SAFETY AUDIT

• Location

• Yes

  No

  N/A

• Conducted on

  Date

• Prepared by

1.0 - Audit Comments

• Comments

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• List of items needed from Safety Team

2.0 - Employee Interviews

• 2.1 - EAP / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.2 - HAZCOM / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.3 - NH3 / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.4 - LOTO / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.5 - PRCS / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.6 - GAS METERS / Demonstrate

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.7 - GRAIN / Interview

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.8 - FALL PROTECTION / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.9 - DOT / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

• 2.10 - NEAR MISS / Interviews

  Yes

  No

  N/A

  Repeat

• Yes

  No

  N/A

3.0 - Emergency Action Plan

• 3.1 - EAP / Initial and annual TRAINING documented for EAP?

  Yes

  No

  N/A

  Repeat

• 3.2 - EAP / REVIEWED and UPDATED annually?

  Yes

  No

  N/A

  Repeat

• 3.3 - EAP / VISITORS LOGS used? (except customers)

  Yes

  No

  N/A

  Repeat

• 3.4 - EAP / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

• 3.5 - FIRE PREVENTION PLAN in place?

  Yes

  No

  N/A

  Repeat

• 3.6 - PORTABLE FIRE EXTINGUISHER employee training documented?

  Yes

  No

  N/A

  Repeat

4.0 - Lockout Tagout Safety Program

• 4.1 - LOTO / Initial and annual TRAINING documented for LOTO PROGRAM?

  Yes

  No

  N/A

  Repeat

• 4.2 - LOTO / Machine specific WRITTEN PROCEDURES are complete?

  Yes

  No

  N/A

  Repeat

• 4.3 - LOTO / Annual LOTO REVIEWS current within 12 months?

  Yes

  No

  N/A

  Repeat

• 4.4 - LOTO / All LOCKS/TAGS identify authorized employees?

  Yes

  No

  N/A

  Repeat

• 4.5 - LOTO / Required LOTO EQUIPMENT is available?

  Yes

  No

  N/A

  Repeat

• 4.6 - LOTO / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

5.0 - Grain Handling Facility Safety Program

• 5.1 - GRAIN / Initial and annual TRAINING documented for GRAIN HANDLING FACILITY SAFETY PROGRAM?

  Yes

  No

  N/A

  Repeat

• 5.2 - GRAIN / HOUSEKEEPING SCHEDULES developed, properly documented and certified by supervisor?

  Yes

  No

  N/A

  Repeat

• 5.3 - GRAIN / PREVENTATIVE MAINTENANCE SCHEDULES developed, properly documented and certified by supervisor?

  Yes

  No

  N/A

  Repeat

• 5.4 - GRAIN / BIN ENTRY PERMITS are completed properly and kept on file for at least 12 months?

  Yes

  No

  N/A

  Repeat

• 5.5 - GRAIN / PERMIT REQUIRED CONFINED SPACE ENTRY PERMITS completed properly and kept on file for at least 12 months?

  Yes

  No

  N/A

  Repeat

• 5.6 - GRAIN / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

6.0 - Hazard Communication Safety Program

• 6.1 - HAZCOM / Initial and annual TRAINING documented for HAZCOM PROGRAM?

  Yes

  No

  N/A

  Repeat

• 6.2 - HAZCOM / Employees are TRAINED on the safe handling of the CATEGORIES OF HAZARDOUS MATERIALS they come into contact with?

  Yes

  No

  N/A

  Repeat

• 6.3 - HAZCOM / Written program includes a LIST of all onsite chemicals (except consumer products)?

  Yes

  No

  N/A

  Repeat

• 6.4 - HAZCOM / All required employees have completed GHS HAZCOM training on LMS?

  Yes

  No

  N/A

  Repeat

• 6.5 - HAZCOM / Agronomy facilities have CDMS website readily available on computer for accessing ag chemical SDS's?

  Yes

  No

  N/A

  Repeat

• 6.6 - HAZCOM / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

7.0 - Near Miss & Unsafe Condition Reporting Safety Program

• 7.1 - NEAR MISS / Initial and annual training documented for NEAR MISS REPORTING PROGRAM?

  Yes

  No

  N/A

  Repeat

• 7.2 - NEAR MISS / Report forms are readily available for employee use.

  Yes

  No

  N/A

  Repeat

• 7.3 - NEAR MISS / Proper implementation of program?

  Yes

  No

  N/A

  Repeat

8.0 - PPE Program

• 8.1 - PPE / Has a hazard assessment of the workplace completed?

  Yes

  No

  N/A

  Repeat

• 8.2 - PPE / Is employee training current?

  Yes

  No

  N/A

  Repeat

• 8.3 - PPE / If needed, has RESPIRATOR FIT TESTING been done?

  Yes

  No

  N/A

  Repeat

• 8.4 - PPE / If required, have EMPLOYEE MEDICAL EVALUATIONS been done?

  Yes

  No

  N/A

  Repeat

• 8.5 - PPE / Is a HEARING CONSERVATION PROGRAM in place?

