Title Page
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Site conducted
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Conducted on
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Prepared by
Inspection Form
Housekeeping
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Lighting Adequate and in good repair
- 1 - Lights won't turn on
- 2 - Multiple Warehouse lights are out and broken
- 3 - Warehouse lights flicker while on/broken
- 4 - Warehouse Lights are on without issue
- 5 - All Warehouse Lights, are LED energy saving technology
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Floors free of debris, holes, grease
- 1 - Floors are a concrete/epoxy surface with holes, spills/stains present, loose debris present
- 2 - Floors are a concrete/epoxy surface with holes and stains present
- 3 - Floors are a concrete/epoxy surface with stains present
- 4 - Floors are a concrete surface but are clean and without damage
- 5 - Floors are an epoxy surface, clean and without damage
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Aisles are clearly marked and free of obstacles with yellow traffic borders which are maintained
- 1 - Multiple aisles and/or lanes are blocked and there are no yellow traffic borders
- 2 - 1 or 2 aisles and/or lanes blocked and there are no yellow traffic borders
- 3 - All aisles and lanes clear but there are no yellow traffic borders
- 4 - All aisles and lanes clear but yellow traffic borders need repaired
- 5 - All aisles and lanes clear and all yellow traffic borders do not need repaired
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Processing areas clean
- 1 - Clutter is present, material is not controlled and is left untagged, equipment is not clean and not controlled, 6s checklists not utilized
- 2 - Material is not controlled and untagged, equipment is not clean and not controlled, 6s checklists not utilized
- 3 - Equipment is clean but not controlled, 6s checklists not utilized
- 4 - No clutter present, material is controlled and tagged, equipment is clean, but 6s checklist not utilized
- 5 - No clutter present, material is controlled and tagged, equipment is clean, and 6s checklist utilized with shadow boards for tools
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Scrap bins and trash containers provided
- 1 - Designated scrap bins are not available, trash cans not available, bio waste bin contains non-bio waste
- 2 - Designated scrap bins are not lockable and are not clearly identified by alloy, trash cans are not co-located to work areas, bio-hazard bins do not contain non-bio waste
- 3 - Designated scrap bins are lockable and are clearly identified by alloy, trash cans are not co-located to work areas, bio-hazard bins do not contain non-bio waste
- 4 - Designated scrap bins are lockable and are clearly identified by alloy, trash cans co-located to work areas, bio-hazard bins do not contain non-bio waste
- 5 - Designated scrap bins are lockable, clearly identified by alloy, bio-hazard bins do not contain non-bio waste, trash cans co-located to work areas and are relevant to materials used in that work area for recycling
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Stairs clear; treads and handrails in good repair
- 1 - Stairs blocked, tread of stairs worn down, handrails broken
- 2 - Stairs unblocked, tread worn down, handrails loose
- 3 - Stairs unblocked tread good, handrails loose
- 4 - Stairs unblocked, tread good, handrails solid
- 5 - Stairs unblocked and signage is posted identifying them, tread is good and identified by yellow stripe, handrails are identified in yellow
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Lunchroom facilities clean
- 1 - Floors dirty, refrigerator unclean/broken, food waste smell is present, trash is collecting pests
- 2 - Floors are dirty, refrigerator has spoiling food contained in it, trash is not being taken out daily but is neutral to smell
- 3 - Floors are clean, refrigerator is not cleaned on a schedule, trash cans are not taken out on a schedule but is neutral to smell
- 4 - Floors are clean, refrigerator is clean, trash cans are maintained and is neutral to smell
- 5 - Eating areas are maintained as part of 5s cleaning schedule for the site using Accountability Board, AO board, or Cell Board for the site, floors are clean, refrigerator has a schedule of cleaning posted on it, air is neutral to smell, trash is taken out daily per a schedule.
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Washroom and toilet facilities clean and operating
- 1 - Leaks are present with fixtures, soap is not available, sink has dirt and grime build up, toilet is stained, floors are dirty, air dryers inoperable, no toilet paper or paper towels are available
- 2 - No leaks are present, soap is available, sink has dirt and grime build up, toilet is stained, floors are dirty, air dryers inoperable, paper towels and toilet paper are available
- 3 - No leaks present, soap is available, sink is clean, toilet is stained, floors are dirty, air dryers are operable, paper towels and toilet paper are available
- 4 - No leaks present, soap is available, sink is clean, toilet is clean, floors are clean, air dryers are operable, paper towels and toilet paper are available
- 5 - Washrooms are maintained as part of 5s cleaning schedule for the site using Accountability Board, AO board, or Cell Board for the site, visual aids are posted with expected target condition for cleanliness, floors are clean, sink is clean, toilet is clean, soap, toilet paper, paper towels are part of a kan-ban type restock program with a vendor, air dryers are clean, no leaks are present
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Storage and service rooms neat and clean
- 1 - Storage room is over populated, floors are dirty, items are strewn about, clutter is uncontrolled
- 2 - Storage room floors are dirty, items are not organized, clutter is uncontrolled
- 3 - Storage room floors are clean, items are not organized and clutter is uncontrolled
- 4 - Storage room floors are clean, items are organized, clutter is controlled
- 5 - Storage rooms are maintained as part of the 5s cleaning schedule for the site using Accountability Board, AO Board, or Cell Board, a schedule is posted for each room with visual aids for expected target condition for cleanliness, a list is present for current inventory in storage room, floors are clean, no clutter is present, items are organized and labeled.
