Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Sprinkler System
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Control Valves open and scaled?
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Monthly 2" drain test conducted?
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Alarm or water going fully operational on 2" drain test?
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A clear space of 5' is maintained in front of the sprinkler riser?
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Outside fire department hookup is not blocked?
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Protective covers in place on fire department hookup?
Forklift & Delivery Truck
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Each piece is equipped with a back up alarm?
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Drivers trained and properly licensed?
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Fuel tanks properly secured on forklifts?
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Glass on trucks in good repair?
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All lights and signals operating?
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Seats and seat belts in good repair?
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Rubber pads on break & clutch pedals do not show excessive wear?
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Horn working?
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Tires in good repair?
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No mechanical repairs needed?
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Load straps in good condition?
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Verify truck annual inspection is current?
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Pallet jacks, dollies, drywall carts in good condition?
Parking Lots & Outside Storage Areas
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Parking lots, yard areas, & sidewalks free from snow ice and sanded/salted?
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Entrances & exits are clear of material, snow, ice, and maintained dry?
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No hazardous areas in parking lots or walkways (potholes or broken asphalt)?
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Fire lanes clearly marked & unobstructed?
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Dumpsters located a minimum of 25' from hydrants?
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Adequate lighting?
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Material stored in a safe manner?
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Good housekeeping practices?
Electrical Systems
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No burnt out light fixtures or buzzing ballast in need of replacement?
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No broken or loose electrical conduit?
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A clear space of 3' is maintained in front of electrical panel boxes?
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No missing knockout plugs or junction box covers?
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Electrical panel doors are maintained in the closed position at all times?
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Electrical cords free of cracks & splices?
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Extension cords free of cracks & splices?
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No multi-plugs utilized in outlets?
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Conduit, junction & panel boxes, outlets & monitors are free of dust and oil?
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Ensure the electrical service panel is properly grounded?
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Electrical panels properly labeled and marked?
Plant
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Electrical in 4 satisfactory?
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Smoking prohibited or confined to designated areas with receptacles provided?
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Floors are free of cigarette butts, trash, & tripping hazards?
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Pressurized cylinders secured in a rack or chained to a fixed object?
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Floor area free of scrap lumber, packing material, & other tripping hazards?
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All fluid leaks cleaned up immediately?
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Exit marked & unobstructed?
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Fire extinguishers clearly marked, accessible, fully charged, & annually serviced?
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Class A fire extinguishers are accessible within 75' or less?
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Class B fire extinguishers are accessible within 50' or less?
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Housekeeping in excellent order?
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Employees wearing proper protective equipment?
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Hard Hat?
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Steel/Composite Toe Boots?
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Hearing Protection?
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Eye Protection?
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An 18" clear space is maintained below the sprinkler heads?
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Posted load limits for deck & shelving?
Employee Observation/ Safe & Unsafe Acts Observed:
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Comments:
Office, Storage, Display, Restroom, & Break Areas
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Electrical in 4 are satisfactory?
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Smoking prohibited or confined to designated areas with proper receptacles?
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Floors are free of cigarette butts, trash, & tripping hazards?
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Lunch areas & rest rooms are clean?
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First aid kits are fully supplied?
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Exits properly marked & unobstructed?
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An 18" clear space is maintained below the sprinkler heads?
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Emergency lighting with battery backup operates properly when test button is depressed?
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Names of employees certified in first aid, CPR, & annually trained in blood borne pathogen with names posted on first aid kits?
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Fire extinguishers clearly marked, accessible, fully charged, annually serviced, & accessible within 75' or less?
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Hallways & storage rooms have clear pathways & aisles free of debis?
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Step stools & small ladders available for reaching bookshelves?
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Easy access to storage room boxes & supplies?
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Emergency telephone numbers posted where all employees have access?
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Emergency Evacuation Plan & Accident Procedures posted?
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OSHA poster and other required legal posters where employees have access?
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Emergency lighting with battery back up
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Sidewalks and parking lots free of ice and snow in winter?
Office Ergonomics
Chairs:
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Adjusted correctly to achieve correct posture - 90 degree angle at hips and knees, feet resting flat and comfortably on the floor or foot rest?
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Forearms, wrists, &hands in straight line while using keyboard?
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Ample clearance to move legs under the desktop, workstation, or keyboard tray?
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Chair provides some clearance behind knees when seated against the backrest?
Monitors:
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Directly in front of the employee while at the keyboard?
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Top of monitor at or just below eye level?
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Positioned an arm's length away?
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Reflection/glare on the screen is minimized either by tilting monitor or using ant-glare filter?
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Document holder used to place materials as close to the monitor as possible, and at the same distance & height?
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Employee knows how to adjust monitor's brightness and contrast to a comfortable level?
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Computer screen is clear?
Lighting:
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Overhead lighting does not cause glare on work surfaces?
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Task lighting is used to illuminate work surfaces?
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Glare on work surfaces is reduced through the use of window shades, blinds, or anti-glare filter on computer screen?
Miscellaneous:
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Frequently used items or materials are within easy reach?
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Temperature in the work area is maintained at a comfortable level?
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Employee takes frequent breaks to allow joints and muscles to rest?
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Noise levels in work area are at a comfortable and non-distracting level?
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Comments:
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Safety Officer
