Information
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Name of Report:
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Conducted on:
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Location of Facility:
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Prepared by:
Responsible Parties:
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Persons responsible for correcting deficiencies?
General Safety:
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All required Posters, Paperwork, posted in a visible location, and up to date?
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Has the previous Inspection Report been distributed through Share Point?
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Are there any outstanding issues which have not been addressed?
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Has the (JHA) Job Hazard Analysis been updated for today? Please note last update:
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Are Toolbox Talks being performed through the UIG safe work application? What topic was covered today?
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Has emergency contact information been clearly posted on the safety center?
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Employees wearing all required PPE (gloves, hi-viz, glasses, hardhats, etc)?
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Signage & Barricades in place where required?
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All employees wearing appropriate rated footwear for tasks today?
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Are employees wearing hearing protection when noise levels are in excess of 85 dBa?
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Is the Uni-pack spill kit available and fully stocked?
Facilities:
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Fire cabinets kept closed
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Fire cabinets free of debris
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Fire Cabinets Properly Vented to Outside Facility?
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Smoke Detector and Fire Suppression System in Place and Functioning?
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Carbon Monoxide detectors in place and functioning?
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Work tables clean and free of debris
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Work areas kept clean
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Emergency exit doors kept clear
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Emergency exit door path kept clear
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Electrical shut off switches kept clear
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Power tools in good working order
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Trip Hazards Observed?
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Comments
Chemical Safety:
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Have all materials/chemicals been labeled using the NFPA labels?
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Have safety data sheets been updated for new products in inventory? Spot check (3):
Fire Extinguishers & Fire Prevention:
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Fire Extinguishers are visible and have proper signage
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Fire Extinguishers are in date
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Evacuation Plans displayed & visible?
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Bottles/Cylinders properly stored?
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Is the eyewash station on the safety board, and within the manufacturers expiration date? / Tested Fixed Eye Wash Station for functionality?
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Is the first aid kit available and stocked?
Shop Floor:
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Floor striping clean and visible?
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Work tables clean and free of debris?
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Work areas kept clean?
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Emergency exit doors kept clear?
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Emergency exit door path kept clear?
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Electrical shut off switches kept clear?
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Electrical Panel Doors Closed and Secured?
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Comments
Clean-up & Housekeeping:
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Are entries walkways and drive lanes kept clear?
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Bins or Dumpsters located at suitable points?
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Oily rags and combustible refuse stored in covered metal containers?
Inventory:
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Emergency exit doors kept clear
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Emergency exit door path kept clear
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Walkway kept clear
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Comments
Tool Room & Chemical Staging Area:
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Work tables clean and free of debris
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Work areas clean
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Walkways kept clear
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Parts washers clean and lids closed
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Tool and equipment put away when not in use
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Bench grinders in good working condition with guards in place
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Comments
Welding & Cutting
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Cylinders stored properly?
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Hoses in good condition?
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Adequate shielding provided?
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Fire Blankets available and used where necessary?
Follow Up & Get Well Plan
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Follow up inspection to be performed
Signatures:
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Performed by Safety Manager: