Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Untitled Page

Site Assessment Checklist

  • CSG−0102 Site Assessment Checklist covers the whole facility (or workspace) shall be performed at least quarterly. At larger facilities, the site assessments can be divided into smaller specific work areas.GSS 0102 Health and Safety Assessments. Site assessments and associated corrective action plans must be documented, maintained, retained, and disposed in accordance with United Airlines record retention requirements (5 yrs) and accessible to all local leadership.https://techsuite.ual.com/techview/main.action

Administration / Injury and Illness Recordkeeping

  • Employees' Right of Access to Medical and IH Monitoring records notice is posted in an accessible location

  • Areas that present specific hazards to employees (i.e., high voltage, noise, chemical storage) have posted signs identifying the hazard and access requirements?

  • A completed and signed copy of the OSHA 300A is posted only between February 1st and April 30th of the current year

  • Signed copies of OSHA 300A's are kept on file for five years plus the current calendar year (only after April 30th)

  • Site inspections are performed using this checklist / one approved by a United division

  • Site assessments covering the whole facility are to be performed at least quartely. At larger facilities the site assessments can be divided into smaller specific work areas

  • Employees performing site assessment have completed OSHA 10 / 30 hour training

  • Document findings from site inspections; hazard tracking

Automatic Sprinklers

  • Automatic sprinkler heads kept clean, items not hanging from the heads

  • Automatic sprinkler heads are protected by metal guards when located in an area exposed to physical damage

  • A minimum clearance of 18 inches is maintained away from sprinkler heads

  • Items must be stored below a horizontal plane 18 inches below the automatic sprinklers

Compressed Gas (Additional LP/propane requirements in separate section; Additional Fuelgas/ Welding requirements in separate section)

  • Are oxidizer cylinders (Eg. Oxygen) stored at least 20 feet away from flammable chemicals (Eg. Hydrogen. Especially oil or grease) or separated from flammable chemicals by a firewall?

  • Compressed gas cylinders are legible marked to clearly identify the gas contained. Cylinders are also free of corrosion, leakage, physical damage, and faded markings/labels

  • Empty compressed gas cylinders are appropriately marked, stored separately from filled cylinders

  • Compressed gas cylinders are not stored close to an external heat source

  • Compressed gas cylinders are stored in areas where they will not be damaged by passing objects

  • Compressed gas cylinders are stored upright, in a manner to prevent them from tipping, falling, or rolling over (chaining the cylinder). For Example, bottles are properly chained from falling at both the top and bottom of the cylinder while in storage

  • Valve protection caps are in place when the compressed gas is not in use

  • Valves are closed before a compressed gas cylinder is moved, empty, or following use

Compressed Gas – LP / Propane Most items will be part of NFPA 58

  • “No Smoking” signs posted on LP/propane gas tank storage areas; storage areas indicate LP / Propane storage

  • When stored horizontally; ensure stored with the valve end up and valve cover in place

  • LP / Propane tank valve is closed; gas is released from the regulator before the regulator is removed

  • Empty LP / Propane cylinders are appropriately marked, stored separately from filled cylinders

  • PPE is available for changing propane tanks (proper gloves, goggles)

  • LP / Propane cylinders stored in a well ventilated area (preferably outside), not close to an external heat source

  • LP / Propane storage areas guarded to prevent from tipping, falling, or rolling over, also guarded against potential GSE damage

  • Outside stored LP gas containers located in an enclosure that protects from damage and tampering by individuals and vehicles. In addition, the enclosures are safe distance from vehicle traffic or protected by concrete barriers

Confined Space Needs Tech Ops completion

  • Have all work areas been inspected to determine if any confined spaces are present? Confined space means a space that: 1) Is large enough and so configured that an employee can bodily enter and perform assigned work; and 2) Has limited or restricted means for entry or exit (for example, tanks, vessels, silos, storage bins, hoppers, vaults, and pits are spaces that may have limited means of entry.); and 3) Is not designed for continuous employee occupancy

  • Is there an inventory of confined spaces and are these confined spaces labeled as "Confined Spaces, Do Not Enter"?

  • Are the confined spaces on a list and are they identified as which are permit required? Is the list updated annually or as conditions change?

Electrical Appliances (Reference "Electrical Space Heater" for additional Space Heater requirements)

  • Is Grounding prong intact and cord not damaged, spliced, or frayed

  • Is electrical equipment damaged or have exposed live parts?

