Information
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Month/Year
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Prepared by
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Conducted on
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Hazard Classification:
Class (A) - Major - To be corrected Immediately
A condition or practice likely to cause permanent disability, loss of life or body and/or extensive loss of structure, equipment or material -
Class (B) - Serious - To be corrected within 24 hours
A condition or practice likely to cause injury or illness, resulting in temporary disability or property damage that is disruptive but not excessive -
Class (C) - Minor - To be placed on action plan
A condition or practice likely to cause minor, non-disabling injury or illness or non-disruptive property damage
Shipping/Receiving
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Housekeeping (5S)
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Hazard Class
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Lighting
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Hazard Class
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Trailer Jacks (proper position)
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Hazard Class
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Eye Wash Station (1)
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Hazard Class
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Racking
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Hazard Class
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Signs
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Hazard Class
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Forklift Inspection Sheets
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Hazard Class
Exterior
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Roadways
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Hazard Class
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Parking Lot
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Hazard Class
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Patio
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Hazard Class
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Walkways
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Hazard Class
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Entrance Hand Rails
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Hazard Class
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Shipping Pad (clean/free of oil)
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Hazard Class
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Transformers (have locks & no fluid)
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Hazard Class
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Housekeeping (5S)
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Hazard Class
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Storm Drain (dock 78, 126 & generator pad)
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Hazard Class
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Generator (no leaks or liquid, accessible)
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Hazard Class
Service
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Housekeeping (5S)
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Hazard Class
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Lights
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Hazard Class
Maintenance Crib
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Housekeeping (5S)
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Hazard Class
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Lights
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Hazard Class
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Gas Cylinders (capped & chained)
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Hazard Class
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Machinery/Grinder (less than 1/8" gap, shields in use)
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Hazard Class
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Chemicals in Approved Containers
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Hazard Class
Maintenance Office
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Housekeeping (5S)
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Hazard Class
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Lights
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Hazard Class
Fire Extinguishers
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1
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2
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3
-
4
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5
-
8
-
9
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10
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16
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26
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29
Comments
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Addition Comments
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Name & Initials