  Yes

  No

  N/A

  Repeat

• 8.6 - PPE / If needed, are employees provided with an annual audiometric assessment?

  Yes

  No

  N/A

  Repeat

• 8.7 - PPE / Is a RESPIRATORY PROTECTION PROGRAM in place?

  Yes

  No

  N/A

  Repeat

• 8.8 - PPE / Has workplace sampling and assessment of dust, chemical vapors, hexavalent chromium, etc., been completed?

  Yes

  No

  N/A

  Repeat

• 8.9 - PPE / Has APPENDIX D to SEC. 1910.134 been provided to employees voluntarily using respirators, e.g., dust masks?

  Yes

  No

  N/A

  Repeat

9.0 - Office Areas

• 9.1 - OFFICE / FIRE EXTINGUISHERS compliant?

  Yes

  No

  N/A

  Repeat

• 9.2 - OFFICE / EXIT routes unobstructed?

  Yes

  No

  N/A

  Repeat

• 9.3 - OFFICE / EXIT routes clearly identified with an EXIT sign?

  Yes

  No

  N/A

  Repeat

• 9.4 - OFFICE / ELECTRICAL SYSTEMS compliant?

  Yes

  No

  N/A

  Repeat

• 9.5 - OFFICE / Free of SLIP or TRIP hazards?

  Yes

  No

  N/A

  Repeat

• 9.6 - OFFICE / Facility SIGNAGE compliant?

  Yes

  No

  N/A

  Repeat

• 9.7 - OFFICE / INFOTRAC contact signs/stickers are displayed?

  Yes

  No

  N/A

  Repeat

• 9.8 - OFFICE / Employee LABOR LAW POSTERS and OSHA 300 posted?

  Yes

  No

  N/A

  Repeat

• 9.9 - OFFICE / CHEMICALS properly marked and stored?

  Yes

  No

  N/A

  Repeat

• 9.10 - OFFICE / Proper PPE and storage available?

  Yes

  No

  N/A

  Repeat

• 9.11 - OFFICE / LP OUT OF GAS scripts/talking points by each phone or in a prominent place within the office?

  Yes

  No

  N/A

  Repeat

• 9.12 - OFFICE / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

10.0 - Grain Handling Areas

• 10.1 - GRAIN / FIRE EXTINGUISHERS compliant?

  Yes

  No

  N/A

  Repeat

• 10.2 - GRAIN / EXIT routes unobstructed?

  Yes

  No

  N/A

  Repeat

• 10.3 - GRAIN / EXIT routes clearly identified with an EXIT sign?

  Yes

  No

  N/A

  Repeat

• 10.4 - GRAIN / ELECTRICAL SYSTEMS compliant?

  Yes

  No

  N/A

  Repeat

• 10.5 - GRAIN / MACHINE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 10.6 - GRAIN / ORGANIZED and free of clutter, rubbish, and spilled / spoiled grain?

  Yes

  No

  N/A

  Repeat

• 10.7 - GRAIN / Free of SLIP or TRIP hazards?

  Yes

  No

  N/A

  Repeat

• 10.8 - GRAIN / RAILINGS AND HOLE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 10.9 - GRAIN / LADDERS compliant?

  Yes

  No

  N/A

  Repeat

• 10.10 - GRAIN / PERMIT SPACES properly marked?

  Yes

  No

  N/A

  Repeat

• 10.11 - GRAIN / HOUSEKEEPING performed adequately?

  Yes

  No

  N/A

  Repeat

• 10.12 - GRAIN / MAINTENANCE performed adequately?

  Yes

  No

  N/A

  Repeat

• 10.13 - GRAIN / DUST COLLECTION system is functioning and compliant?

  Yes

  No

  N/A

  Repeat

• 10.14 - GRAIN / EMERGENCY RESCUE EQUIPMENT on site and stored properly? (Rope retrieval kit, plywood coffer dams, proper harness, and lifelines)

  Yes

  No

  N/A

  Repeat

• 10.15 - GRAIN / Proper PPE and storage available?

  Yes

  No

  N/A

  Repeat

• 10.16 - GRAIN / DUMP PIT GRATES compliant? Maximum space allowed is 2 1/2 inches between each bar.

  Yes

  No

  N/A

  Repeat

• 10.17 - GRAIN / Grain processing equipment MAGNETS properly maintained?

  Yes

  No

  N/A

  Repeat

• 10.18 - GRAIN / CHEMICALS properly labeled and stored?

  Yes

  No

  N/A

  Repeat

• 10.18 - GRAIN / NO SMOKING WITHIN 50 FEET signs posted?

  Yes

  No

  N/A

  Repeat

• 10.20 - GRAIN / LOTO ENERGY ISOLATION POINTS properly marked?

  Yes

  No

  N/A

  Repeat

• 10.21 - GRAIN / EXTENSION CORDS are OSHA compliant. No cuts on the cover, no black tape over defects and grounding pin in place.

  Yes

  No

  N/A

  Repeat

• 10.22 - GRAIN / Facility SECURITY adequate ? (Ladders, doors, electrical, overheads, etc.)

