Safety Inspection

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 - Previous inspection

• 1.1 - Has the last inspection been reviewed?

  Yes

  No

  N/A

• 1.2 - Are there no outstanding actions?

  Yes

  No

  N/A

• Corrective Actions:

2.0 - Fire Prevention

• 2.1 - Is there an Emergency Evacuation plan in place and understood by all employees?

  Yes

  No

  N/A

• 2.2 - Evacuation procedures discussed regularly? (3 to 4 times a year)

  Yes

  No

  N/A

• 2.3 - Extinguishers in place, clearly marked?

  Yes

  No

  N/A

• 2.4 - Extinguishers recently serviced? (Check punch mark on tabs.)

  Yes

  No

  N/A

• 2.5 - Extinguishers clear of obstructions?

  Yes

  No

  N/A

• 2.6 - Extinguisher no more than 5' off of floor and not lower than 3' from floor?

  Yes

  No

  N/A

• 2.7 - Indicator signs are clearly visible?

  Yes

  No

  N/A

• 2.8 - Adequate direction notices for fire exits?

  Yes

  No

  N/A

• 2.9 - Exit doors easily opened from inside?

  Yes

  No

  N/A

• 2.10 - Exits clear of obstructions?

  Yes

  No

  N/A

• 2.11 - Fire alarm system functioning correctly?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

3.0 - General Lighting

• 3.1 - Good natural lighting?

  Yes

  No

  N/A

• 3.2 - Reflected light from walls & ceilings not causing glare to employees?

  Yes

  No

  N/A

• 3.3 - Light fittings clean and in good condition?

  Yes

  No

  N/A

• 3.4 - Emergency exit lighting operable?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

4.0 - Building Safety

• 4.1 - Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• 4.2 - Entry and walkways kept clear?

  Yes

  No

  N/A

• 4.3 - Walkways adequately and clearly marked?

  Yes

  No

  N/A

• 4.4 - Intersections kept clear of boxes etc?

  Yes

  No

  N/A

• 4.5 - Stair and risers kept clear?

  Yes

  No

  N/A

• 4.6 - Are liquid spills removed quickly?

  Yes

  No

  N/A

• 4.7 - Are railings in good condition?

  Yes

  No

  N/A

• 4.8 - Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• 4.9 - Are footpaths in good condition?

  Yes

  No

  N/A

• 4.10 - Furniture in sound condition?

  Yes

  No

  N/A

• 4.11 - Loading area clean and tidy?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

5.0 - Work Benches

• 5.1 - Clear of rubbish?

  Yes

  No

  N/A

• 5.2 - Tools not in use kept in place?

  Yes

  No

  N/A

• 5.3 - No damaged hand tools in use?

  Yes

  No

  N/A

• 5.4 - No damaged power tools in use?

  Yes

  No

  N/A

• 5.5 - Work height correct for the type of work and the employee?

  Yes

  No

  N/A

• 5.6 - No sharp edges?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

6.0 - Rubbish Removal

• 6.1 - Bins located at suitable points around site?

  Yes

  No

  N/A

• 6.2 - Bins emptied regularly?

  Yes

  No

  N/A

• 6.3 - Oily rags and combustible refuse in covered metal containers?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

7.0 - Storage Design and Use

• 7.1 - Materials stored in racks and bins wherever possible?

  Yes

  No

  N/A

• 7.2 - Storage designed to minimise lifting problems?

  Yes

  No

  N/A

• 7.3 - Floors around racking clear of rubbish?

  Yes

  No

  N/A

• 7.4 - General condition of racks and pallets?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

8.0 - Machines

• 8.1 - Are they kept clean?

  Yes

  No

  N/A

• 8.2 - Are the floors around the machines kept clean?

  Yes

  No

  N/A

• 8.3 - Guards in good condition?

  Yes

  No

  N/A

• 8.4 - Starting and stopping devices within easy reach of operator?

  Yes

  No

  N/A

• 8.5 - Waste/off cuts removed and stored safely?

  Yes

  No

  N/A

• 8.6 - Drip pans on floor to prevent spillage?

  Yes

  No

  N/A

• 8.7 - Adequate work space?

  Yes

  No

  N/A

• 8.8 - Is lighting adequate?

  Yes

  No

  N/A

• 8.9 - Noise levels controlled?

  Yes

  No

  N/A

• 8.10 - No bending or stooping required?

  Yes

  No

  N/A

• 8.11 - Is ergonomics a concern with this operation?

  Safe

  At Risk

  N/A

• 8.12 - Operators trained/inducted into the operation of the machines?

  Yes

  No

  N/A

• 8.13 - Is the training recorded?

  Yes

  No

  N/A

• 8.14 - Do operators comply with the training?

  Yes

  No

  N/A

• 8.15 - Are lockout procedures implemented and followed?

  Yes

  No

  N/A

• 8.16 - Are gas bottles secured?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Yes

  No

  N/A

• Risk:

  Low

  Medium

  High

9.0 - Electrical Safety

• 9.1 - Safety switches installed?

  Yes

  No

  N/A

• 9.2 - Safety switches tested every 6 months and tests recorded?

