Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Audit conducted by:
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Select date
Office
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General workspace in main office: neat and orderly/ electrical ok/ no trio hazards etc.?
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Cabinets: neat and orderly/ doors closed?
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Electrical power panel: signs posted/ switches marked/ 36 inch of clearance?
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Signs in place and legible?
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Work stations: desk areas organized, electrical safe, no trip hazards?
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File cabinets: drawers closed and cabinet secured?
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Entrance: clean and clear of obstructions, and exit signs posted?
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Evacuation maps in place?
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Women's restroom, clean and orderly
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Men's restroom, clean and orderly
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Fire extinguisher: monthly inspection performed/ charged/ zip tie attached/ looks to be in general good working order?
Office pass thru
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Work stations: desk areas organized, electrical safe, no trip hazards?
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File cabinets: drawers closed and cabinet secured?
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Exit: access area clear of obstruction?
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Office equipment: good condition/ clean
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Exit: access way clean and clear of obstructions
Kitchen area in pass though
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Sink: clean and empty
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Cabinets: neat and orderly/ doors closed?
Break room
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Employee notice board and required postings: all information up to date and required posters hung?
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Desk/time clock area: neat and orderly
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IIPP/hazcom location
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Required cal/OSHA and fed postings
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If the above is not checked, immediately fix outage or report to supervisor
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Cabinets: neat and orderly/ doors closed?
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Refrigerator: clean and in good condition?
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Ice machine: clean and in good working condition?
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Coffee machine/microwave/counter: clean and in good working condition?
Telephone room
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Access way free and clear?
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IT Phone/computer wiring: no exposed, loose wires?
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Area absent of potential electrical hazards?
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Items stored in room are neat and orderly?
Upstairs office area
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Door to storage: closed, opens and closes smoothly?
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Stairs: handrail intact/ steps clean free of any obstructions?
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Office: neat and orderly, no trip hazards present?
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Desks/workstations: neat and orderly/ electrical ok/ no trip hazards etc.?
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bathroom: clean, soap, toilet paper and paper towels stocked?
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File cabinets: drawers closed and cabinet secured?
Maint. Shop
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Welders: cords in good condition/ tanks secured/ caps in place when not in use?
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Shelves/bins: all items securely stored/ neat and orderly?
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Fire extinguisher# 1 monthly inspection performed/ charged/ zip tie attached/ looks to be in general good working order?
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Drill press: in good safe working condition, drill bits in good condition?
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Welding table
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Oxy/acet rig : cords in good condition, cylinders secured, valve protection caps in place when not in use?
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Cabinets: in good condtion, items inside are labeled and stored neatly, no leaking containers?
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Rolling door: opens and closes smoothly/ wheels in good condition?
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Carts: wheels in good condition, brakes working, no hazards?
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Drill press: in good safe working condition, drill bits in good condition?
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Large grinder: guards in place
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Small grinder: guards in place
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Band saw
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Steel rack
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Shank point storage
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Cut off saw: guards in place etc
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Plasma cutter
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Switches
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Electrical power panel: signs posted/ switches marked/ 36 inch of clearance?
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Two storage cabinets
Maint shop ( center)
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Oxygen cylinder storage?
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Fire extinguisher #2
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Storage rack
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Sliding door: on track/no damage?
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Flammable cabinet: in good condtion, items inside are labeled and stored neatly, no leaking containers?
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Cabinets?
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Cabinet?
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Another cabinet????????????
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Parts washer?
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Misc bolt bin?
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Compressed air hose: hose in good condition, no leaks?
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Table?
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Sliding door #2
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Acetylene storage area?
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First aid kit: supplies adequate?
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Trained first aid responders?
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Men's bathroom: clean, soap, toilet paper and paper towels stocked?
Yard
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Tire press?
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Overhead hoist: certified and in good working condition?
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Parking area?
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Main gate?
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Water main?
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Gas main?
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Equipment parking?
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Container 1 - storage area
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Container 2- HAZ WASTE STORAGE: area clean and organized?
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Tanks: signed/ marked inside containment?
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Waste oil: signed/ marked inside containment ?
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Containment: intact, no damage/ spills, etc?
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Storage racks?
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Fire extinguisher #8?
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Pesticide storage building(brick): clean and organized?
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Pesticide storage signs/ and others posted?
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Locked?
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Container 7?
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Container 8?
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Container 9?
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Electrical power panel: signs posted/ switches marked/ 36 inch of clearance?
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Emergency shower?
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Bin??????????
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Container 10?
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Gravel storage area?
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Parking?
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Scale?
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Tank 3047???????
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Fire extinguisher #6
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Cylinder storage?
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Loading area?
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Propane tank?
Tank farm
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Tank farm signed and marked?
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Containment: no cracks, empty, no spills,etc.?
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Fire extinguisher #7
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Switches?
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Fertilizer pumps?
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Dry silos?
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Valves?
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Switches?
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Fire extinguisher #4?
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Floor storage?
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Emergency eyewash/shower?
Ammonia tank storage
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Ammonia tank: in good condition, tags in place etc.
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Signed and posted?
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Switches?
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Ammonia pumps and valves?
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Emergency eyewash?
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Electrical power panel: signs posted/ switches marked/ 36 inch of clearance?
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Scale shed?
Fenced line.
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Storage tanks?
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Tank: signed and marked and in good condition?
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Flammable storage cabinet?
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Floor storage????????
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Storage building?
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Fire extinguisher #5?
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Parts bin?
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Gate?
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Acid pump?
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Switches?
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Evaporative cooler (10-34-0)
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Switches?
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Tanks 3026/3027?
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Signed marked/containment?
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Propane tank?
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Signed/marked
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Boiler?
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Certified?
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Tanks 3028/3053/3052?
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Signed/marked?
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Containment?
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Fire extinguisher#3?
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Control room: clean and orderly/trip hazards etc?
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Cabinets?
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Sink and counter area?
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Switches?
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Tanks 3030-3044?
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Signed/marked?
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Valves?
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Switches?
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Additional tanks?
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Signed/marked?
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Containment?
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Power cleaner?
Final summary
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Equipment damage if any
Type of equipment
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Any additional comments?
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Facility representative:
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Regulatory Compliance &Safety officer:
