UMA - New Equipment Evaluation

• Company Name

• Machine / Equipment name

• Checklist being completed?

  Select Electrical Inspection Checklist Ergonomic Checklist Laser Inspection Checklist PLC Controls Checklist Mechanical Inspection Checklist Safety Hazard Identification

  • Electrical Inspection Checklist
  • Ergonomic Checklist
  • Laser Inspection Checklist
  • PLC Controls Checklist
  • Mechanical Inspection Checklist
  • Safety Hazard Identification

• Select area of the plant equipment is located in

• Inspection Conducted by (select all that are involved)

  Select

• Enter Other participants here

• Equipment Name

• Manufacturer Name

• Serial #

• TAG #

• Which checklist do you need?

  Select Safety Hazard Identification Ergonomic Mechanical Inspection Electrical Inspection PLC Controls Laser Inspection

  • Safety Hazard Identification
  • Ergonomic
  • Mechanical Inspection
  • Electrical Inspection
  • PLC Controls
  • Laser Inspection

Item

• 1. Has a machine safety risk assessment been conducted?

  Yes

  No

  N/A

REQUIREMENTS FOR ALL SAFEGUARDS

• 2. Do the safeguards provided meet the minimum OSHA requirements?

  Pass

  Fail

  N/A

• 3. Do the safeguards prevent workers' hands, arms, and other body parts from making contact with dangerous moving parts?

  Pass

  Fail

  N/A

• 4. Are the safeguards firmly secured and not easily removable?

  Pass

  Fail

  N/A

• 5. Do the safeguards ensure that no objects will fall into the moving parts?

  Pass

  Fail

  N/A

• 6. Do the safeguards permit safe, comfortable, and relatively easy operation of the machine?

  Pass

  Fail

  N/A

• 7. Can the machine be serviced without removing the safeguards?

  Pass

  Fail

  N/A

• 8. Is there a system for shutting down the machinery before safeguards are removed?

  Pass

  Fail

  N/A

• 9. Can the existing safeguards be improved?

  Pass

  Fail

  N/A

MECHANICAL HAZARDS - The point of operation

• 10. Is there a point-of-operation safeguard provided for the machine?

  Yes

  No

  N/A

• 11. Does it keep the operators hands, fingers, body out of the danger area?

  Pass

  Fail

  N/A

• 12. Could you suggest a more practical, effective safeguard?

  Pass

  Fail

  N/A

• 13. Could changes be made on the machine to eliminate the point-of-operation hazard entirely?

  Yes

  No

  N/A

MECHANICAL HAZARDS - Power transmission apparatus

• 14. Are there any exposed belts or chain drives?

  Pass

  Fail

  N/A

• 15. Are there any exposed set screws, key ways, collars, etc.?

  Pass

  Fail

  N/A

• 16. Are starting and stopping controls within easy reach of the operator?

  Pass

  Fail

  N/A

• 17. If there is more than one operator, are separate controls provided?

  Pass

  Fail

  N/A

NON-MECHANICAL HAZARDS

• 18. Have appropriate measures been taken to safeguard workers against noise hazards?

  Pass

  Fail

  N/A

• 19. Have special guards, enclosures, or personal protective equipment been provided where necessary to protect workers from exposure to harmful substances used in machine operation?

  Pass

  Fail

  N/A

ELECTRICAL HAZARDS

• 20. Is the machine equipped with e-stops? Do the e-stops function properly? Do the e-stops meet NFPA 79 standards? Are the e-stops easily accessible?

  Pass

  Fail

  N/A

• 20-b. Do the e-stops function properly?

  Yes

  No

  N/A

• 20 -c. Do the e-stops meet NFPA 79 standards?

  Yes

  No

  N/A

• 20 -d. Are the e-stops easily accessible?

  Yes

  No

  N/A

• 21. Do interlock switches meet OSHA standards for “Tamper Resistant”<br>(difficult to defeat)?