  Yes

  No

  N/A

  Repeat

• 10.23 - GRAIN / LOADERS, skid steers, etc., are compliant, in safe operating condition and stored outside of the elevator?

  Yes

  No

  N/A

  Repeat

• 10.24 - GRAIN / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

11.0 - Shop Areas

• 11.1 - SHOP / FIRE EXTINGUISHERS compliant?

  Yes

  No

  N/A

  Repeat

• 11.2 - SHOP / EXIT routes unobstructed?

  Yes

  No

  N/A

  Repeat

• 11.2a - SHOP / EXIT routes clearly identified with an EXIT sign?

  Yes

  No

  N/A

  Repeat

• 11.3 - SHOP / ELECTRICAL SYSTEMS compliant?

  Yes

  No

  N/A

  Repeat

• 11.4 - SHOP / MACHINE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 11.5 - SHOP / ORGANIZED and free of clutter and rubbish?

  Yes

  No

  N/A

  Repeat

• 11.6 - SHOP / Free of SLIP or TRIP hazards?

  Yes

  No

  N/A

  Repeat

• 11.7 - SHOP / RAILINGS and HOLE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 11.8 - SHOP / LADDERS compliant?

  Yes

  No

  N/A

  Repeat

• 11.9 - SHOP / OILY RAGS and MATERIALS are placed in covered metal containers?

  Yes

  No

  N/A

  Repeat

• 11.10 - SHOP / HAND TOOLS are kept picked up and put away when not in use?

  Yes

  No

  N/A

  Repeat

• 11.11 - SHOP / POWER HAND TOOLS are in good working order, i.e. cords aren't pulled from the casing, casings aren't cracked, etc.?

  Yes

  No

  N/A

  Repeat

• 11.12 - SHOP / EXTENSION CORDS are OSHA compliant? No cuts on the cover, no black tape over defects and grounding pin in place.

  Yes

  No

  N/A

  Repeat

• 11.13 - SHOP / All JACKS and HOISTS are marked with lifting capacities?

  Yes

  No

  N/A

  Repeat

• 11.14 - SHOP / Proper PPE and storage is available?

  Yes

  No

  N/A

  Repeat

• 11.15 - SHOP / BATTERY CHARGING stations have flushing water near by?

  Yes

  No

  N/A

  Repeat

• 11.16 - SHOP / LOTO ENERGY ISOLATION POINTS properly marked?

  Yes

  No

  N/A

  Repeat

• 11.17 - SHOP / CHEMICALS properly labeled and stored?

  Yes

  No

  N/A

  Repeat

• 11.18 - SHOP / FLAMMABLES and AEROSOLS are stored in fire resistant cabinets?

  Yes

  No

  N/A

  Repeat

• 11.19 - SHOP / ALL FUELS are stored in OSHA compliant containers?

  Yes

  No

  N/A

  Repeat

• 11.20 - SHOP / FLAMMABLES are not stored in entrance or exit routes?

  Yes

  No

  N/A

  Repeat

• 11.21 -SHOP / OXYGEN CYLINDERS stored properly? (Greater than 20 feet from combustibles/flammables, e.g., acetylene cylinders)

  Yes

  No

  N/A

  Repeat

• 11.22 - SHOP / All STORED CYLINDERS are capped and secured from falling over?

  Yes

  No

  N/A

  Repeat

• 11.22a - SHOP / OXY/ACETYLENE TORCH has flash arrestors installed within the torch, by the torch or by the regulators.

  Yes

  No

  N/A

  Repeat

• 11.23 - SHOP / PROPANE CYLINDERS are stored in cages outside? (Gas grills stored indoors must have LP cylinders removed.)

  Yes

  No

  N/A

  Repeat

• 11.24 - SHOP / USED OIL is placed in covered containers that are marked as "USED OIL"?

  Yes

  No

  N/A

  Repeat

• 11.25 - SHOP / OVERHEAD STORAGE areas are marked with max load ratings.

  Yes

  No

  N/A

  Repeat

• 11.25a - SHOP / OVERHEAD STORAGE has an OSHA compliant railing system in place? (Chains aren't allowed.)

  Yes

  No

  N/A

  Repeat

• 11.26 - SHOP / STORAGE RACKS are secured and in good condition.

  Yes

  No

  N/A

  Repeat

• 11.27 - SHOP / All WEED SPRAYERS are emptied and rinsed before placing or storing inside shops?

  Yes

  No

  N/A

  Repeat

• 11.28 - SHOP / Proper facility MARKINGS and SIGNS?

  Yes

  No

  N/A

  Repeat

• 11.29 - SHOP / AUTO LIFT is annually inspected and documentation filed?

  Yes

  No

  N/A

  Repeat

• 11.29a - SHOP / AUTO LIFT is inspected each day before first use and documented?

  Yes

  No

  N/A

  Repeat

• 11.30 - SHOP / Towing and lifting straps are free from cuts, abrasions and fraying?

  Yes

  No

  N/A

  Repeat

• 11.31 - SHOP / CHAINS are free from bolts and rods that are being used to join links or attach a clevis?