  • Are electrical appliances including coffee makers, toasters, and refrigerators plugged directly into a wall outlet? (Multiple radios being charged is permissible)

  • Appliance within 6ft of a direct water source plugged into a GFCI outlet. These outlets include a Test and Reset button

  • Electrical cords are free of any repairs with electrical tape. Cords that are worn, frayed, corroded or otherwise damaged are destroyed and replaced immediately

Electrical Circuit Breaker / Electrical Panels

  • Panels must be kept closed, unblocked, and have 30in. of clearance

  • All circuit breakers and disconnecting switches are labeled as to their function

  • Any unused openings are covered with appropriate covers, plugs, or plates

Electrical General: Sockets, Face Plates, Junction Boxes

  • All unused openings (including conduit knockouts) are enclosed with appropriate covers, plugs, or plates

  • All switches, sockets, and receptacles are provided with tight fitting covers and plate

  • All electrical wiring is enclosed; live wires are capped and not exposed

  • Multiprong adapters / splitters are not to be used for any appliance in the workplace

  • Is all electrical equipment such as outlets, junction boxes, panels, disconnects inspected for damage, missing parts and/or exposed electrical parts?

  • Electrical equipment and panels in PIV traffic areas/routes guarded or protected from being damaged by the PIVs?

Electrical Employees performing Live / Hot work Needs Tech Ops Completion

  • Are areas that present specific hazards to employees (i.e., high voltage, noise, chemical storage) posted with signs identifying the hazard and access requirements?

  • Is proper electrical PPE provided and used by authorized employees when working on or near live parts? Is the protective equipment maintained in a safe, reliable condition and periodically inspected or tested? Warning: Consider safe distance standards during observations. Flash Protection Boundary – distance from exposed live parts within which a person could receive a second degree burn if an electrical arc flash were to occur. This boundary may only be crossed by a qualified person wearing the appropriate PPE. (Review GSS0603 Apendix B Approach Boundaries for Exposed Energized Parts)

  • When working near exposed energized conductors or circuit parts, each employee shall use insulated tools or handling equipment if the tools or handling equipment might make contact with such conductors or parts

Electrical GSE Charging

  • Charging cables are in good condition, not frayed or spliced, repaired with electrical tape

  • Emergency eyewash provided if batteries are being serviced* / GSE maintenance work is performed

Electrical Extension Cords

  • Extension cord must be plugged directly into an electrical outlet, not piggybacked / daisy chained

  • Grounding prong intact and cord not damaged, spliced, or frayed

  • Extension cords may not be in use if repaired with electrical tape

  • Extension Cords not being used on a permanent basis

Electrical Surge Protectors / Power Strip

  • Must be plugged directly into an electrical outlet, not piggybacked / daisy chained. Power strips are not designed for high powered loads e.g. refrigerators and space heaters

  • Grounding prong intact and cord not damaged, spliced, or frayed

Electrical Space Heaters (In addition to items listed for electrical appliances )

  • Must be used at ground level, in an open location where it cannot easily be tipped over or be subject to falling items. The unit must also be kept away from combustible items

  • May not produce heat from flames or heating coils

  • Electrical cords cannot be a trip hazard

  • Space Heater / Supplemental Heating Unit may not have any safety systems bypassed

  • Must be equipped with thermal cutoff for overheating and have functioning tipover protection

  • Must not overload the circuit causing breakers to trip or fuses to be replaced (contact building maintenance for circuit capability)

  • Space Heater / Supplemental Heating Unit may not be left running while unattended

Elevated Walking Surfaces / Elevated Surfaces (Includes Catwalks, Scaffolds)

  • Signs posted, showing the elevated floor load bearing capacity

  • Are elevated platforms equipped with 42” high guardrail on both sides? Or is there a 42" barrier along the open sides of stairways and platforms that prevent falling

  • Do guardrails include a 3.5” tall toe board Are guardrails designed with a midrail midway between the top edge and the walking surface and / or vertical balusters or other members not more than 19 inches apart

  • Material stored are piled / stacked in a manner to prevent it from tipping, falling, collapsing, or rolling

  • Containers / pallets / objects are stacked safely so that they do not tip; objects / boxes do not fall

  • Containers/ pallets/ objects are stored safely on industrial shelving so that there is not an overhang from the shelf

Emergency Lights

  • Emergency lights illuminate; are functional if tested

  • Emergency lighting is adequate in exit / egress routes

Emergency Action Plan

  • Emergency Action Plan must contain at a minimum: reporting a fire or other emergency, emergency evacuation, and accounting for all employees following an evacuation

  • Are emergency phone numbers and evacuation maps/information posted in all operating areas?