First Aid
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Eye Wash equipment placed for quick access, clean and in good condition
- 1 - No Eye Wash stations are present
- 2 - Eye Wash stations are bottles, no sinks present
- 3 - Eye Wash stations are portable stations but are not inspected and are not clean
- 4 - Eye Wash stations are portable sinks, are inspected and are clean
- 5 - Eye Wash stations are portable sinks and are maintained as part of the 5s cleaning schedule for the site using Accountability Board, AO board, or Cell Board, eye wash stations are clean, with current inspections, are co-located to high risk areas of the warehouse for eye injuries, and are able to provide a flow of 1.5 liter's per minute for 15 minutes.
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Emergency information posted (ambulance, fire, hospital, police)
- 1 - No emergency contact information posted
- 2 - Emergency contact information is outdated or incomplete
- 3 - Emergency contact information posted and current but is not complete
- 4 - Emergency contact information posted, is current, is complete, but not at each control
- 5 - Emergency information is posted at each control point that details contact for local Urgent Care, local Police Department, nearest Hospital, local fire department, building property manager (can be FM employee) site management leadership, safety management and consultant as applicable, and the subsequent contact person for each.
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Is there a list posted which identifies those responsible and certified to administer First Aid and CPR?
- 1 - No persons are trained in First Aid and CPR
- 2 - Less then 2 people are trained in First Aid and CPR
- 3 - Less then 25% of staff are First Aid and CPR trained
- 4 - At least 25% of staff are First Aid and CPR trained
- 5 - All personnel at the site are trained in CPR and carry their cards on their person with ID signs updated to reflect the training
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First-aid kit fully stocked and clean
- 1 - No First-Aid materials are present
- 2 - Out of date first-aid materials are present, first-aid stations are unkept and dirty, first-aid materials relevant to potential work-type injuries are not present
- 3 - Out of date first-aid materials are present, first aid stations are clean, first-aid materials are relevant to potential work-type injuries
- 4 - First-aid materials are not out of date, first-aid stations are clean, first-aid materials are relevant to potential work-type injuries
- 5 - First-Aid stations are maintained as part of the 5s cleaning schedule for the site using Accountability Board, AO board, or Cell Board, first-aid materials are relevant to work type and are co-located to work areas, documentation exists for the review of items with expiration dates confirming only unspoiled materials are present
Fire Hazards
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Fire extinguishers securely mounted & currently inspected
- 1 - Some Fire Extinguishers are mounted, few inspections are current
- 2 - Most Fire Extinguishers are mounted, backups are not mounted and loose on the floor, some Fire Extinguishers are not inspected
- 3 - Most Fire Extinguishers are mounted, backups are not mounted but are contained as gas cylinders, all Fire Extinguishers are inspected
- 4 - Fire Extinguishers are all mounted and are currently inspected
- 5 - Fire Extinguishers are all mounted with current inspections and are tracked on Accountability Board for documentation
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Flammables stored in approved UL listed safety containers and or a NFPA approved Fire Proof Cabinet
- 1 - No control of flammables present
- 2 - Flammables are located in the corrosives cabinet
- 3 - Flammables are left uncontrolled outside of a container or cabinet
- 4 - All flammables are stored either in a UL approved container or a Fire Proof Cabinet
- 5 - Flammables and Cabinets are maintained as part of the Site's 5s cleaning schedule, all flammables are controlled and stored in a cabinet when not in use with a list of items per cabinet posted on the cabinet
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No smoking signs in areas containing flammable materials & battery chargers
- 1 - Smoking, vaping, smoking debris and/or paraphernalia is present
- 2 - No smoking signs are missing from flammable/fire proof cabinets and PIT battery chargers
- 3 - No smoking signs are missing around flammable/fire proof cabinets, but are near PIT battery chargers
- 4 - No smoking signs are posted near flammable/fire proof cabinet and PIT battery charger
- 5 - No smoking signs are posted on the outside of doors exiting the building, no smoking signs are posted over each battery charger, no smoking signs are placed by each flammable/fire proof cabinet
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Exits clearly marked and unobstructed
- 1 - Exit signs not posted/not working, exit routes obstructed
- 2 - Exit signs not working, not posted, exit routes obstructed
- 3 - Some exit signs are not working, Exit routes unobstructed
- 4 - Exit routes are clearly marked and are unobstructed
- 5 - Exit routes are maintained as part of the site's 5s cleaning schedule using AO board, Accountability Board, Cell Board, exits are marked on AO boards, each exit is marked with a working exit sign if electric or posted as an exit, doors not leading to an exit is marked as "not an exit", signage/maps are posted throughout facility showing exits, no exit routes are blocked
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Fire extinguisher locations clearly marked & readily accessible
- 1 - No Fire Extinguishers are present
- 2 - Fire Extinguishers are not clearly marked and are not readily available in needed areas
- 3 - Fire extinguishers clearly marked, but some are blocked
- 4 - Fire Extinguishers are accessible and are clearly marked
- 5 - Fire Extinguishers are maintained as part of the 5s practice of the site and are documented on the AO board and Cell Boards, all fire extinguishers are clearly marked, readily accessible, and the local Fire Department is made aware of Fire Extinguisher locations and updated on changes.