  Pass

  Fail

  N/A

TRAINING

• 22. Has a Work Instruction for the equipment been written?

  Yes

  No

  N/A

• 22 a. Have the operators been trained using this work instruction?

  Yes

  No

  N/A

• 23. Has a JSA been completed that identifies hazards and how to control the hazards?

  Yes

  No

  N/A

• 24. Has a safeguarding checklist been written and have operators been trained on inspections and procedures to follow if guards are damaged, missing, or inadequate?

  Yes

  No

  N/A

PROTECTIVE EQUIPMENT AND PROPER CLOTHING

• 25. Is protective equipment or clothing required (glasses, hearing<br>protection, lab coat, steel-toed shoes, etc.)?

  Yes

  N/A

• Required PPE

  Select Apron ARC Flash Gear Face Shield Fall Protection Gloves - Cut Resistant Gloves- Not Cut Resistant Gloves - Electrical Rated Gloves - Nitrile Hearing Protection Respirator Safety Glasses Safety Shoes Welding PPE

  • Apron
  • ARC Flash Gear
  • Face Shield
  • Fall Protection
  • Gloves - Cut Resistant
  • Gloves- Not Cut Resistant
  • Gloves - Electrical Rated
  • Gloves - Nitrile
  • Hearing Protection
  • Respirator
  • Safety Glasses
  • Safety Shoes
  • Welding PPE

• 26. If protective equipment is required, is it appropriate for the job, in good<br>condition, kept clean and sanitary, and stored carefully when not in<br>use?

  Yes

  No

  N/A

MACHINERY MAINTENANCE AND REPAIR

• 25. Is protective equipment or clothing required (glasses, hearing protection, lab coat, steel-toed shoes, etc.)?

  Yes

  N/A

• Required PPE

  Select Apron ARC Flash Gear Face Shield Fall Protection Gloves - Cut Resistant Gloves- Not Cut Resistant Gloves - Electrical Rated Gloves - Nitrile Hearing Protection Respirator Safety Glasses Safety Shoes Welding PPE

  • Apron
  • ARC Flash Gear
  • Face Shield
  • Fall Protection
  • Gloves - Cut Resistant
  • Gloves- Not Cut Resistant
  • Gloves - Electrical Rated
  • Gloves - Nitrile
  • Hearing Protection
  • Respirator
  • Safety Glasses
  • Safety Shoes
  • Welding PPE

• 26. If protective equipment is required, is it appropriate for the job, in good condition, kept clean and sanitary, and stored carefully when not in use?

  Yes

  No

  N/A

WORK PROCESS HAZARDS

• 27. Have maintenance workers received up-to-date instruction on the machines they service?

  Pass

  Fail

  N/A

• 28. Has a LOTO procedure been written and put on the Google drive?

  Yes

  No

  N/A

• 29. Is the maintenance equipment itself properly guarded?

  Pass

  Fail

  N/A

• 30. Have PM’s been written for the equipment?

  Yes

  No

  N/A

WORK ENVIRONMENT

• 31. Are there materials on the floor that could trip a worker?

  Pass

  Fail

  N/A

• 32. Is the lighting adequate?

  Pass

  Fail

  N/A

• 33. Are there any live electrical hazards at the site?

  Pass

  Fail

  N/A

• 34. Are any explosive materials used or stored at the site?

  Pass

  Fail

  N/A

• 35. Are tools, including hand tools, machines, and equipment, properly maintained?

  Yes

  No

  N/A

• 36. Is there excessive noise in the work area that might hinder worker communication?

  Pass

  Fail

  N/A

• 37. Is fire protection equipment readily accessible? Have employees been trained to use it?

  Yes

  No

  N/A

• 38. Are emergency exits clearly marked?

  Yes

  No

  N/A

• 39. Are fork trucks or other motor vehicles properly equipped with brakes, overhead guards, backup signals, horns, steering gear and identification, as necessary?

  Pass

  Fail

  N/A

• 40. Are all vehicles and equipment operators properly trained and authorized to use the machinery?