  • Has at least one emergency drill(s) been conducted for fire, weather, chemical and/or spill response within a 12 month period?

  • Does the Emergency Action Plan contain emergency routes and safe muster areas?

  • Emergency Action Plan reviewed and approved annually

Exit / Egress Routes

  • Exit routes must be free and unobstructed. No materials or equipment may be placed, either permanently or temporarily, within the exit route. The exit access must not go through a room that can be locked, such as a bathroom, to reach an exit or exit discharge, nor may it lead into a deadend corridor

  • Each exit route must be adequately lighted so that an employee with normal vision can see along the exit route

  • Exit routes must be kept free of highly flammable Materials (e.g. flammable / chemical / compressed gas storage)

  • Exit route must be at least 28 inches wide at all points

  • If the direction of travel to the exit or exit discharge is not immediately apparent, signs must be posted along the exit access indicating the direction of travel to the nearest exit and exit discharge

  • Lineofsight to an exit sign must clearly be visible at all times

  • Each doorway or passage along an exit access that could be mistaken for an exit must be marked "Not an Exit" or similar designation, or be identified by a sign indicating its actual use (e.g., storage closet, office name)

Exit Signs / Exit Doors

  • Each exit sign must be illuminated or selfluminous / electroluminescent (capable of retaining illumination during a power loss)

  • Exit doors must be identified with an exit sign

  • Exit doors must remain unlocked

  • Exit doors must be able to be opened from the inside at all times without keys, tools, or special knowledge

  • Exit route doors must be free of any device or alarm that could restrict emergency use of the exit route if the device or alarm fails

  • Exit Doors must swing out in the direction of exit travel if the room is designed to be occupied by more than 50 people

Eye Wash / Shower Plumbed

  • Emergency eye wash stations are within the immediate work area (10 seconds <50ft) where employees are exposed to corrosive materials; employees must have unimpeded access

  • A Portable / gravity feed eyewash may only be used in place of a plumed/piped system if it can maintain a minimum flow of 0.4 gpm, and hardpiped eyewashes/showers 3 gpm and 20 gpm, respectively, for a continuous period of at least 15 minutes

  • Emergency Eyewash stations must have a 3ft. Clearance

  • Eyewash stations must have a tag/form to indicate inspections

  • Plumbed/piped eyewash stations must be flushed weekly. Is there evidence of the weekly task of flushing eye wash stations in building reports? (Contact Facility Maintenance)

  • All Emergency Eyewash stations must be inspected monthly to ensure cleanliness and proper working condition. Is there evidence of monthly building report inspections of cleanliness and proper working condition? (Contact Facility Maintenance)

  • Water nozzles are protected by airtight covers or dust guards

Fire Extinguishers

  • Fire extinguishers are visually inspected monthly and inspected on an annual basis by an approved fire extinguisher inspection vendor. Note: Check the fire extinguisher inspection tags to ensure that the inspection is up to date

  • Fire extinguishers are maintained in an accessible location and not blocked

  • Each fire extinguisher location is properly identified by a sign

  • Each fire extinguisher is mounted to the wall and is accessible so as not to cause injury to anyone

First Aid Kits / Portable Eye Wash

  • First Aid kits must be inspected monthly

  • First Aid kits must be adequately stocked and contain a list of items that must be contained inside the kit. (Follow local guidance on requirements)

  • Are all supplies (including portable eye washes) with an expiration date not expired?

  • First Aid kit must contain a number / directions for employee to get emergency assistance

Flammable Materials / Flammable Storage Cabinets

  • Flammable Storage Cabinet is an approved cabinet, and labeled “FLAMMABLE: KEEP FIRE AWAY”

  • Flammable Storage Cabinets have a three point locking mechanism; are stored on a noncombustible surface

  • Are "NO SMOKING" signs posted in areas where flammable or combustible materials are used or stored?

  • Cabinet vents are sealed unless vented to the outdoors

  • Combustible items are not stored on top of / beside / inside Flammable Storage Cabinets

  • Flammable Storage Cabinets are not located in exit routes, next to exit doors

  • Flammable liquids, such as gasoline, are kept in an approved safety container. A plastic container may be used if it has been approved by an NRTL or the DOT and has a capacity of 5 gallons or less

  • Are all flammable and combustible liquid containers inspected for proper grounding and bonding if transferred between containers?