  Yes

  No

  N/A

  Repeat

• 11.32 - SHOP / AIR HOSES have only compression fittings on the air hoses? Worm gear hose clamps aren't to be used on high pressure air hoses.

  Yes

  No

  N/A

  Repeat

• 11.33 - SHOP / EYEWASH STATION is available in he immediate work area?

  Yes

  No

  N/A

  Repeat

• 11.34 - SHOP / BENCH GRINDER guards are properly adjusted - tongue guard within 1/4 in. and the tool rest within 1/8 in. from the <br> face of the wheel.

  Yes

  No

  N/A

  Repeat

• 11.35 - SHOP / DRILL PRESS has a guard over the chuck and drill bit?

  Yes

  No

  N/A

  Repeat

• 11.36 - SHOP / DRILL PRESS is anchored to the floor to prevent tipping?

  Yes

  No

  N/A

  Repeat

• 11.37 - SHOP / HYDRAULIC PRESS is anchored to the floor to prevent tipping?

  Yes

  No

  N/A

  Repeat

• 11.38 - SHOP / FIRST AID KIT is available and stocked with supplies?

  Yes

  No

  N/A

  Repeat

• 11.39 - SHOP / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

12.0 - Warehouse Areas

• 12.1 - WAREHOUSE / FIRE EXTINGUISHERS compliant?

  Yes

  No

  N/A

  Repeat

• 12.2 - WAREHOUSE / EXIT routes are unobstructed?

  Yes

  No

  N/A

  Repeat

• 12.3 - WAREHOUSE / ELECTRICAL SYSTEMS compliant?

  Yes

  No

  N/A

  Repeat

• 12.4 - WAREHOUSE / MACHINE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 12.5 - WAREHOUSE / ORGANIZED and free of clutter and rubbish?

  Yes

  No

  N/A

  Repeat

• 12.6 - WAREHOUSE / Free of SLIP or TRIP hazards?

  Yes

  No

  N/A

  Repeat

• 12.7 - WAREHOUSE / RAILINGS and HOLE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 12.8 - WAREHOUSE / LADDERS compliant?

  Yes

  No

  N/A

  Repeat

• 12.9 - WAREHOUSE / EXTENSION CORDS are OSHA compliant. No cuts on the cover, no black tape over defects and grounding pin in place.

  Yes

  No

  N/A

  Repeat

• 12.10 - WAREHOUSE / STORAGE RACKS are secured and in good condition?

  Yes

  No

  N/A

  Repeat

• 12.11 - WAREHOUSE / STORAGE RACKS and STORAGE AREAS are not unsafely loaded or stacked?

  Yes

  No

  N/A

  Repeat

• 12.12 - WAREHOUSE / OVERHEAD STORAGE areas are marked with max load ratings?

  Yes

  No

  N/A

  Repeat

• 12.12a - WAREHOUSE / OVERHEAD STORAGE has an OSHA compliant railing system in place? (Chains aren't allowed.)

  Yes

  No

  N/A

  Repeat

• 12.13 - WAREHOUSE / CHEMICALS are in original containers, properly labeled, free of leaks and stored in approved areas?

  Yes

  No

  N/A

  Repeat

• 12.14 - WAREHOUSE / Compliant with HAZCOM and DOT package marking requirements?

  Yes

  No

  N/A

  Repeat

• 12.15 - WAREHOUSE / LOTO ENERGY ISOLATION POINTS properly marked?

  Yes

  No

  N/A

  Repeat

• 12.16 - WAREHOUSE / Proper facility MARKINGS and SIGNS?

  Yes

  No

  N/A

  Repeat

• 12.17 - WAREHOUSE / Adequate SECURITY at facility? (Ladders, doors, chemicals)

  Yes

  No

  N/A

  Repeat

• 12.18 - WAREHOUSE / FORKLIFTS used and maintained in compliance with OSHA standards.

  Yes

  No

  N/A

  Repeat

• 12.18a - WAREHOUSE / FORKLIFTS are inspected daily, prior to first use, with documentation.

  Yes

  No

  N/A

  Repeat

• 12.19 - WAREHOUSE / Proper PPE and storage is available?

  Yes

  No

  N/A

  Repeat

• 12.20 - WAREHOUSE / Loading dock and steps in good repair?

  Yes

  No

  N/A

  Repeat

• 12.21 - WAREHOUSE / Wheel chalks available and in use?

  Yes

  No

  N/A

  Repeat

• 12.22 - WAREHOUSE / Bagged feed and boxes/drums of lubricants are segregated?

  Yes

  No

  N/A

  Repeat

• 12.23 - WAREHOUSE / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

13.0 - Liquid Fertilizer & Chemical Areas

• 13.1 - LIQ FERT / FIRE EXTINGUISHERS compliant?

  Yes

  No

  N/A

  Repeat

• 13.2 - LIQ FERT / EXIT routes unobstructed?

