Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Section 1.0: Bulk's Ten Golden Rules

  • Fall protection is required whenever working above 4 feet.

  • Rail priority rules, track clearances and crossing rules must be followed.

  • Safety devices must not be intentionally disabled or bypassed.

  • Entry into a permit required confined space is not allowed.

  • Maintaining clearance under suspended loads and objects.

  • Slings in use must be properly rated, inspected and rigged.

  • While actively inflating tires, all employees must stay clear of the tire's trajectory zone.

  • All traffic and vehicle rules must be followed.

  • All work must comply with Bulk Equipment's Lockout/Tagout policy.

  • Site is in compliance with Bulk Equipment's Jacking and Blocking policy.

Section 2.0: Administrative

  • Are Near Misses being documented?

  • Are required postings (Worker's Compensation Information, Labor Laws, Employee Rights, etc.) prominently displayed?

Section 3.0: General

  • Are Safe Work Practices/Standard Operating Procedures/JHA’s being followed?

  • Are man doors being used and overhead door avoided for pedestrian traffic?

  • Is PPE being used as required and properly maintained?

  • Is all PPE clean and stored in its respective locations (i.e., fall arrest gear, welding gear)?

  • Are areas generally clean and free of housekeeping hazards (i.e., tripping hazards)?

  • Have oil spills on the shop floor and property been properly cleaned up to avoid slips and maintain environmental compliance?

  • Are all doorways clear of obstructions?

  • Is the area well lit?

  • Are fumes, vapors and/or exhaust controlled or vented from the building?

  • Do portable tools, bench grinders, tooling and equipment have all their guards in place?

  • Are tool rests (1/8”) and tongues (1/4”) set at proper distances on bench/pedestal grinders?

  • Is there a First Aid Kit available? Is it clearly marked and fully stocked? Are monthly inspections done?

  • Are portable ladders inspected and maintained in good working order?

  • Is storage shelving secured to floor or wall and capacity noted?

  • Is the overhead crane inspected and certified on an annual basis?

  • Is a crane log maintained?

  • Electrical cabinets closed?

  • Are all electrical outlets and cords in safe condition (free of cuts, splices or exposed wires)?

  • Are outlets GFCI rated or is a GFCI rated adapter used?

  • Extension cords not used as permanent wiring?

  • Are parking spots and walkways appropriately lighted?

  • Is snow, ice and other debris controlled on all walking/driving paths?

Section 4.0: Fire Safety

  • Are all fire extinguisher stations properly marked, free of obstructions and mounted off the floor?

  • Have all fire extinguishers been checked on a monthly basis to ensure they are fully charged and in good working order?

  • Have all building/storage area fire extinguishers been inspected by an outside agency on an annual basis?

  • Are area emergency lights in place and functioning?

  • Are smoke, fire and burglar alarms in place and functional?

  • Have NO SMOKING signs been posted in the chemical/flammable material storage areas?

  • Has an (ERP) Emergency Response Plan been developed? Is the plan up to date and posted at key locations in the building (i.e., near all exits and phones)?

  • Are Assembly Points known and identified?

  • Are emergency exits well identified and unobstructed?

  • Are emergency evac alarms or air horns onsite and accessible?

  • Are oily or contaminated rags stored in approved receptacles for approved disposal?

Section 5.0: Compressed Gases & Hot Work

  • Are flashback arrestors and back-flow prevention devices installed on all oxy-acetylene torches?

  • Are oxy-acetylene cylinders turned off and the system depressurized when not in use?

  • Are flammable liquids and combustible items stored away from welding equipment?

  • Are gas cylinders secured upright? Are oxygen and flammable gas cylinders stored separately?

  • Are cylinder caps on cylinders when not in use?

Section 6.0: Chemical Safety

  • Is there a current chemical inventory for the site? Is 3E online management available and do employees know how to use/access it?

  • Are secondary containers properly labeled?

  • Are chemicals being stored in their appropriate locations? (ie Flammable Storage Cabinet)

  • Are chemical containers stored over containment?

  • Are all chemical containers closed properly and free of leaks?

  • Is material for chemical spill clean-up or containment available (i.e., spill kit, spill tray, additional supply of Oil Dri, etc.)?

  • Has the Safety Shower/eyewash been routinely checked to ensure that it is functioning properly, within expiration and has not leaked out?

  • Are aerosol containers properly disposed of?

Section 7.0: Vehicles and Equipment

  • Are Fire Extinguishers mounted on all vehicles and Equipment?

  • Have all equipment-mounted Fire Extinguishers been checked on a monthly basis to ensure they are fully charged and in good working order?

  • Are all vehicles and equipment equipped with the appropriate safety equipment (i.e., reflective triangles, wheel chocks, clip on air chuck, no touch tool, etc.)?

  • Are all vehicles equipped with First Aid Kits? Are they fully stocked? Are monthly inspections done?

  • Do all DOT qualifying vehicles have a current DOT inspection?

  • Are all vehicles in safe operating condition (tire condition, windshield free of defects, warning lights, etc.)?

  • Are all documents current (i.e., insurance documents, registration, Annual DOT Inspection, IFTA if applicable)?

  • Are portable fall protection units current on biannual inspections?

  • Are manlifts, scissor lifts, etc. current on required inspections?

Section 8.0: Inspection Closure

  • NUMBER OF NEAR MISSES REPORTED THIS MONTH:

  • NUMBER OF HAZARD ASSESSMENTS COMPLETED THIS MONTH:

  • INSPECTOR SIGNATURE:

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.