  Pass

  Fail

  N/A

• 41. Have employees complained of headaches breathing problems, dizziness, strong odors, etc.?

  Yes

  No

  N/A

• 42. Is there adequate ventilation?

  Yes

  No

  N/A

WORK ENVIRONMENT cont.

• 43. Have tests been made for oxygen deficiency, toxic fumes, and other health hazards?

  Yes

  No

  N/A

WORK PROCESS HAZARDS

• 44. Are work positions, machinery, pits or holes, and hazardous operations adequately guarded?

  Pass

  Fail

  N/A

• 45. Is the worker wearing clothing or jewelry or long hair that could get caught in the machinery?

  Yes

  N/A

• 46. Are there fixed objects that may cause injury such as sharp machine edges?

  Yes

  No

  N/A

• 47. Is the flow of work improperly organized? For example, is the worker required to make movements that are too rapid?

  Yes

  No

  N/A

• 48. Can the worker get caught in or between machine parts?

  Yes

  No

  N/A

• 49. Can reaching over moving machine parts or material injure the worker?

  Yes

  No

  N/A

• 50. Is the worker off balance at any time?

  Yes

  No

  N/A

• 51. Is the worker positioned to the machine in a way that is potentially dangerous?

  Yes

  No

  N/A

• 52. Is the worker required to make movements that could cause hand or foot injuries, or strain from lifting?

  Yes

  No

  N/A

• 53. Can an object strike the worker or lean against or strike a machine part or object?

  Yes

  No

  N/A

• 54. Does the work produce environmental hazards - dust, chemicals, radiation, welding rays, heat, or excessive noise?

  Yes

  No

  N/A

Dials, Display, Controls

• Displays are easy to read

  Pass

  Fail

  N/A

• Displays and controls follow population stereotypes or are compatible

  Pass

  Fail

  N/A

• Labeling on controls and display panels is clear

  Pass

  Fail

  N/A

• Displays are adequately lit

  Pass

  Fail

  N/A

• Controls are within reach (69 inches maximum height)

  Pass

  Fail

  N/A

• Frequently used controls are between waist and eye level (30 to 62 inches)

  Pass

  Fail

  N/A

• Monitors are between 48 to 62 inches in height or are adjustable in height and tilt.

  Pass

  Fail

  N/A

Physical Demands

• Manual lifting on and off the machine is limited to between 18 and 52 inches

  Pass

  Fail

  N/A

• Manual lifting is less than 40 pounds

  Pass

  Fail

  N/A

• Lifting equipment is available for loads of 40 pounds or more

  Pass

  Fail

  N/A

• Team lifting for items greater than 60 inches in length and 25 pounds

  Pass

  Fail

  N/A

• Use of handling aids, such as drum cart, air hoist, scissors table for large, awkward or heavy loads

  Pass

  Fail

  N/A

• Out of body lifting is less than 15 inches (hand placement from body)

  Pass

  Fail

  N/A

• No static muscle loading

  Pass

  Fail

  N/A

• Ladder climbing is limited

  Pass

  Fail

  N/A

• Padding to avoid high pressure on hands or forearms from thin edge, such as pail handles, or sheet metal

  Pass

  Fail

  N/A

• Human control of machine for pacing of handling such as on and off of conveyors

  Pass

  Fail

  N/A

• Materials are easy to grasp

  Pass

  Fail

  N/A

Workplace Characteristics

• Anti-fatigue mats for operators

  Pass

  Fail

  N/A

• Forward reaching is less than 18 inches

  Pass

  Fail

  N/A

• Reaching is less than 72 inches (vertical height)

  Pass

  Fail

  N/A

• Machine design avoids use of awkward positions when exerting forces with hands/tools (routine tasks)

