Office
Does this location have a "manned" office?
There is a site specific Emergency Action Plan with proof of training/review.
There is a site specific Emergency Response Plan with proof of training/review.
There is a Bloodborne Pathogens Program in place with proof of training/review.
There is a Confined Space Entry Program (or Non-Entry) in place with proof of training/review.
There is a site specific Fire Prevention Plan with proof of training/review.
There is a plan in place for Forklift Operator Evaluation.
There is a site specific Hazard Communication Program with proof of training/review.
There is a site specific Hot Work Program with proof of training/review.
There is a site specific Hazard Assesment Program with proof of training/review.
There is a site specific LOTO program, appropriate equipment, and proof of training/review.
There is a copy of the most recent site inspection.
There is proper documentation of monthly Safety Awareness Meetings.
There is proof of Classroom Training.
There is proof of Hands on Training—Appendix C completed for each employee.
There is proof of Hands on Training—Appendix D completed for each employee.
Supplies for conducting inspections are readily available and appear to be being used appropriately. (Tube and Stick or Interstitial Gauge)
Annual Inspection Checklist is current, complete, and correct.
Monthly Inspection Checklist is current, complete, and correct.
Portable Container Monthly Inspection Checklist is current, complete, and correct.
Is this a PE SPCC facility?
Fire extinguishers are hung properly.
Monthly inspections have been properly documented.
Electrical breakers are properly labeled.
Exits and non-exits are labeled properly.
OSHA posters are prominently displayed.
OSHA 300 Log has been hung/taken down as appropriate.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Shop
Does this location have a shop?
Used oil is properly labeled.
Used oil is stored in proper receptacle.
Proper disposal information is posted/available.
Fire extinguishers are hung properly.
Monthly inspections have been properly documented.
Does this area have equipment requiring a 6 sided guard?
Does this area have a bench grinder?
Does this area have any other machines requiring guards?
Are there areas requiring eye protection?
Exits and Non-Exits are properly labeled.
Proper and adequate NFPA signs are posted.
Does this area have electrical overhead doors?
Electrical breakers are properly labeled.
Does this area have shelving and storage?
Combustible materials/trash are in a steel can with lid in accordance with the recently implemented fire prevention plan. (May SAM)
The general cleanliness of this area promotes prevention of slips, trips, and falls.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Liquid Operations
Does this location have Liquid Operations?
Tanks and their contents are properly labeled.
Does this facility have elevated walkways and/or platforms?
Adequate measures have been taken to provide site security.
Secondary containment structures are in good repair and appear to be functioning properly.
There is an eyewash/safety shower station located on site.
Exits and Non-Exits are properly labeled.
Proper and adequate NFPA signs have been posted.
Does this facility have electrical overhead doors?
Is this facility required to have a fire extinguisher?
Electrical breakers are properly labeled.
Does this facility have shelving and storage?
All tanks have proper confined space stickers.
The general cleanliness of this area promotes prevention of slips, trips, and falls.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Dry Operations
Does this location have Dry Operations?
The contents of all bins are properly labeled.
Does this facility have elevated walkways and platforms?
Adequate measures have been taken to provide site security.
Secondary containment structures are in good repair and appear to be functioning properly.
Exits and Non-Exits are properly labeled.
Proper and adequate NFPA labels have been posted.
Does this facility have electrical overhead doors?
6 sided guards are complete and have been installed properly.
Fire extinguishers are hung properly.
Monthly inspections have been properly documented.
Electrical breakers are properly labeled.
The general cleanliness of this area promotes prevention of slips, trips, and falls.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Chemical Warehouse, Seed Storage, Treatment
Does this location have a Chemical Warehouse, Seed Storage, Treatment area?
Exits and Non-Exits are properly labeled.
Proper and adequate NFPA signs have been posted.
Does this facility have electrical overhead doors?
Does this facility have equipment requiring 6 sided guards?
Does this facility have other equipment requiring guards?
Fire extinguishers are hung properly.
Monthly inspections have been properly documented.
Electrical breakers are properly labeled.
Does this facility have shelving and storage?
The general cleanliness of this area promotes prevention of slips, trips, and falls.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
NH3 Operations
Does this location have NH3 Operations?
Adequate and proper crash protection is installed.
Adequate measures have been taken to provide site security.
Emergency water tank is full and water is generally clear and free of debris.
Bleed off water tank is properly sized and labeled.
Tank is properly labeled.
Emergency shutdowns are properly labeled and in working order.
Stairs to the riser are built according to OSHA standards.
6 sided guards are complete and installed properly.
Electrical breakers are properly labeled.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
LP Operations
Does this location have LP Operations?
Adequate and proper crash protection is installed.
Adequate measures have been taken to provide site security.
Tank is properly labeled.
Emergency shutdowns are properly labeled and in working order.
6 sided guards are complete and properly installed.
Fire extinguishers are hung properly.
Monthly inspections have been properly documented.
Electrical breakers are properly labeled.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Bulk Fuel Operations
Does this location have Bulk Fuel Operations?
All tanks are properly and adequately labeled.
Adequate measures have been taken to provide site security.
Gasoline nozzle extension is installed.
Secondary containment structures are in good repair and appear to be working properly.
Fire extinguishers are hung properly.
Monthly inspections have been properly documented.
Electrical breakers are properly labeled.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
911 Information
911 contact information sign is up to date.
Non-essential 911 information is updated or removed.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Forklift
Does this location have a forklift?
Green inspection card is posted and legible.
Seatbelt is in working order.
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Other Areas
If this box is not checked you have the following additional concerns to address:
Observation
Corrected By and Date Corrected:
Review and Sign
