Untitled template

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Are all exist door and walkways free from tripping hazards?

  Yes

  No

  N/A

• Are all floors free from litter and/or spilled liquids?

  Yes

  No

  N/A

• Are all areas on the department clear of clutter or any unnecessary items?

  Yes

  No

  N/A

• Are tools and materials properly stored by workers?

  Yes

  No

  N/A

• Are all tools, machines, and equipment if safe working condition?

  Yes

  No

  N/A

• Are all flammable materials (liquor, paint, thinner, etc.) stored in approved containers and Stored in a safe location?

  Yes

  No

  N/A

• Are fire extinguishers adequately supplied, properly located and maintained by MFE Service or Supervisor?

  Yes

  No

  N/A

• Have fire extinguishers been inspected by MFE Services? (3 Month )

  Yes

  No

  N/A

• Are all electrical distribution panels properly maintained? Panel doors closed?

  Yes

  No

  N/A

• Are cover plates for electrical switches or receptacles cracked or broken?

  Yes

  No

  N/A

• Are all electrical extension cords in safe condition and not used to carry excessive loads?

  Yes

  No

  N/A

• There is no temporary wiring in evidence.

  Yes

  No

  N/A

• Is personal protective equipment available and worn by all workers? (Eye protection, particle masks, Ear plugs, etc.)

  Yes

  No

  N/A

• Are the exit lights working properly?

  Yes

  No

  N/A

• Are the emergency lights working properly?

  Yes

  No

  N/A

• First aid box is shown , in good condition and reachable.

  Yes

  No

  N/A

• Are warning signs posted or need to add?

  Yes

  No

  N/A

• Are the spray boot has been maintained?

  Yes

  No

  N/A

• Are the water in flower vases/pots have been changed once in a week?

  Yes

  No

  N/A

• Are the dish rack/drying tray cleared from stagnant water?

  Yes

  No

  N/A

Auditor Comment

• Comment any issue found:

Authorized

• Name, Sign & Date Supervisor/Line Leader Department

  Sign