  Pass

  Fail

  N/A

• Clearance for handling tasks

  Pass

  Fail

  N/A

• Space for handling/lifting equipment

  Pass

  Fail

  N/A

• Space for temporary storage

  Pass

  Fail

  N/A

• Space for product carts

  Pass

  Fail

  N/A

• Avoidance of awkward body positions with human interface with machines

  Pass

  Fail

  N/A

• Dials and displays that are easy to reach or read

  Pass

  Fail

  N/A

• Efficient work motions because of workplace layout

  Pass

  Fail

  N/A

• Adjustable height table/surfaces are used when fine/medium dexterity is required on a frequent to constant basis (Assembly Areas)

  Pass

  Fail

  N/A

Environment

• Noise does not interferes with conversation or doing job

  Pass

  Fail

  N/A

• Noise is not annoying and distracting

  Pass

  Fail

  N/A

• Vibration is not annoying

  Pass

  Fail

  N/A

• Temperature/humidity comfortable and does not distract or interfere with the job

  Pass

  Fail

  N/A

• Good air circulation

  Pass

  Fail

  N/A

• Adequate lighting provided for the job

  Pass

  Fail

  N/A

• Glare does not interfere with reading or inspecting work

  Pass

  Fail

  N/A

• Static is not present

  Pass

  Fail

  N/A

• Floors are even, (no platforms, or steps in work area)

  Pass

  Fail

  N/A

• Floors: non-skid, drains

  Pass

  Fail

  N/A

• Hot surfaces are guarded and/or labeled

  Pass

  Fail

  N/A

• Personal Protective Equipment needed:<br>- Eye Protection<br>- Ear Protection<br>- Steel-toed Shoes<br>- Hand Protection(gloves)<br>- Protective Clothing

  Pass

  Fail

  N/A

POWER TRANSMISSION EQUIPMENT

• Are motors, bearings, shafts, pulleys/sprockets and other power transmission equipment securely mounted?

  Pass

  Fail

  N/A

• Are belt and/or chain paths properly aligned and tensioned?

  Pass

  Fail

  N/A

• Are there any exposed setscrews, key ways, collars, etc.?

  Pass

  Fail

  N/A

EQUIPMENT GUARDING

• Is adequate guarding in place to prevent access to moving parts, pinch points, hot surfaces and other mechanical hazards? Are pinch point labels in place? Are hot surfaces labels in place?

  Pass

  Fail

  N/A

• Are guards adequately secured? Do guards require a tool to remove?

  Pass

  Fail

  N/A

• Are guards interlocked? Are interlocks easily defeatable?

  Pass

  Fail

  N/A

• Do the guards ensure that no objects will fall into moving parts?

  Pass

  Fail

  N/A

• Do guards pose any kind of obstacle or hinder operation of the machine?

  Pass

  Fail

  N/A

OPERATOR CONTROLS

• Are proper E-Stop push buttons, pull cords or other means of stopping the equipment available in operator areas and near potential hazards?

  Pass

  Fail

  N/A

• Are operator controls easily accessible?

  Pass

  Fail

  N/A

• Do the controls to operate the machine keep the operator’s hands, fingers, body out of the danger area?

  Pass

  Fail

  N/A

• Are operator controls properly applied, labeled and color-coded per NFPA 79?

  Pass

  Fail

  N/A

WORK AREA

• Is adequate lighting provided in and around the equipment work areas?

  Pass

  Fail

  N/A

• Is the work area(s) free of trip hazards, overhead hazards or protrusions?

  Pass

  Fail

  N/A

• Has the area been evaluated for appropriate PPE use? If so, has the appropriate PPE been provided?

  Pass

  Fail

  N/A

• Is there a possibility the worker might sustain injury for lifting, pulling, or carrying heavy objects?

  Pass

  Fail

  N/A

• Is there excessive noise in the work area that would require hearing protection?

  Pass

  Fail

  N/A

• Are work platforms and/or ladders used? Adequate guard railing? Maximum weight capacities identified and labeled where applicable?

  Pass

  Fail

  N/A

• Do workers occasionally receive minor shocks while operating any of the machines?

