Safety Audit

• Document No.

• Audit Title

• Site

• Conducted on

  Date

• Prepared by

• Personnel Present

Program Manuals

• Is There a Minteq SMS Health & Safety Program - US Operations Manual on Hand?

  Yes

  No

  N/A

Clarity Net Completion

• Clarity Net Completion- 25 % Percent Completed Per Quarter <br>

  Yes

  No

  N/A

Training Matrix and Corrective Action Tracker

• Is training Matrix in use and up to date?

  Yes

  No

  N/A

• Is corrective action tracker in use and being maintained?

  Yes

  No

  N/A

STOP Card Implementation

• Are STOP cards being used?

  Yes

  No

  N/A

• Are STOP completion being tracked monthly

  Yes

  No

  N/A

Safe Job Procedures

• Are All Tasks Covered by SJP?

  Yes

  No

  N/A

• Is There a Current Index Available?

  Yes

  No

  N/A

• Is the Review Date Less than 1 Year?

  Yes

  No

  N/A

• Are Employees Reviewing SJP's? One SJP reviewed each week by every employee and are SJP's reviewed by employees documented by Initials or signature?

  Yes

  No

  N/A

Safe Job Observations

• Is one SJO per month per employee being completed? unless shop requirements are different "USS 2 per month" <br>

  Yes

  No

  N/A

• Are SJO being reviewed with employee and documented review with initials or signature? <br>

  Yes

  No

  N/A

• Are you tracking trends and behaviors? <br>

  Yes

  No

  N/A

Near Miss Reporting

• 4 Near misses per employee per shop completed? Are the shops posting near misses reports and the safety board?

  Yes

  No

  N/A

OSHA Annual Compliance Requirements

• Is the Annual PPE Hazard Assessment been completed? Q1

  Yes

  No

  N/A

• Is the Crisis Management Plan updated with teams, contacts, and evacuation routes? Q1

  Yes

  No

  N/A

• Is the annual review of the Crisis Management Plan by all employees documented with initials or signature? Q1

  Yes

  No

  N/A

• Is fall protection training completed and documented with initials or signature? Q2

  Yes

  No

  N/A

• Is there a list of jobs that require fall protection? Q2

  Yes

  No

  N/A

• Is there documented inspections of fall protection equipment? Q2

  Yes

  No

  N/A

• Are annual LO/TO inspections completed with signatures for each piece of equipment or task? Q3

  Yes

  No

  N/A

• Is annual LO/TO training completed and documented with initials or signature? Q3

  Yes

  No

  N/A

• Are all MSDS's on site reviewed annually and documented review with initials or signature? Q4

  Yes

  No

  N/A

• Is Annual Hazcom training documented with initials or signature? Q4

  Yes

  No

  N/A

NRTR & R3's

• Are sites using Non Routine Task Review form?

  Yes

  No

  N/A

• Are shops completing one R3 per month?

  Yes

  No

  N/A

Monthly Safety Meeting

• Are monthly safety meetings documented and signed off by all attending?

  Yes

  No

  N/A

Medical Monitoring

• Are all employees Annual Exams up to date? If not how many are out of date.

  Yes

  No

  N/A

Monthly Site Inspection (at least 3/quarter)

• Are Monthly Site Safety Inspection by Shop Supervisor or DSM completed and documented?

  Yes

  No

  N/A

OSHA 300 Log Work-Relate Injury/Illness Reporting

• OSHA 300 Log form posted 2/1 to 4/30 each year and 5 Years of History

  Yes

  No

  N/A

Quarterly Tests on Relief Valves

• Are test completed quarterly on all tanks and are the results documented?

  Yes

  No

  N/A

Standard Work

• 100% of all employees trained in SW?

  Yes

  No

  N/A

• 100% of all employees participate in a SW event?

  Yes

  No

  N/A

• 100% SW completed for critical processes?

  Yes

  No

  N/A

• 100% of SW completed for other tasks completed?

  Yes

  No

  N/A

• Are bi-weekly review of Standard Work and results documented

  Yes

  No

  N/A

• Is Standard Work Posted at Work Site

  Yes

  No

  N/A

Kaizens

• 2 Kaizen's per Month completed?

  Yes

  No

  N/A

• 100% of all employees have participated in a Kaizen event?

  Yes

  No

  N/A

• Kaizen newspapers or Mini-Kaizen form being used to track events and progress?

  Yes

  No

  N/A

• Action items added to corrective action tracker?