  Select Yes No N/A Repeat

  • Yes
  • No
  • N/A
  • Repeat

• 13.3 - LIQ FERT / ELECTRICAL SYSTEMS compliant?

  Yes

  No

  N/A

  Repeat

• 13.4 - LIQ FERT / MACHINE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 13.5 - LIQ FERT / ORGANIZED and free of clutter and rubbish?

  Yes

  No

  N/A

  Repeat

• 13.6 - LIQ FERT / Free of TRIP or SLIP hazards?

  Yes

  No

  N/A

  Repeat

• 13.7 - LIQ FERT / RAILINGS and HOLE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 13.8 - LIQ FERT / LADDERS compliant?

  Yes

  No

  N/A

  Repeat

• 13.9 - LIQ FERT / EXTENSION CORDS are OSHA compliant? No cuts on the cover, no black tape over defects and grounding pin in place.

  Yes

  No

  N/A

  Repeat

• 13.10 - LIQ FERT / STORAGE RACKS are secured and in good condition?

  Yes

  No

  N/A

  Repeat

• 13.11 - LIQ FERT / STORAGE RACKS and storage areas are safely loaded or stacked?

  Yes

  No

  N/A

  Repeat

• 13.12 - LIQ FERT / OVERHEAD STORAGE areas are marked with max load ratings?

  Yes

  No

  N/A

  Repeat

• 13.13 - LIQ FERT / CHEMICALS are in original containers, free of leaks and stored in approved areas?

  Yes

  No

  N/A

  Repeat

• 13.14 - LIQ FERT / LOTO ENERGY ISOLATION POINTS properly marked?

  Yes

  No

  N/A

  Repeat

• 13.15 - LIQ FERT / Proper MARKINGS and SIGNS (including "NO SMOKING")?

  Yes

  No

  N/A

  Repeat

• 13.16 - LIQ FERT / SDSs are readily available?

  Yes

  No

  N/A

  Repeat

• 13.17 - LIQ FERT / INFOTRAC signs posted?

  Yes

  No

  N/A

  Repeat

• 13.18 - LIQ FERT / PERMIT REQUIRED CONFINED SPACES identified?

  Yes

  No

  N/A

  Repeat

• 13.19 - LIQ FERT / Proper PPE and storage is available?

  Yes

  No

  N/A

  Repeat

• 13.20 - PPE / Storage of PPE in sanitary conditions?

  Yes

  No

  N/A

  Repeat

• 13.21 - LIQ FERT / EYEWASH & SHOWER STATION unobstructed, sanitary and operational?

  Yes

  No

  N/A

  Repeat

• 13.22 - LIQ FERT / Adequate SECURITY at facility? (Ladders, doors, chemicals, etc.)

  Yes

  No

  N/A

  Repeat

• 13.23 - LIQ FERT / FORKLIFTS used and maintained in compliance with OSHA standards?

  Yes

  No

  N/A

  Repeat

• 13.23a - LIQ FERT / FORKLIFTS are inspected daily, prior to first use, with documentation?

  Yes

  No

  N/A

  Repeat

• 13.24 - LIQ FERT / STORMWATER is tested for nitrogen and documented before being pumped out of the secondary containment?

  Yes

  No

  N/A

  Repeat

• 13.25 - LIQ FERT / STORAGE TANKS are labeled for the contents stored within?

  Yes

  No

  N/A

  Repeat

• 13.26 - LIQ FERT / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

14.0 - Dry Fertilizer Storage Areas

• 14.1 - DRY FERT / FIRE EXTINGUISHERS compliant.

  Yes

  No

  N/A

  Repeat

• 14.2 - DRY FERT / EXIT routes are unobstructed?

  Yes

  No

  N/A

  Repeat

• 14.3 - DRY FERT / ELECTRICAL SYSTEMS compliant?

  Yes

  No

  N/A

  Repeat

• 14.4 - DRY FERT / MACHINE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 14.5 - DRY FERT / ORGANIZED and free of clutter, rubbish, and spilled fertilizers?

  Yes

  No

  N/A

  Repeat

• 14.6 - DRY FERT / Free of TRIP and SLIP hazards?

  Yes

  No

  N/A

  Repeat

• 14.7 - DRY FERT / RAILINGS and HOLE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 14.8 - DRY FERT / LADDERS compliant?

  Yes

  No

  N/A

  Repeat

• 14.9 - DRY FERT / EXTENSION CORDS are OSHA compliant? No cuts on the cover, no black tape over defects and grounding pin in place.

  Yes

  No

  N/A

  Repeat

• 14.10 - DRY FERT / OVERHEAD STORAGE areas are marked with max load ratings?

  Yes

  No

  N/A

  Repeat

• 14.11 - DRY FERT / CHEMICALS are in original containers, free of leaks and stored in approved areas?

  Yes

  No

  N/A

  Repeat

• 14.12 - DRY FERT / Proper PPE and storage is available?

  Yes

  No

  N/A

  Repeat

• 14.13 - DRY FERT / LOTO ENERGY ISOLATION POINTS properly marked?

  Yes

  No

  N/A

  Repeat

• 14.14 - DRY FERT / PERMIT REQUIRED SPACE marked?