  Pass

  Fail

  N/A

• Hazardous energy sources / LOTO

  Pass

  Fail

  N/A

• Electrical – Single/Multiple supply voltages? Disconnect(s) lockable?

  Pass

  Fail

  N/A

• Pneumatic – Valve(s) lockable or present & any pressure vessel needs to have a pressure release valve?

  Pass

  Fail

  N/A

• Where several maintenance persons work on the same machine, are multiple LOTO devices used?

  Pass

  Fail

  N/A

• Others – List additional sources and lock means

  Pass

  Fail

  N/A

• Potential energy/gravity sources?

  Pass

  Fail

  N/A

• Has a LOTO procedure been written and added to g: drive?

  Pass

  Fail

  N/A

HOT SURFACES PROTECTION

• Are Hot Surfaces (> 120 F°) adequately guarded, insulated and/or labeled?

  Pass

  Fail

  N/A

• Hot Melt adhesive systems

  Pass

  Fail

  N/A

• Thermolator piping

  Pass

  Fail

  N/A

• Ovens

  Pass

  Fail

  N/A

• Are Leisters adequately guarded and/or labeled?

  Pass

  Fail

  N/A

• Are thermolator (hot oil/liquid) hoses labeled to handle system temperature and pressure?

  Pass

  Fail

  N/A

OTHER

• Machine/ Equipment has a completed and released ECR drawing package.

  Pass

  Fail

  N/A

LABELING

• Machine label installed and correctly filled out (voltages, amps, SCCR …)?

  Pass

  Fail

  N/A

• SCCR documentation filled out and saved to g: drive?

  Pass

  Fail

  N/A

• All electrical enclosures and raceways labeled (on the outside cover) with all voltages (AC and/or DC) contained within the enclosure/raceway. All warning stickers are applied (hazardous, voltage), on all enclosures and raceways with 50 volts or higher?

  Pass

  Fail

  N/A

• Machine Disconnect labeled on outside with max fuse size and type and power source voltage, panel source name and breaker number(s)?

  Pass

  Fail

  N/A

• Control cabinet contains fuse schedule and/or circuit breaker schedule to include fuse size, type and class or CB size. All control components must be NRTL listed?

  Pass

  Fail

  N/A

• All receptacles installed on equipment labeled with power source panel name and circuit breaker number or fuse size?

  Pass

  Fail

  N/A

• Is Arc Flash Hazard Label(s) current and on machine?

  Pass

  Fail

  N/A

• 8. Has an Electrical Risk assessment been completed?

  Pass

  Fail

  N/A

POWER

• Circuit breakers and or fuses correctly sized for total equipment amperage?

  Pass

  Fail

  N/A

• Circuit Breaker/fuse size:

• Number of Poles:____

• Conduit and Service wire sized correctly for total equipment amperage?

  Pass

  Fail

  N/A

• Conductor size:_______

• Measured Full Load Amperage:_______

• Neutral: ________ Amp

• L1: ________ Amp

• L2: ________ Amp

• L3: ________ Amp

GROUND

• Check resistance from earth ground to machine ground. Max allowed is 0.1 ohm.

  Pass

  Fail

  N/A

• Measured: _______ohms.

• All receptacles and boxes are properly grounded per NEC. All receptacles are 15-ampere receptacles and protected by an over current protective device not greater than 15-amperes. Equipment receptacles must be GFCI protected?

  Pass

  Fail

  N/A

• All doors must be grounded and no grounds are double lugged.

  Pass

  Fail

  N/A

GENERAL

• All electrical covers are secured and no knockouts missing in boxes?

  Pass

  Fail

  N/A

• No wire nuts to be used on equipment.

  Pass

  Fail

  N/A

• Proper use of SO or flex cord where applicable, Proper use of connectors or strain relief’s on conduit, seal tight and SO cord and sized correctly?

  Pass

  Fail

  N/A

• Proper termination and numbering/labeling of wires? No splices in raceways and proper use of wire colors?