  • Are all spray booths inspected for combustible residue, scrapings or debris contaminated with paint residue and if items are found, are approved metal waste cans used for disposal? Are these waste cans emptied daily? (Contact Environmental Affairs)

GSE General / Powered Industrial Vehicle (PIV)

  • Modifications that have been made to the powered industrial vehicle(s) have been approved by the manufacturer in writing

  • Powered industrial vehicles inspected prior to each day's use and these inspections are documented

  • Powered industrial vehicles that are "out of service" tagged or disabled to prevent operation until repairs are made

GSE Forklifts

  • Must be in good condition (applicable items on daily user inspection)

  • Manufacturer safety instruction placard is in place, readable

  • Must ensure seat belts are provided/operable if required by the manufacturer

  • Must be inspected daily, documented on GSE checklist or other similar document

  • If electric powered, charging cables are in good condition, not frayed or spliced

Hand Power Tools

  • Power tools and equipment in good repair (i.e., no damaged cords, broken parts or casings)?

  • Compressed air nozzles provided with pressure relief ports to maintain the pressure at the end of the nozzle at less than 30 p.s.i. if the nozzle end is blocked

  • Power tool hoses are protected from pedestrian / GSE traffic

  • Grounding prong intact and cord not damaged, spliced, or frayed

  • Is electrical equipment damaged or have exposed live parts?

  • If an inspection finds equipment to be faulty, has it been removed from use and marked accordingly?

Hazard Communication (HAZCOM) / incora

  • All chemicals / substances have manufacturer label or approved label (e.g. printed from incora website). Containers must be clearly labeled name and manufacturer of the material, tagged or marked with the identity of the hazardous chemical

  • Hazardous chemicals / substances in the work area been inventoried and recorded on the incora website

  • Chemical / substance list for the location is updated at least annually or as new chemicals are introduced into the work area(s), added to incora website

  • Areas that present specific hazards to employees (i.e., high voltage, noise, chemical storage) posted with signs identifying the hazard and access requirements

  • If Lead and/or chromium are being used at the location, the applicable elements of 29 CFR 1910.1025 and 29 CFR 1910.1026 being adhered to

Housekeeping / Building Condition / Walking Surfaces

  • All work areas, including but not limited exit routes, storerooms, service rooms, and walkingworking surfaces are kept in a clean, orderly, and sanitary condition

  • Floor openings guarded by a cover, a guardrail, or equivalent on all sides (except at stairways or ladder entrances)

  • Areas such as the top of cabinets, lockers, and underneath desks kept clear of stored materials to reduce the potential for fire

  • Stacked materials stable, aligned, and stacked to a safe height

  • Are areas free of unnecessary accumulations of trash or other stored items that could start or fuel a fire?

  • Are computer cables and wiring enclosed within the cubicle wall cable runs (i.e., cables extending into the aisles are a tripping hazard, maintaining clear aisles is important to ensure a safe exit from the building during an emergency situation)

  • Are grates or similar type covers over floor openings such as floor drains designed to allow unimpeded foot traffic or rolling equipment?

  • Are all lighting fixtures, including fluorescent lights, less than 7 feet from the floor or working surface, covered or guarded?

  • Aisles and walkways are free of hazards

  • Are areas free of unnecessary accumulations of trash or other stored items that could start or fuel a fire?

Industrial Storage Racks * Industrial Storage Racks are single or multilevel structural storage system that are utilized to support high stacking of single items or palletized loads, loading/unloading is almost always done with mechanical assist (e.g. forklift trucks, etc.)

  • The load bearing capacity of the storage rack must be identified

  • Industrial Storage Rack legs / support members are not be bent / disconnected / damaged

  • Wooden stringers or decking are laid between front and rear rack beams and in good condition

  • Containers/ pallets/ objects are stacked safely so that they do not tip; objects / boxes do not fall

  • Industrial Steel Storage rack columns shall be anchored to the floor with anchor bolts capable of resisting the forces caused by the horizontal and vertical loads on the rack

Ladders Fixed

  • Fixed ladders with height of more than 20ft are equipped with cages / wells

  • Rungs, cleats and steps are free of splinters, sharp edges, burrs, or other projections which may be a hazard

  • Base of the ladder is in good condition, not damaged

  • Method of securing access point at top of the ladder to prevent an accidental fall, such as a self closing gate

Ladders Portable

  • Ladders are marked in a manner to uniquely identify it, so that none are overlooked during inspection

  • Ladders are visually inspected prior to each use, removed from service and tagged "Do not Operate" if any defects are found? Items to be inspected include:

  • Steps, rungs, braces, pivot points, side rails and nonskid surfaces are free of damage such as (loose, cracked, split, bent or otherwise damaged), ladders are clean (free of grease, oil or slippery materials); ladder wheels and axles are in good condition, not worn or missing parts; Ladder safety feet not worn or missing parts

