Title Page
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Area Inspected
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Date and Time of Inspection
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Auditor
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Location
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Start Inspection with 100% Score
Housekeeping
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Are floors free of standing water, oil, debris, or other slip, trip or fall hazards?
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Are all pallet jacks properly stowed? (Forks under pallet)
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Are safety eyewashes readily accessible? Clean?
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Tools, equipment, and materials properly stored when not in use?
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Material/Totes stored in tiers or stacks so that the material is secure and can not fall?
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Waste materials stored in appropriate containers and disposed of safely? (Haz Waste, Non-Haz Waste, Flammables)
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Are stairs clear of debris?
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Are individual workstations clean, orderly and in good repair? No slip, trip, fall hazards?
Exit Routes
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Are exit doors and routes unblocked, accessible, and unobstructed?
Fire Protection
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Are fire extinguishers hung and unblocked (36")?
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Flammable material stored in Flammable storage cabinet?
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Are Flammable storage cabinets free from material stored on top of them?
Do Employees know?
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Where the nearest fire extinguisher is?
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Where the nearest fire alarm pull station is?
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Where the nearest exit is?
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Where their secondary exit is?
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Do employees know where the evacuation rally point is located?
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Where the Emergency Stop button is on their machine?
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Do employees know how and when to report an injury?
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Does the employee know how to get a copy of the current SDS?
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Do employees know the proper waste receptical for waste in their area? (Haz/Non-Haz Waste Bins, Flammables, Scrap Barrels, etc.)
Machine Guarding/Lockout Tagout
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Are light curtain inspections completed?
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Are the guards secured in place, during operation?
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Are LOTO/alternate procedures posted and clearly visible?
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If guards are missing, is machine properly locked out to prevent unintentional startup?
Personal Protective Equipment
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Are employees wearing required PPE properly:
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Is PPE chart for operation being followed by employees?
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Safety glasses properly donned?
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Hearing protection is worn correctly?
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Respirators worn correctly?
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Goggles or face shields used appropriately?
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Protective clothing in good repair?
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Are safety toe shoes in good condition and are laced properly?
Material Handling Equipment
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Are cables, chains, slings and below-the-hook lifting devices in good condition and tagged?
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Are hoist/crane inspections completed?
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Is forklift daily inspection completed?
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Are forklift operators wearing seatbelts where applicable?
Tools
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Are hand tools in good repair?
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Are power cords on tools in good condition?
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Bench Grinder - is the grinding wheel work rest within 1/8 inch and tongue guard within 1/4 inch of wheel?
Electrical
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Are extension cords being used for temporary use only? And are ground plugs present?
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Are electrical devices properly enclosed to prevent shock from incidental contact? (Missing knockouts?)
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Are electrical panels clear of storage (36")
HAZCOM
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Are tanks/containers properly labeled?
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Are acids, caustics, and chemicals stored correctly?
Miscellaneous
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Are employees using proper utility knives (Ceramic & Self Retracting)
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Are compressed air nozzles restricted to < 30 psi?
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Are compressed air relief ports unblocked? (Located on the side of the air nozzle)
Completion
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Overall Comments
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Inspected by: (Name and Signature)