  Pass

  Fail

  N/A

• All electrical safety interfaces (E-stops and interlocks) tested and operational. Doors on control cabinets and junction boxes must be interlocked, require a tool to open, or lockable (key)?

  Pass

  Fail

  N/A

• Panel schedule updated to reflect equipment?

  Pass

  Fail

  N/A

PLC/CONTROLS

• Verify the Risk Assessment has been completed.

  Pass

  Fail

  N/A

• Verify Automation & Control (A&C) Risk Reductions have been completed according to RA.

  Pass

  Fail

  N/A

• Verify Safety PLC/Relay is programmed/wired correctly to achieve the appropriate performance level/Cat.

  Pass

  Fail

  N/A

• Verify Safety PLC/Relay is programmed/wired correctly to achieve the appropriate performance level/Cat.

  Pass

  Fail

  N/A

• Verify each E-stop provides an input signal to notify PLC.

  Pass

  Fail

  N/A

• All E-STOPS shall remove control power to output cards of components and air valves that present a hazard. Removing power cannot present a hazard.

  Pass

  Fail

  N/A

• Verify emergency stop pushbuttons are colored red with a yellow background.

  Pass

  Fail

  N/A

• No actions shall occur upon an E-Stop release.

  Pass

  Fail

  N/A

• Verify a reset does not initiate a restart or hazardous motion.

  Pass

  Fail

  N/A

• Verify that after machine power loss, the machine does not automatically start when power is restored.

  Pass

  Fail

  N/A

• Verify start does not occur when stop button is held and start button is pressed

  Pass

  Fail

  N/A

• Verify Run or Auto operation is inhibited during Jog mode.

  Pass

  Fail

  N/A

• Verify that resetting of an overload device does not restart the motor.

  Pass

  Fail

  N/A

• Verify that motor contactors and starters that initiate opposing motion are both mechanically and electrically interlocked to prevent simultaneous operation.

  Pass

  Fail

  N/A

• Verify all components are approved by a recognized third party such as UL, RU, CSA or TUV. CE is not acceptable.

  Pass

  Fail

  N/A

• Verify Light curtain/Safety scanner/door interlock stop times and distances have been recorded in RA.

  Pass

  Fail

  N/A

• Verify that Muting of light curtains/safety scanners have been accomplished in accordance with manufacturer requirements and RA.

  Pass

  Fail

  N/A

• Verify that light curtain blanking has been accomplished in accordance with manufacturer requirements and RA.

  Pass

  Fail

  N/A

• Two-hand controls are using a two-hand control relay or FB in safety PLC in accordance with manufacturer recommendations.

  Pass

  Fail

  N/A

• Verify SCCR documentation is complete.

  Pass

  Fail

  N/A

• Verify that Zero Speed controllers are wired in accordance with manufacturer’s recommendations and RA.

  Pass

  Fail

  N/A

• Verify STO or other safe motion modes are using correct FBs in accordance with manufacturer’s recommendations and are applied correctly according to RA.

  Pass

  Fail

  N/A

• Verify all door interlocks and non-contact switches use diversity and are compliant with the RA for the associated risk reduction requirements. Verify that these are “Tamper Resistant” and applied in accordance with manufacturer’s recommendations.

  Pass

  Fail

  N/A

• Verify all electrical schematics are complete and not red-lined. Verify the latest revision is released in Team Center.

  Pass

  Fail

  N/A

• Verify Keyed switches in the cabinet are implemented and documented correctly.

  Pass

  Fail

  N/A

LASER HAZARD ANALYSIS

• Has the LSO (Laser safety Officer) completed a ‘Laser Hazard Analysis’ for this type of laser machine? The ‘Laser Hazard Analysis’ should include:<br><br>- Software calculations for MPE (maximum permissible exposure) limits, minimum required OD (optical density) for protective eyewear, NHZ’s (nominal hazard zones) for various viewing conditions. <br>- A listing of potential hazards for the laser system<br>- A listing of control measures that must be in place to mitigate the hazards.<br>- This Laser Hazard Analysis should be on file with the LSO.<br>

  Pass

  Fail

  N/A

GENERAL EQUIPMENT REVIEW

• Is the laser securely mounted?