  Yes

  No

  N/A

  Repeat

• 14.15 - DRY FERT / Proper MARKINGS and SIGNS (including "NO SMOKING")?

  Yes

  No

  N/A

  Repeat

• 14.16 - DRY FERT / INFOTRAC signs posted.

  Yes

  No

  N/A

  Repeat

• 14.17 - DRY FERT / Adequate SECURITY at facility? (Ladders, doors, chemicals, etc.)

  Yes

  No

  N/A

  Repeat

• 14.18 - DRY FERT / No additional corrective actions required.

  Yes

  No

  N/A

  Repeat

15.0 - Anhydrous Ammonia Facilities

• 15.1 - NH3 / Initial and annual TRAINING documented?

  Yes

  No

  N/A

  Repeat

• 15.2 - NH3 / Load out facility compliant with ANSI/CGA & IDALS standards?

  Yes

  No

  N/A

  Repeat

• 15.3 - NH3 / Minimum 150 gals of EMERGENCY WATER on site?

  Yes

  No

  N/A

  Repeat

• 15.4 - NH3 / Proper PPE and storage available?

  Yes

  No

  N/A

  Repeat

• 15.5 - NH3 / INSPECTION and MAINTENANCE documented for bulk plants and nurse tanks?

  Yes

  No

  N/A

  Repeat

• 15.6 - NH3 / System free of LEAKS?

  Yes

  No

  N/A

  Repeat

• 15.7 - NH3 / MACHINE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 15.8 - NH3 / ELECTRICAL SYSTEMS compliant?

  Yes

  No

  N/A

  Repeat

• 15.9 - NH3 / LOTO ENERGY ISOLATION POINTS properly marked?

  Yes

  No

  N/A

  Repeat

• 15.10 - NH3 / PLANT SECURITY compliant (security lighting at night & locked belly valves when the plant is unattended)?

  Yes

  No

  N/A

  Repeat

• 15.11 - NH3 / Proper MAINTENANCE of plant and tanks (paint, repair, etc.)?

  Yes

  No

  N/A

  Repeat

• 15.12 - NH3 / Proper MARKINGS and SIGNS?

  Yes

  No

  N/A

  Repeat

• 15.13 - NH3 / EMERGENCY SHUT OFF cable functional?

  Yes

  No

  N/A

  Repeat

• 15.14 - NH3 / Terminal end of the EMERGENCY SHUTOFF cable is identified?

  Yes

  No

  N/A

  Repeat

• 15.15 - NH3 / PRESSURE GAUGE works and is readable?

  Yes

  No

  N/A

  Repeat

• 15.16 - NH3 / TEMPERATURE GAUGE (if the tank has one) works and is readable?

  Yes

  No

  N/A

  Repeat

• 15.17 - NH3 / FIRE EXTINGUISHER compliant?

  Yes

  No

  N/A

  Repeat

• 15.18 - NH3 / TRANSPORT BLEEDOFF TANK labeled as "Aqua Ammonia" or "Ammoniated Water"?

  Yes

  No

  N/A

  Repeat

• 15.19 - NH3 / RISER STANDS steps with 4 or more risers have handrails on both sides of the steps?

  Yes

  No

  N/A

  Repeat

• 15.20 - NH3 / RISER STANDS have wheel chocks (or something similar) available?

  Yes

  No

  N/A

  Repeat

• 15.21 - NH3 / RISER STANDS - valves on hoses are locked when the plant is unattended?

  Yes

  No

  N/A

  Repeat

• 15.22 - NH3 / RISER STANDS - hoses are due to be replaced?

  Yes

  No

  N/A

  Repeat

• 15.23 - NH3 / LIQUID PUMP is de-energized with the electrical box padlocked when the plant is unattended?

  Yes

  No

  N/A

  Repeat

• 15.24 - NH3 / HOUSEKEEPING is good with weeds managed and refuse picked up?

  Yes

  No

  N/A

  Repeat

• 15.25 - NH3 / PIPING is color coded with Orange = Liquid and Vapor = Yellow?

  Yes

  No

  N/A

  Repeat

• 15.26 - NH3 / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

16.0 - Anhydrous Ammonia Nurse Tanks

• 16.1 - NH3 NURSE TANKS / Has proper MARKINGS and SMV SIGN?

  Yes

  No

  N/A

• 16.2 - NH3 NURSE TANKS / 5 gallon EMERGENCY WATER TANK mounted on the tank with a hose attached? (In-season it is filled.)

  Yes

  No

  N/A

• 16.3 - NH3 NURSE TANKS / SAFETY CHAINS are available?

  Yes

  No

  N/A

• 16.4 - NH3 NURSE TANKS / TIRES are in good shape, i.e., have adequate tread, aren't severely weather checked and are inflated?

  Yes

  No

  N/A

• 16.5 - NH3 NURSE TANKS / GAUGES are functioning and readable (pressure and liquid)?

