Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Document No.

I. GENERAL HOUSE KEEPING?

  • A.) Floors, walls, windows, clean and in good repair.

  • B.) Break rooms cleaned/ disinfected daily.

  • C.) Trash containers sufficient to prevent overflow and emptied and cleaned periodically.

  • D.) All required posters and company policies in place with completed & current information.

  • E.) Aisles and hallways clearly marked and kept clear of obstacles. (1910.22)

  • F.) Cleaning supplies readily available. MSDS and CIL file electronically and in binder.

  • G.) a) Equipment properly stored and designated areas.<br> b) Unused & broken equipment properly stored and tagged "out of service" as appropriate.

  • H.) Products / supplies stored in designated areas. <br>Inventory performed and maintained.

  • I.) Outside area around building(s) clean and neat.<br>Landscaping maintained. Building in good repair.

  • J.) Proper signs posted at entrances, doorways, storage areas, maximum floor loading, etc..

  • K.) Lighting in good repair and sufficient. Bulbs replaced as needed. Light bulbs and tubes shielded as required to prevent shattering.

  • L.) Doors and locks functional and in good repair.<br>Fencing & gates working.

  • N.) Smoking prohibited within building and smoking area designated.

  • O.) Work areas properly and sufficiently ventilated.

  • P.) Trucks and trailers cleaned and disinfected as needed.

  • Q.) Secondary containment/spill control pallets utilized to prevent uncontrolled releases of bulk chemicals.

  • R.) Operational and customer records purged/shredded such that only 3 years records are retained. Review records retention policy as needed.

  • S.) Floor drains are clean and free of debris. Screen netting in place to prevent large items from drains.

II. EMERGENCY RESPONSE/FIRE CONTROL & PREVENTION

  • A.) Fire extinguishers - Inspect all extinguishers and initial tags monthly. Check all units are properly hung, clean, and accessible. Place "out of service" tags on units needing repair.

  • B.) Review Emergency Contacts List and update as needed. Insure that modified list is provided to appropriate agencies. Provide emergency numbers by each phone.

  • C.) Check sprinkler system valves and sprinkler heads/pipes for damage. Inspected annually? 12" clearance for heads.

  • D.) Check all exits/non-exits for proper signage and access.

  • E.) Spill kit available and stocked with proper equipment.

  • F.) Emergency Evacuation Plan current and available.

  • G.) Emergency evacuation maps posted.

  • H.) Trained First-Aid/CPR employee on duty if shift if required.

  • I.) Fire hose connections not obstructed.

  • J.) All flammables stored in approved containers and cabinets. MSDS's & CIL available.

  • K.) Flame and spark producing operations limited to appropriate areas away from flammables/combustibles?

  • L.) Emergency eyewash and shower units provided, accessible, and checked/activated weekly.

III. BASIC HEALTH & SAFETY

  • A.) New employees properly trained for specific duties.

  • B.) PPE designated, provided and utilized in accordance with completed Hazard Assessments.

  • C.) Uniforms provided and utilized.

  • D.) Employee work places clean and orderly - free of spills, oil, grease, and other hazards.

  • E.) Hand sinks available, accessible, maintained and used.

  • F.) First Aid Kit available, stocked, no outdated items in cabinet.

  • G.) Equipment guarding provided and utilized.

  • H.) All equipment working and properly maintained.

  • I.) Safety devices(I.e. lights, alarms, other signals) working.

IV. ELECTRICAL SAFETY

  • A.) Permanent wiring, boxes, switches, outlets, and lights secure, properly mounted, and free of defects. No exposed wiring

  • B.) Wiring for extension cords, portable lighting, power tools free of kinks, cuts, other damage.

  • C.) Extension cords not utilized for permanently mounted equipment.

  • D.) Breaker and fuse boxes clean, accessible, and all breakers identified.

  • H.) Portable tools and machinery properly grounded and/or double insulted. Grounding prong on plugs not removed or converted.

V. MACHINES, EQUIPMENT, & TOOLS (Operations/shop)

  • A.) Employees properly trained to utilize equipment.

  • B.) All moving parts within 7 feet of floor enclosed (fans, pulleys, etc.)

  • C.) Ladders & stairways in good repair.

  • D.) Appropriate warning signs posted on or near equipment as needed.

  • E.) Confined space program in place and current. All required signage provided.

  • F.) Necessary hand tools provided and maintained in good repair.

  • G.) Forklift training provided. Operated by certified employees only. Warning signs posted as needed. Inspections completed each shift.

  • H.) Tool rests on grinders within 1/8 of wheel & 1/4 of tongue guard.

VI. MONITORING, REPORTING & TRACKING DOCUMENTS

  • A.) 300 & 301 Log - Review. Ensure both are current.

  • C.) Driver Spill Kit Checklist - check completeness

  • D.) DOT Incident reports - use Form 5800.1 . Affected facilities notified/copy to corporate.

  • F.)Equipment Inspections. Monitor for daily/shift change inspections.

  • G.) Weekly Inspections. Weekly inspections are being performed and filed for 1year.

  • I.) d) Are all containers labeled properly?

VII. PROGRAM SPECIFIC REVIEWS

  • C.) MVR's Review current listing of drivers and modify to obtain MVR'S for drivers operating company vehicles.

  • G.) Driver Spill Kit Checklists - Review and replenish as needed. Perform inspections monthly.

  • H.) Ensure vehicles are labeled correctly for each state the vehicle is operated in.

  • I.) Vehicle Maintenance Files - review minimum 10% of files.

  • J.) Vehicle Emergency Response Manuals. Check for completeness & update as needed.

Complete audit

  • Add any photos that would be beneficial to this audit.

  • Safety manager signature

  • Manager/supervisor 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.