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
PART I. GENERAL HOUSE KEEPING
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C1.) Floors, walls, windows, clean and in good repair.
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C2.) Break rooms cleaned/disinfected daily.
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C3.) Trash containers sufficient to prevent overflow and emptied and cleaned daily.
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C4.) All required posters and company policies in place and completed with current information.
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C5.) Aisles and hallways clearly marked and kept clear of obstacles. (1910.22)
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C6.) Cleaning supplies readily available. MSDS's and CIL on file electronically and in binder.
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C7.) a.) Equipment properly stored in designated areas.<br> b.) Unused & broken equipment properly stored and tagged "out of service" as appropriate.
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C8.) Products/supplies stored in designated areas. Inventory performed and maintained.
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C9.) Outside area around building(s) clean and neat. Landscaping maintained, Building in good repair.
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C10.) Proper signs posted at entrances, doorways, storage areas, maximum floor loading, etc..
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C11.) Lighting in good repair and sufficient. Bulbs replaced as needed. Light bulbs and tubes shielded as required to prevent shattering.
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C12.) Doors and locks functional and in good repair. Fencing & gates working.
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C13.) Locker rooms and showers clean and in good repair. Uniforms, towels, & PPE properly stored. Lockers provided and utilized.
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C14.) Smoking prohibited within building and smoking area designated.
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C15.) Cargo areas cleaned and disinfected as needed; spills cleaned immediately. Truck cabs clean and orderly.
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C16.) Secondary containment/spill control pallets utilized to control releases of bulk chemicals.
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C17.) Floors drains are clean and free of debris. Floor grates/screen netting in place.
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C18.) Equipment wash water properly disposed. No mixing of industrial process water and rainwater.
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C19.) Operational and customer records purged/shredded such that only 3 years of records are retained onsite. Review records retention policy as needed.
PART II. EMERGENCY RESPONSE/FIRE CONTROL & PREVENTION
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C1.) Fire Extinguishers - Inspect all extinguishers and initial tags monthly. Check that all unit are properly hung, clean, and accessible. Place "out of service" tags o n units needing repair.
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C2.) Review Emergency Contacts List and update as needed. Insure that modified list is provided to appropriate agencies. Provide emergency numbers by each phone.
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C3.) Check sprinklers system valves and sprinkler heads/pipes for damage. Inspected annually? 18" clearance for heads. Has the sprinkler system had annual inspections?
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C4.) Check all exits/non-exits for proper signage and access.
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C5.) Spill kits available and stocked with proper equipment.
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C6.) Emergency Evacuation Plan posted at required locations throughout facility.
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C7.) Fire hose connections not obstructed.
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C8.) All flammables stored in approved containers and cabinets. MSDS's & CIL available electronically and in binder.
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C9.) Compressed gas cylinders stored & secured. Oxygen/acetylene separated by 20 ft or solid wall.
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C10.) Emergency eyewash and shower units provided, accessible, and checked/activated weekly.
PART III. BASIC HEALTH & SAFETY
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C1.) New employees properly trained for specific duties.
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C2.) PPE designated, provided and utilized for all job duties?
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C3.) Employee work places clean and orderly - free of spills, oil, grease, and other hazards.
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C4.) Hand sinks available, accessible, maintained, and used.
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C5.) First Aid Kit available, stocked, no outdated items and no oral medications in the cabinet.
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C6.) Chemical containers properly marked/labeled & stored. MSDS & CIL updated as needed.
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C7.) Engulfment hazards identified and protective measures in place.
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C8.) All piping properly labeled for contents.
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C9.) Trained First-Aid/CPR Employee on duty each shift if required.
PART IV. ELECTRICAL SAFETY
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C1.) Permanent wiring, boxes, switches, outlets, and lights secure, properly mounted, and free of defects. No exposed wiring.
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C2.) Wiring for extension cords, portable lighting, power tools free of kinks, cuts, other damage.
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C3.) Extension cords not utilized for permanently mounted equipment.
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C4.) Portable tools and machinery properly grounded and/or double insulated. Is the ground prong or plugs not removed or converted?
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C5.) LOTO Program in place and updated as needed. All locks and marking equipment provided.
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C6.) GFI receptacles present in wet/damp locations.
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C7.) Breaker and fuse boxes clean, accessible, and all breakers identified
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C8.) Has a documented Arc Flash analysis been conducted? Is the analysis on site for review?
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C9.) Are all switchboards, panel boards, industrial control panels, meter socket enclosures, and motor control centers labeled with appropriate Arc Flash Warning?
PART V. MACHINES, EQUIPMENT, & TOOLS (OPERATIONS/SHOP)
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C1.) Employees properly trained to utilize equipment.
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C2.) Tool rests on grinders within 1/8 of wheel & 1/4 of tongue guard.
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C3.) Appropriate warning signs posted on or near equipment as needed (i.e. automatic start, etc.).
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C4.) Confined space program in place and current. All required signage posted.