  Yes

  No

  N/A

• 16.6 - NH3 NURSE TANKS / RUNNING GEAR is maintained - the reach isn't broken, the steering axle isn't damaged, tank mounting brackets aren't damaged)?

  Yes

  No

  N/A

• 16.7 - NH3 NURSE TANKS / WHEEL RIMS aren't bent, cracked and lug nuts aren't loose or missing?

  Yes

  No

  N/A

• 16.8 - NH3 NURSE TANKS / VALVES are color coded (liquid = orange and vapor = yellow), aren't damaged & have dust caps in place.

  Yes

  No

  N/A

17.0 - LP Storage Facility

• 17.1 - LPG / Initial (CETP) and annual refresher TRAINING documented?

  Yes

  No

  N/A

• 17.2 - LPG / Proper MARKINGS and SIGNS posted on the tank - "Liquid Propane," “Flammable,” and a "No Smoking,” or “No Open Flame” sign posted near the tank?

  Yes

  No

  N/A

• 17.3 - LPG / GAUGES are functional and glass is clear?

  Yes

  No

  N/A

• 17.4 - LPG / EMERGENCY # is posted, not faded and has current phone #s?

  Yes

  No

  N/A

• 17.5 - LPG / SECURITY fence is adequate, gates are functional and padlocked.

  Yes

  No

  N/A

• 17.6 - LPG / METHANOL is properly stored and dispensed?

  Yes

  No

  N/A

• 17.7 - LPG / EMERGENCY SHUTOFF VALVES function properly?

  Yes

  No

  N/A

• 17.8 - LPG / ESV CABLES function properly and the terminal end is identified with a sign?

  Yes

  No

  N/A

• 17.9 - LPG / FIRE EXTINGUISHER (18 lb B:C rated) is available and is monthly inspected.

  Yes

  No

  N/A

• 17.10 - LPG / HOUSEKEEPING is good with weeds under control and refuse is not present?

  Yes

  No

  N/A

• 17.11 - LPG / BOBTAIL FILL HOSES aren't severely weather checked and dust caps are in place on the valves?

  Yes

  No

  N/A

• 17.12 - LPG / LIQUID PUMP BELT GUARD completely covers the belt and pulleys?

  Yes

  No

  N/A

• 17.13 - LPG / PIPING is either labeled as "Vapor" and "Liquid" or color coded with Liquid = Red and Vapor = Yellow?

  Yes

  No

  N/A

• 17.14 - LPG / LIQUID PUMP is de-energized and the electrical box padlocked when the plant is unattended?

  Yes

  No

  N/A

• 17.15 - LPG / No additional corrective actions required?

  Yes

  No

  N/A

18.0 - LP Bottle Fill Shed

• 18.1 - LPG / BOTTLE FILL SHED MARKINGS posted on the building - "No Smoking" & NFPA 704 diamond numbered blue = 2, Red = 4, Yellow = 0 & white = leave blank

  Yes

  No

  N/A

• 18.2 - LPG / Proper MARKINGS and SIGNS posted on the tank - "Liquid Propane," “Flammable,” and a "No Smoking,” or “No Open Flame” sign posted near the tank?

  Yes

  No

  N/A

• 18.3 - LPG / EMERGENCY # is posted, not faded and has current phone #s?

  Yes

  No

  N/A

• 18.4 - LPG / FIRE EXTINGUISHER (18 lb B:C rated) is available and is monthly inspected.

  Yes

  No

  N/A

• 18.5 - LPG / HOUSEKEEPING is good with weeds under control and refuse is not present?

  Yes

  No

  N/A

• 18.6 - LPG / PPE consisting of goggles, insulated gloves and first aid kit are available?

  Yes

  No

  N/A

• 18.7 - LPG / STEPS and LOADING DOCK is in good repair?

  Yes

  No

  N/A

• 18.8 - LPG / CYCLINDER SCALE is current in its certification?

  Yes

  No

  N/A

• 18.9 - LPG / CYLINDERS are being stored upright, secured, with out of service tanks segregated and with safety caps covering the valves?

  Yes

  No

  N/A

• 18.10 - LPG / DOCUMENTATION of all cylinders being filled?

  Yes

  No

  N/A

• 18.11 - LPG / ELECTRICAL is explosion proof, switches are labeled and is in a state of good repair?

  Yes

  No

  N/A

19.0 - Bulk Refined Fuel Plant

• 19.1 - REFINED FUEL / SECONDARY CONTAINMENT well maintained with repairs done as needed?

  Yes

  No

  N/A

• 19.2 - REFINED FUEL / STORAGE TANKS are labeled for the contents stored within?

  Yes

  No

  N/A

• 19.3 - REFINED FUEL / PIPING is painted/weather proofed and adequately supported with non-combustible material?

  Yes

  No

  N/A

• 19.4 - REFINED FUEL / TANK VALVES seals aren't weeping and the fusible links are in place?

  Yes

  No

  N/A

• 19.5 - REFINED FUEL / RISER BONDING/GROUNDING CABLE is in place and being used?

  Yes

  No

  N/A

• 19.6 - REFINED FUEL / RISER STEPS AND PLATFORM are stable and in good repair?