  Pass

  Fail

  N/A

• Is the laser (embedded laser) properly labeled with its classification?

  Pass

  Fail

  N/A

• Is the laser beam path fully enclosed or mostly enclosed with only a minimal gap between optics and work piece?<br><br>- There should be no large openings in the beam path where incidental contact with the beam is possible.

  Pass

  Fail

  N/A

• Is the machine (laser system) adequately labeled to identify laser hazards?<br><br>- Laser system classification label(s)<br>- Laser aperture label<br>- Guarding label(s)

  Pass

  Fail

  N/A

• Are there any visible diode lasers (spot or line alignment markers) used on the machine? If so, are they properly labeled (Class II or III) and properly applied to minimize incidental eye exposures?

  Pass

  Fail

  N/A

• Is an ‘assist gas’ (compressed air? nitrogen?) used? Is it properly applied?<br><br>- Is it a separate pressurized tank? Is it secured to the machine or other support means? Are adequate shut off valves & regulators in place?<br><br>- Is assist gas critical for proper operation? If so, are adequate controls (low pressure switch, flow switch) in place to notify or shut off machine if assist gas is compromised?

  Pass

  Fail

  N/A

HAZARD CONTROL MEASURES

• Has a Laser Hazard Area been established around the laser machine (required for all Class IV laser systems)? <br><br>- Is this area clearly marked and identified with proper signage? <br>- Is the area marking consistent with WFD practices (magenta/yellow striped floor tape, overhead signage)? <br>- Do the Laser Hazard Area markings identify an area adequate based on the NHZ (nominal hazard zone) calculations in the Laser Hazard Analysis?

  Pass

  Fail

  N/A

• Is proper PPE being worn within the Laser Hazard Area?<br><br>- Is the PPE clearly marked with adequate OD (optical density) at the laser in use wavelength?

  Pass

  Fail

  N/A

• Does the JSA for the job using the laser machine adequately address potential hazards and control measures?<br><br>- Is proper PPE identified?<br>- Are procedural controls for burn & skin hazard addressed?<br>- Are procedural controls for fire hazards addressed?<br>- Are LGAC (laser generated air contaminants) hazards addressed? (operator responsibilities)<br>- Are ALL hazards identified in the Laser Hazard Analysis adequately addressed?

  Pass

  Fail

  N/A

• Has basic ‘laser safety’ training been given to operators? Maintenance personnel?<br><br>- Do they understand the laser hazards?

  Pass

  Fail

  N/A

LASER GENERATED AIR CONTAMINANTS (LGAC’S)

• Is an exhaust system or ventilation provided to adequately remove LGAC’s from the work area?<br><br>- Is the exhaust/ventilation system effective? Does it appear to adequately remove LGAC’s from the work area?<br>- Are LGAC’s exhausted from the building or adequately ‘cleaned’/filtered before being returned to the room?

  Pass

  Fail

  N/A

• Has an evaluation been done of materials being processed with the laser to determine if any potentially hazardous LGAC’s might be present? (Examples: Are metals being cut/processed? PVC’s?)<br><br>- Consult with EHS. Should air sample testing be conducted?

  Pass

  Fail

  N/A

• Completed by

  Select

• Position

  Select EHS Manager Engineer Operations Manager Maintenance Manager Electrician Safety Specialist Director of Operations Other: Director of Safety UMA

  • EHS Manager
  • Engineer
  • Operations Manager
  • Maintenance Manager
  • Electrician
  • Safety Specialist
  • Director of Operations
  • Other:
  • Director of Safety UMA

• Enter Position

• Signature of Lead Auditor:

  Sign

• Date Completed

  Date