Safety Behavior - Shipping & Receiving Department

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Conducted & Prepared by

• Location
  Address

• Additional Personnel

Shipping & Receiving Department

Personal Protective Equipment (PPE)

• Operator(s) using required PPE: safety glasses and safety shoes?

  Yes

  No

  N/A

• Operator(s) using required safety gloves when changing propane tanks?

  Yes

  No

  N/A

• PPE being worn properly?

  Yes

  No

  N/A

• Operator(s) ensuring that driver(s), if outside of truck, have on the required PPE?

  Yes

  No

  N/A

Fire Line

• Fire extinguisher(s) easily accessible / identifiable?

  Yes

  No

  N/A

• Fire extinguisher(s) inspected monthly/annually?

  Yes

  No

  N/A

Forklift Operation

• Forks are tilted down and stored at ground level when not in use?

  Yes

  No

  N/A

• Operator(s) turning the forklift "off" before dismounting from the cab?

  Yes

  No

  N/A

• Operator(s) engaging the "brake" before dismounting from the cab?

  Yes

  No

  N/A

• Are load(s) balanced while forklift is in transit?

  Yes

  No

  N/A

• Operator(s) sounding the horn before moving with a load?

  Yes

  No

  N/A

• Is the operator(s) ensuring that loads do not pass over head of other personnel?

  Yes

  No

  N/A

Employee

• Operator(s) wearing seatbelt while operating the forklift?

  Yes

  No

  N/A

• Are daily inspections being performed?

  Yes

  No

  N/A

• Operator(s) using proper lifting techniques (using legs, back straight, weight close to body, feet flat on floor, knees bent)?

  Yes

  No

  N/A

• Employee(s) safely handling materials?

  Yes

  No

  N/A

Pipe Storage

• All chocks are in place before operator places pipe in storage locations?

  Yes

  No

  N/A

Loading & Unloading

• Is the delivery truck parked in a stable / flat area (i.e. not on an incline)?

  Yes

  No

  N/A

• Have the operator(s) ensured that no one is walking or standing between the forklift and the delivery truck?

  Yes

  No

  N/A

• if the operator(s) have a helper, are they positioned at the ends of the loads (i.e. not in front of the load, etc.)?

  Yes

  No

  N/A

• When loading, has the operator(s) ensured that each row is chocked before loading?

  Yes

  No

  N/A

Sound Level

• Screen Capture (15s - 30s) using Sound Meter app

  Media