  Yes

  No

  N/A

• 9.3 - No double adapters in use?

  Yes

  No

  N/A

• 9.4 - Portable equipment tested and tagged?

  Yes

  No

  N/A

• 9.5 - No broken plugs, sockets or switches?

  Yes

  No

  N/A

• 9.6 - No power leads across walkways?

  Yes

  No

  N/A

• 9.7 - No frayed or damaged leads?

  Yes

  No

  N/A

• 9.8 - No strained leads?

  Yes

  No

  N/A

• 9.9 - Portable power tools in good condition?

  Yes

  No

  N/A

• 9.10 - Where required are emergency shut-down procedures in place?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

10.0 - Chemical Safety

• 10.1 - Hazardous Substance Register complete and available?

  Yes

  No

  N/A

• 10.2 - Material Safety Data Sheets available for all chemicals?

  Yes

  No

  N/A

• 10.3 - All containers labelled correctly?

  Yes

  No

  N/A

• 10.4 - Do special storage conditions apply?

  Yes

  No

  N/A

• 10.5 - If applicable are special storage conditions followed?

  Yes

  No

  N/A

• 10.6 - Workers trained in the use of hazardous substances?

  Yes

  No

  N/A

• 10.7 - If required is PPE available?

  Yes

  No

  N/A

• 10.8 - Is adequate ventilation provided?

  Yes

  No

  N/A

• 10.9 - Are eye washes and showers easily accessed?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Yes

  No

  N/A

• Risk:

  Low

  Medium

  High

11.0 Ladders

• 11.1 - Are all ladders Industrial strength? (Non Household rated, check label.)

  Yes

  No

  N/A

• 11.2 - Are ladders in good condition?

  Yes

  No

  N/A

• 11.3 - If used for electrical work are they non conductive? (Wood or fibre glass.)

  Yes

  No

  N/A

• 11.4 - Used according to instructions?

  Yes

  No

  N/A

• 11.5 - For extension ladders are ropes, pulleys and treads in a good state of repair?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

12.0 - First Aid Facilities

• 12.1 - Are cabinets and contents clean and orderly?

  Yes

  No

  N/A

• 12.2 - Are contents regularly checked?

  Yes

  No

  N/A

• 12.3 - No contents past their expiry date?

  Yes

  No

  N/A

• 12.4 - Cabinets clearly labelled?

  Yes

  No

  N/A

• 12.5 - Is there easy access to cabinets?

  Yes

  No

  N/A

• 12.6 - Employees aware of location of first aid cabinet?

  Yes

  No

  N/A

• 12.7 - Are First Responders accessible?

  Yes

  No

  N/A

• 12.8 - Are emergency numbers displayed?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

13.0 - Office Hazards

• 13.1 - Condition of filing cabinets?

  Yes

  No

  N/A

• 13.2 - Condition of chairs? (Five star bases.)

  Yes

  No

  N/A

• 13.3 - Desks in good condition? (No damage.)

  Yes

  No

  N/A

• 13.4 - Screen Based Equipment positioned to reduce glare from windows etc?

  Yes

  No

  N/A

• 13.5 - Photocopiers positioned to avoid fumes?

  Yes

  No

  N/A

• 13.6 - Tasks designed to prevent Occupational Overuse Syndrome? (Breaks included.)

  Yes

  No

  N/A

• 13.7 - Air conditioning systems regularly maintained?

  Yes

  No

  N/A

• 13.8 - Stable non-slip floor coverings in good condition?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Yes

  No

  N/A

• Risk:

  Low

  Medium

  High

14.0 - Vehicle Condition

• 14.1 - Schedule maintenance performed?

  Yes

  No

  N/A

• 14.2 - Condition of tires?

  Yes

  No

  N/A

• 14.3 - Brake performance?

  Yes

  No

  N/A

• 14.4 - Lights? (Check operation of brake, indicator and reversing lights)

  Yes

  No

  N/A

• 14.5 - Condition of drivers seat?

  Yes

  No

  N/A

• 14.6 - Condition of other seats?

  Yes

  No

  N/A

• 14.7 - First aid kit supplied and adequate?

  Yes

  No

  N/A

• 14.8 - Storage provisions?

  Yes

  No

  N/A

• Corrective Actions:

• Responsible Person/Task Owner:

  Select EH&S - Kevin Gould Engineering - Scott Bontrager Facility - Rachel Tudor Maintenance - Bob Wyckoff Production - Jonathan Balash - Tim Edgell Production - Supervisors Quality - Jon Gawlak Tool Room - Tom Nix Warehouse - Kevin Cook

  • EH&S - Kevin Gould
  • Engineering - Scott Bontrager
  • Facility - Rachel Tudor
  • Maintenance - Bob Wyckoff
  • Production - Jonathan Balash - Tim Edgell
  • Production - Supervisors
  • Quality - Jon Gawlak
  • Tool Room - Tom Nix
  • Warehouse - Kevin Cook

• Risk:

  Low

  Medium

  High

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• Environmental, Health and Safety Representative

  Sign

• Auditor's signature

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