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C5.) Are Powered Industrial Trucks (forklifts) operated by trained/authorized team members only? Are warning signs posted as necessary?
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C6.) Ladders & Stairways in good repair.
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C7.) All needed hand tools provided and in good repair.
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C8.) Freezer and refrigerated trailer(s) maintaining required temperatures.
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C9.) Are jack and hoist capabilities clearly marked? Are all jack(s) & hoist(s) in good repair?
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C10.) Secondary storage level - load rating posted.
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C11.) All moving parts, fans, pulleys, etc., within 7 feet of floor enclosed?.
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C12.) Boiler inspection certificate up-to-date? Boilore operator certifications up-to-date?
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C13.) Is boiler maintenance log up-to-date and boiler being blown down daily?
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C14.) Is Boiler room neat and orderly – no leaks present?
PART VI. MONITORING, REPORTING & TRACKING DOCUMENTS
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C1.) OSHA 300 & 301 Log: - Has the OSHA 300 log been reviewed for accuracy? Have the 301(s) been reviewed for accuracy?
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C2.) Have all DOT incident reports been reviewed? (i.e. 5800.1 form completed accurately, affected facilities/agencies notified, copies provided to corporate and on file for two (2) years)
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C3.) Has the TrueNorth Training/Medical Monitoring Log/report(s) been reviewed? (Review TNCompliance Reports, employees been notified of required training/medical exams, vaccinations)
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C4.) Have facilities Shipping Documents been reviewed for completeness and accuracy?
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C5.) Have the Powered Industrial Truck (forklift) daily/shift change inspections been reviewed?
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C6.) Have Weekly Inspections been performed and reviewed? Are Weekly inspections are being retained on site for 1 year?
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C7.) Have the BioSystems Cart Logs been reviewed for completeness and accuracy?
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C8.) Do the Bio System cart shelves have a full complement of containers and security bar in place?
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C9.) Does each Bio System cart have a completed inspection log that is accurate?
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C10.) Do all Bio Systems containers containing waste have caps in place?
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C11.) Are all Bio Systems containers labeled properly?
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C12.) Are the autoclave records maintained as required by the State and/or policy; time, temperature recording charts; accurate daily operating reports indicating weight/volume processed; maintenance records/logs; completed inspection logs; etc. and available for review?
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C13.) Are the incinerator records maintained as required by the State and/or policy; time, temperature records charts; accurate daily operating reports indicating weight/volume processed; maintenance records/logs; completed inspection logs; etc. and available for review?
PART VII. RADIATION
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C1.) Is the radiation storage area clearly marked as required?
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C2.) Are radiation monitors in place, calibrated, and functional?
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C3.) Is the detection meter checked and a log available for review?
PART VIII. VEHICLES
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C1.) Required Safety decals on vehicles - wide right turn, 3 point dismount, height markings, GOAL.
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C2.) Is the Conspicuity tape on all vehicles correctly applied and functional?
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C3.) For vehicles that carry bulk material, are proper Bulk Markings on the vehicle? (i.e. 6" Biohazard sign and 3291 Identification Markings)
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C4.) Has a review of spill kits been conducted?
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C5.) Has a review of proper load securement been conducted?
PART IX. DRIVER SPECIFIC ISSUES
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C1.) Have MVR's been reviewed? Review current listing of drivers and modify to obtain MVR's for drivers operating company vehicles.
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C2.) Have Hours of Service been reviewed? Determine compliance with 10 hour off duty, 11-hr driving/14-hr on-duty, and 60/70 hr 7/8 day limitations. Compare DMO with log books/time records.
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C3.) Have DVCR's been reviewed? Review to insure accuracy and to insure corrections have been made as needed.
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C4.) Has the Driver Spill Kit Checklist been reviewed? - Review & replenish equipment/material as needed. Perform monthly inspections.
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C5.) Hs the Vehicle Emergency Response Manuals been reviewed. Check for completeness & update as needed.
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C6.) Hs the Driver Management (DMO-JJ Keller) violation reports been reviewed? Has Disciplinary action documented for non-compliant individuals.
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C7.) Are all vehicles properly signed and marked for each State the vehicle the operates in?
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C8.) Have the vehicle maintenance files been reviewed? Review minimum 10% of files and record truck numbers.
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Location CSA current point total:
PART X. DOT PACKAGING
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C1.) Are Bulk Containers (>119 gallons) labeled with Large 3291, 6" Biohazard symbol, stack weight rating?
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C2.) Are Tubs/boxes properly labeled with Regulated Medical Waste, n.o.s.; the work "Biohazard", Biohazard symbol, UN 3291 and up arrows?
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C3.) Are all non-gasketed sharps containers packaged in secondary containers, (excluding Bio Systems containers).
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C4.) Are all tubs/boxes are in good repair? Are no damaged containers shipped to customer or another SRCL location?
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Date Inspection Completed:
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Supervisor/ Facility Manager Signature:
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Area Safety Manager Signature: