weights/Measures. TOPP 70-40-10

• Cranes

• Checked for stability?

  Yes

  No

  N/A

• Checked for damage?

  Yes

  No

  N/A

• Does it have a Max Load Placard?

  Yes

  No

  N/A

• Is there an Inspection Placard? Did you check the expiration date?

  Yes

  No

  N/A

• Lifting Slings

• Checked for stability?

  Yes

  No

  N/A

• Checked for damage?

  Yes

  No

  N/A

• Does it have a Max Load Placard?

  Yes

  No

  N/A

• Is there an Inspection Placard? Did you check the expiration date?

  Yes

  No

  N/A

• Lifting Bar

• Checked for stability?

  Yes

  No

  N/A

• Checked for damage?

  Yes

  No

  N/A

• Does it have a Max Load Placard?

  Yes

  No

  N/A

• Is there an Inspection Placard? Did you check the expiration date?

  Yes

  No

  N/A

• Scales / Electrostatic Area

• Checked for stability?

  Yes

  No

  N/A

• Checked for damage?

  Yes

  No

  N/A

• Does it have a Max Load Placard?

  Yes

  No

  N/A

• Is there an Inspection Placard? Did you check the expiration date?

  Yes

  No

  N/A

8. Gas Cylinders. SPPM 83

• Are they stored properly and secured? (i.e. with a chain)

  Yes

  No

  N/A

9. Daily and Weekly Safety Checklists. EPM 8.13

• Are the Daily and Weekly Safety Checklists completed?

  Yes

  No

  N/A

10. Outstanding CAR's. TOPP 00-40-19

• Are the outstanding CAR's completed or updated?

  Yes

  No

  N/A

11. Drain Identification. (Blue Book, Quarterly #5) EPM 4.09, 4.16

• Are the drains within the departmental area of responsibility identified?

  Yes

  No

  N/A

12. Monthly Diesel-Powered Fuel Logs (Blue Book only, Monthly #20)

• Have the Monthly Diesel-Powered vehicle fueling logs been completed and verified?

  Yes

  No

  N/A

13. Asbestos (Blue Book only, monthly supplemental #1).

• Enter any additional discrepancy information or CAR's here:

• Visually inspect for any signs that asbestos insulation has been disturbed. Is there any evidence that requires reporting?

  Yes

  No

  N/A

• Tap to enter information

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