Information

  • Date & Time of Inspection:

  • Type of Inspection:

  • Country:

  • Branch:

  • Inspected By/ Inspection Team (Name, Job Title):

  • Inspection Area:

  • Customer's Company Name:

  • RI Branch Name:

  • Please indicate which other area. If for residence, please indicate Residence Name/ Address.

Technician/ Service Specialist/ Cleaner/ Storekeeper

Technician/ Service Specialist/ Cleaner/ Storekeeper

  • Interview 1-2 of the above colleague about their work hours and rest hours, and spot check/ test their understandings of the SHE Golden Rules & Zero Tolerance Policy relevant to them.

  • Technician/ Service Specialist/ Cleaner/ Storekeeper
  • Name:

  • Job Title:

  • A. Staff do not work excessive work hours (beyond regulatory requirements) and has adequate rest hours between work shifts?

  • B. Staff understands and can explain the SHE Golden Rules well?

  • C. Staff understands and can explain the relevant Zero Tolerance Policy (ZTP) completely?

Inspections

  • INSPECTION GUIDE

    1. Answer "Yes", "Partial", "No", "NA" on the questions below.
    2. Add photos and notes for your findings by clicking on the paperclip icon.
    3. For any Non-Conformance (NC) or Area for Improvement (AFI), please add in Corrective Actions. Click on the paperclip icon, then select "Add Action". Write down the finding & action to take, assign to a designated person (from the given list in iAuditor), set priority level and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF and/or Word format.

Inspections

  • 1. Thermal Fogger stored in the vehicle in secured manner? Extinguisher and First Aid kit available and accessible from the vehicle / customer’s site?

  • 2. Customer and site occupants have been notified of the fogging schedule?

  • 3. SRA has been conducted at the site? (check SRA report on service docket/ hand phone and take a photo.)

  • 4. Are the hazards and risk control measures updated accurately in the SRA?

  • 5. People and animals/ pets in the areas to be fogged have been cleared/ moved from the area, or have been protected?

  • 6. Windows, air conditioner compressor, food, utensils, cups, personal items etc, in the areas to be fogged, have been closed/ covered up/ removed?

  • 7. Technician completed M16 Thermal Fogging Critical Safe Behaviors training?

  • 8. Standard “Caution. Fogging In Progress” sign is available and being used?

  • 9. Is the thermal fogger in good condition e.g. shoulder strap, guard on fog tube, tanks, tank cap, pump? (do visual check and take a photo of the unit)

  • 10. Is technician aware of the minimum cooling time for a hot thermal fogger after use? Does he practice it? Answer: At least 15 minutes

  • 11. Is technician aware of the minimum distance to maintain between an operating fogger nozzle and a wall/ other object? Does he practice it?<br>Answer: At least 60cm to prevent fire due to blocking of airflow that cools the machine.

  • 12. Is technician aware of the maximum level that a fogger solution tank and fuel tank can be filled up to? Does he practice it? (check the tanks for sign of spill/ leak and take photo)<br>Answer: Maximum level is Three-quarter (3/4) tank only. Over-filling & spillage can cause fire!!

  • 13. No fogging into any confined space e.g. drain hole, manhole, underground sewer, silo, tank. (no pointing of fog tube into any drain and confined space manhole)

  • 14. Technician has the right PPE and in good condition? Answer 14(a)-(k) below. (take photos)

  • 14(a). Long sleeve shirt/ jacket/ coverall

  • 14 (b). Long trousers

  • 14 (c). Ear muff (Do not use ear plugs, it does not provide adequate noise protection)

  • 14 (d). Cartridge respirator with suitable organic vapor and particulate filters (half-face/ full face)

  • 14 (e). Safety goggles (not required if using full-face respirator)

  • 14 (f). Chemical resistant gloves <br>(rubber/ nitrile reusable gloves for preparing fogging solution, filling up solution & fuel tanks. <br>Do not use disposable gloves or cotton gloves.)

  • 14 (g). Fire retardant gloves (leather/ kevlar gloves for fog application)

  • 14 (h). Safety Shoes

  • 14 (i). High visibility vest (if fogging areas are near to road/ carpark/ areas with moving vehicles)

  • 14 (j). Cap/ Hat

  • 14 (k). Other PPE as required by customer/ due to risk identified from SRA. If yes, please provide more details in the Comments below.

  • 15 (a). Technician is wearing the right PPE during chemical mixing, filling up solution tank and fuel tank : <br>long sleeve shirt/ coverall/ jacket, long trousers, cartridge respirator with suitable filters, safety goggles, chemical resistant gloves, safety shoes, high visibility vest? (take photos)

  • 15 (b). Technician is wearing the right PPE during fog application :<br>long sleeve shirt/ coverall/ jacket, long trousers, cartridge respirator with suitable filters, safety goggles, fire retardant gloves, ear muff, safety shoes, high visibility vest, cap/ hat? (take photos)

  • 16. Technician used funnels while preparing fogging solution and filling in the solution tank and fuel tank, to prevent spillage. Take photo.

  • 17. Technician fog in the same direction of the wind (not against the wind). His visibility is not affected by wind direction and fog. Take photo.

  • 18. Technician walk forward while fogging, to avoid the risk of slips, trips and falls. Take photo. (Only walk backwards if you can be physically guided by another person.)

  • 19. No slip, trip & fall hazard observed e.g. open drain, slope, slippery floor, uneven ground, tall grass area? (warn technician and take photo)

  • 20. Any other hazards observed? <br>If no, please mark NA below.<br>If yes, please provide more details in the Note below.

Signature - Inspection done by

  • Inspection Done By

  • Person
  • Name & Signature (click on pen icon to sign):

  • Job Title:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.