Safety Audit - One Man Shops

• 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

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

• 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

• Is There a Current Index Available?

  Yes

  No

  N/A

• Are All Tasks Covered by SJP?

  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

R3's Completed

• Are shops completing one R3 per quarter?

  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 If not how many are out of date.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/Gemba (at least 3/quarter)

• Are Monthly Site Safety Inspection or Gemba Walk by Shop Supervisor or SM 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

• Are weekly review of Standard Work and results documented

  Yes

  No

  N/A

• Is Standard Work Posted at Work Site

  Yes

  No

  N/A

Communication Board

• 5S Audits (Weekly, Monthly, Quarterly) Posted or available.

  Yes

  No

  N/A

• Are Safety Alerts Posted and reviewed by all employees?

  Yes

  No

  N/A

Suggestion Board

• 2 Suggestions per employee per month being collected?

  Yes

  No

  N/A

• Are suggestions entered into KMI or reconciled on the master file?

  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 MSDS'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 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 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 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

• 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

• 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

• 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

Comments or findings