  Yes

  No

  N/A

TPM

• TPM events being completed for all equipment? What % completed?

  Yes

  No

  N/A

• Action items from from TPM events added to corrective action tracker?

  Yes

  No

  N/A

• Visual management created for all events?

  Yes

  No

  N/A

• 100% of employees trained in TMP?

  Yes

  No

  N/A

Communication Board

• 5S Map, Jobs, and Areas of Responsibility Posted?

  Yes

  No

  N/A

• 5S Audits (Weekly, Monthly, Quarterly Posted)?

  Yes

  No

  N/A

• Are 5S Before and After Photos Posted and up to date for applicable shops?

  Yes

  No

  N/A

• Are Gemba walks completed daily? Is one documented Gemba walk posted on communications board?

  Yes

  No

  N/A

• Daily Metrics and Tracking Documents Posted (PP/T, Lasers)?

  Yes

  No

  N/A

• Days Without Injury Posted and up to date?

  Yes

  No

  N/A

• Are Safety Alerts Posted and reviewed by all employees?

  Yes

  No

  N/A

• Are visual boards following the OE standard?

  Yes

  No

  N/A

Suggestion Board

• 2 Suggestions per employee per month being collected? Is progress being tracked?

  Yes

  No

  N/A

• Are suggestions being inputted into KMI? And are they being closed out?

  Yes

  No

  N/A

Safety Items

• Are your hazardous chemicals labeled, is their a list of hazardous chemicals for your work area, and are the SDS's available?<br>

  Yes

  No

  N/A

• Do extension cords have grounding conductor, are all cords and cable connections intact, are all extension cords or cables free of splices, and are GFCI's available for use? <br> <br> <br> <br>

  Yes

  No

  N/A

• Are first aid kits and eye wash stations available, inspected, and replenished

  Yes

  No

  N/A

• Are emergency phone numbers posted and easy to find in case of an emergency

  Yes

  No

  N/A

• Are exits properly marked, are they free of obstructions, and are directions to exits posted when not apparent <br> <br> <br>

  Yes

  No

  N/A

• Are approved containers and/or tanks used for storage and handling flammable or combustible liquids, are the containers properly labeled or tagged for contents, and are the storage cabinets labeled "Flammable Keep Fire Away" <br> <br>

  Yes

  No

  N/A

• Are fork-lifts and Minteq equipment being inspected prior to each shift? Are forklifts or Minteq equipment removed from service when not in safe operating condition? Are forklifts inspected daily or before each shift? Do forklifts have flashing lights, horn, overhead guard and nameplate?

  Yes

  No

  N/A

• Are operators licensed? Every three years? Are operator licenses on hand? Performance Evaluation and Training Certificate available? Per SAF-EHS-15 <br>

  Yes

  No

  N/A

• If your operations generate hazardous waste or oil or grease, do you handle it in an approved manner? <br>

  Yes

  No

  N/A

• Are workers protected from sources of excessive noise? Are approved hearing protective equipment available? <br>

  Yes

  No

  N/A

• Are work areas clean and free of debris? Are all work areas adequately illuminated? <br>

  Yes

  No

  N/A

• Is the compressed air for cleaning regulated to less than 30 psi? <br>

  Yes

  No

  N/A

• Is all machinery or equipment capable of movement, required to be de-energized or disengaged and locked out during cleaning, servicing, adjusting or setting up operations, whenever required? Are correct lockout/tagout procedures in use?

  Yes

  No

  N/A

• Are rotating or moving parts of equipment guarded to prevent physical contact? Are all moving chains and gears properly guarded? Are machinery guards secure and so arranged that they do not offer a hazard in their use?

  Yes

  No

  N/A

• Are machinery guards secure and so arranged that they do not offer a hazard in their use? Are power tools used with the correct shield, guard, or attachment recommend by the manufacturer?

  Yes

  No

  N/A

• Are all employees required to use personal protection equipment (PPE) as needed? Is PPE functional and in good repair? Are all employees required to use personal protective equipment (PPE) when handling chemicals (gloves, eye protection, respirators, etc.)?

  Yes

  No

  N/A

• Are appropriate fire extinguishers mounted located and identified so that they are readily accessible (not obstructed) to employees? Are all fire extinguishers inspected monthly and serviced annually, and noted on the inspection tag?

  Yes

  No

  N/A

• Are pits and floor openings covered or otherwise guarded?

  Yes

  No

  N/A

Comments or findings