  Yes

  No

  N/A

• 19.7 - REFINED FUEL / ELECTRICAL panel and switches are labeled.

  Yes

  No

  N/A

• 19.8 - REFINED FUEL / PUMPS are de-energized and the panel padlocked when the plant is unattended?

  Yes

  No

  N/A

• 19.9 - REFINED FUEL / EMERGENCY #s aren't faded and are current?

  Yes

  No

  N/A

• 19.10 - REFINED FUEL / FIRE EXTINGUISHER (20 lb with a minimum 40 B:C rating) is available and is monthly expected?

  Yes

  No

  N/A

• 19.11 - REFINED FUEL / HOUSEKEEPING is good with weeds under control and refuse isn't present?

  Yes

  No

  N/A

• 19.12 - REFINED FUEL / STORMWATER is observed as having no sheen before being pumped over the secondary containment?

  Yes

  No

  N/A

• 19.13 - REFINED FUEL / SUMP PUMP doesn't have a float?

  Yes

  No

  N/A

20.0 - Facility General

• 20.1 - FACILITY GEN / FIRST AID adequate? (kit may be shared among multiple worksites within a facility if located in close proximity)

  Yes

  No

  N/A

  Repeat

• 20.2 - FACILITY GEN / PERSONAL FALL PROTECTION EQUIPMENT properly stored and in safe condition?

  Yes

  No

  N/A

  Repeat

• 20.3 - FACILITY GEN / RESPIRATORY PROTECTION EQUIPMENT properly stored and in safe condition?<br>

  Yes

  No

  N/A

  Repeat

• 20.4 - FACILITY GEN / Proper SIGNAGE? (free of excessive fading and damage)

  Yes

  No

  N/A

  Repeat

• 20.5 - FACILITY GEN / ORGANIZED and free of clutter and rubbish?

  Yes

  No

  N/A

  Repeat

• 20.6 - FACILITY GEN / Free of SLIP and TRIP hazards?

  Yes

  No

  N/A

  Repeat

• 20.7 - FACILITY GEN / WORKING and WALKING AREAS safe? (Impalement hazards, sharp edges, etc.)

  Yes

  No

  N/A

  Repeat

• 20.8 - FACILITY GEN / RAILING and HOLE GUARDING compliant?

  Yes

  No

  N/A

  Repeat

• 20.9 - FACILITY GEN / Adequate SECURITY LIGHTING at facility?

  Yes

  No

  N/A

  Repeat

• 20.10 - FACILITY GEN / RAILROAD SIDINGS in safe condition?

  Yes

  No

  N/A

  Repeat

• 20.11 - FACILITY GEN / FALL PROTECTION SYSTEMS in safe condition? (Rail trolleys, cable systems, etc.)

  Yes

  No

  N/A

  Repeat

• 20.12 - FACILITY GEN / Other ELECTRICAL

  Yes

  No

  N/A

  Repeat

• 20.13 - FACILITY GEN / Other GUARDING

  Yes

  No

  N/A

  Repeat

• 20.14 - FACILITY GEN / Other LADDERS

  Yes

  No

  N/A

  Repeat

• 20.15 - FACILITY GEN / Proper PPE and storage available?

  Yes

  No

  N/A

  Repeat

• 20.16 - FACILITY GEN / No additional corrective action required?

  Yes

  No

  N/A

  Repeat

21.0 - Rolling Stock & Equipment

• 21.1 - ROLLING STOCK & EQUIP / Tractors, pay loaders, skid steers and accessories compliant?

  Yes

  No

  N/A

  Repeat

• 21.2 - ROLLING STOCK & EQUIP / Portable augers, grain vacs and conveyors compliant?

  Yes

  No

  N/A

  Repeat

• 21.3 - ROLLING STOCK & EQUIP / Yard trucks and trailers inspected and maintained in safe condition with documentation?

  Yes

  No

  N/A

  Repeat

• 21.4 - ROLLING STOCK & EQUIP / Commercial trucks and trailers maintained and inspected in compliance with DOT standards with documentation?

  Yes

  No

  N/A

  Repeat

• 21.5 - ROLLING STOCK & EQUIP / No additional corrective actions required?

  Yes

  No

  N/A

  Repeat

22.0 - ALL IN SAFETY

• 22.1 - ALL-IN / Safety training documented each month since last inspection?

  ALL-IN

  Comments

• 22.2 - ALL-IN / Representative attends company safety committee meetings?

  ALL-IN

  Comments

• 22.3 - ALL-IN / No workplace injuries since last inspection?

  ALL-IN

  Comments

• 22.4 - ALL-IN / No vehicle or machine crashes since last inspection?

  ALL-IN

  Comments

• 22.5 - ALL-IN / No FMCSA violations since last inspection?

  ALL-IN

  Comments

• 22.6 - ALL-IN / No observation reports of employees engaged in unsafe actions or in violations of any safety rules since previous inspection.

  ALL-IN

  Comments

Sign Off

• Auditor's signature

  Sign

• On site representative

  Sign