  • Ladders are being used appropriately (e.g. not standing on top rung, used in accordance with placard instructions) and for the purpose for which they were designed

  • All portable ladders shall be kept clean and dry, and any water, oil or other slippery substance shall be removed prior to and after use

  • All portable ladders should be stored in a covered or enclosed area to prevent contact with inclement weather

  • Ladders are inspected to ensure conformity with purchase specifications, GSS, and local standards upon receipt

Loading Docks / Loading Dock Operations

  • Dock boards (bridge plates) used when loading or unloading operations are taking place between vehicles and docks

  • Trucks and trailers capable of being secured from movement during loading and unloading operations (Chocks, ICC locking device, or other device available)

  • Vehicles required to be shut off with brakes set during loading / unloading operations

  • Roll up doors / truck guards are closed / secure to provide fall protection when loading dock platform is not in use

Lockout / Tagout

  • Are lockout/tagout (energy control) procedures developed and documented for all pieces of equipment that is serviced or maintained? (The procedures must identify all hazardous energy sources and methods to be used to control/mitigate the hazards.) Are these procedures followed?

  • Are all machine specific LO/TO procedures reviewed annually and is the inspection documented? Are periodic inspection of the energy control/LOTO procedures conducted at least annually?

  • Are standardized and dedicated lockout devices (i.e., valve covers, breaker lockouts, hasps, etc.) available and used? Do they identify the employee applying the device?

  • Are written lockout/tagout procedures developed, maintained and communicated to all employees?

Machine Guarding

  • Ingoing nip points, rotating parts, belts, pulleys, and fan blades are guarded

  • Guards are installed on grinding wheels, drill presses, and other shop equipment (Note: All grinder tool rests cannot exceed a 1/8 inch distance from the wheel, top tongue guards cannot exceed a 1/4 inch distance from the wheel)

  • Machinery is unable to be activated accidentally (must have a manual reset feature or antirestart in the event of a power interruption)

  • Machinery, that can be activated by a foot pedal, is covered so that they cannot be accidentally stepped on

  • Points of operation are properly guarded to prevent employees from having any part of their body in the danger zone during operating cycles

  • Machines/equipment designed for fixed locations are anchored/secured to the floor

  • Radial arm saw has a cutting head return device that is installed so that the front end of the unit is slightly higher than the rear and there is an adjustable stop provided to prevent the forward travel of the blade beyond the position necessary to complete the cut in repetitive operations (i.e. belly bar)

  • Immediately before mounting, all wheels are closely inspected and sounded by the user (ring test) to make sure they have not been damaged in transit, storage, or otherwise. The spindle speed of the machine shall be checked before mounting of the wheel to be certain that it does not exceed the maximum operating speed marked on the wheel. Wheels should be tapped gently with a light nonmetallic implement, such as the handle of a screwdriver for light wheels, or a wooden mallet for heavier wheels. If they sound cracked (dead), they shall not be used. This is known as the "Ring Test"

  • Exposed parts of horizontal shafting on conveyor systems are properly guarded?

  • Projecting shaft ends have a smooth edge and/or the end of the shaft project less than onehalf the diameter of the shaft unless guarded by nonrotating caps or safety sleeves

  • Pulleys with rotating/moving parts 7 feet or less from the floor are properly guarded?

  • Safety guards cover the top half of the wheel and the sides of the wheel so that the opening does not exceed 180 degrees

PPE

  • Personal protective equipment (i.e. gloves, aprons, safety glasses) is maintained in a clean and sanitary condition?

Respiratory Protection

  • Is a program administrator designated at each location where respirators are used?

  • Has a respirator filter change out schedule been established that replaces the filters before the end of their service life?

  • Have all respirators been inspected for proper storage.(Respirators must be cleansed and disinfected and stored in plastic bags to protect from dust and placed where it will not become damaged.)

  • Has a written respiratory protection program been developed and implemented that includes procedures to ensure adequate air quality, quantity and flow of breathing air for atmospheresupplying respirators

Storage Shelves / Lockers *Storage Shelves are designed to accept and store nonpalletized loads, usually loaded manually. The following items are not intended for use on Industrial Storage Racks; reference “Industrial Shelving” in separate section

  • Areas such as the top of cabinets, lockers, and underneath desks are kept clear of stored materials to reduce the potential for fire

  • A clearance of 18 inches or greater shall be maintained between the sprinklerhead (deflector) and the top of the storage

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.