Material Handling and Storage
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Crane hoist chains, cables, hooks, and forklift attachments in good condition safety latch operating
- 1 - Chains, cables, hooks, or attachments are broken, damaged, bent, not controlled
- 2 - Chains, cables, hooks, or attachments are not assessed for use and not controlled
- 3 - Chains, cables, hooks, or attachments are not inspected every 6 months, some may not be operable
- 4 - Chains, cables, hooks, or attachments are inspected every 6 months and are operable
- 5 - Chains, cables, hooks, or attachments are reviewed monthly as part of a 5s program, are operable, and are documented for inspection every 6 months
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Storage racks in good condition; not overloaded
- 1 - Racks are damaged and material is bowing rack arms
- 2 - Racks are damaged and need repaired. Rack weight limits is unknown.
- 3 - Racks are not damaged, weight ratings are posted but rack weight limits are not assessed for overloading.
- 4 - Racks are not damaged and weights are assessed for overloading
- 5 - Racks are not damaged and are identified by material type (Sheet, Boxes, Pans, etc.) with weight ratings posted. Rack weights are assessed weekly to ensure racks are not overloaded as part of 5s Program.
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Synthetic web slings in good condition
- 1 - Web slings are frayed, damaged, not inspected and are still being used.
- 2 - Web slings are damaged, frayed and not inspected are still in inventory for use
- 3 - Web slings are undamaged but are not inspected
- 4 - Web slings are undamaged and are inspected
- 5 - Web slings are part of a kan ban pull system for replacement once every 6 months or when damaged to ensure safe operation. Web Slings are inspected every 6 months and documented.
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Tools and working materials properly stored
- 1 - Tools are uncontrolled, lost, no system of replacement exists, employees are using their own tools
- 2 - Tools are uncontrolled, lost, and no system of replacement exists
- 3 - Tools are lost and no system of replacement exists
- 4 - Tools are controlled by shadow boards and all are accounted for during 6s checklist inspections and are treated as FOD during production.
- 5 - Tools are part of a shadow board and assessed on daily 6s checklists for damage. Tools are treated as FOD during production time in the work cell and are constantly maintained. Tools that have a "shelf life" are part of a kan ban replacement system.
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Load limits clearly marked on cranes, forklifts, side-loaders, and other material handling equipment
- 1 - Load limits are not present on items, equipment, or machinery
- 2 - Load Limits are present on PIT's only
- 3 - Load limits are clearly marked on all items, equipment, and machinery, but are not assessed for being overburdened
- 4 - Load limits are clearly marked on all items, equipment, and machinery and are assessed to ensure loads are within limits
- 5 - All load bearing items, equipment, and machines are clearly marked with load limits. Warehouse exhibits signage where heavy loads may be overhead. Machinery, equipment, items are assessed at time of purchase to understand load limits and are clearly marked prior to use. A system exists to ensure loads do not over-encumber limits by equipment.
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Tool handles in good condition. Shock tools free of mushroom heads
- 1 - Tools are damaged and being used
- 2 - Tools are damaged and still in inventory, not segregated or tagged out
- 3 -Some tools are damaged and no system exists for replacement
- 4 - Tools are in good condition, appropriate for job needs, and are assessed during 6s checklist inspections
- 5 - All tools are free from damage, are part of 6s checklist inspections, and are appropriate for job needs. Employees are part of the process for tool implementation and assessment.
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Mobile equipment warning devices operational and Daily Start-up Inspections being performed and recorded
- 1 - No startup inspections are being performed
- 2 - Startup inspections are being done for some equipment but inspections are not available as records
- 3 - Some startup inspections are being done and some inspections are available as records
- 4 - All startups are being done and all inspections are readily available
- 5 - Operational startup inspections are being done daily for all pieces of equipment required. Evidence of inspections such as photos and/or videos are documented with the inspections. Actions are assigned and tracked for issues being documented. Equipment inoperable are controlled per Lockout/Tagout requirements and notated as such on the inspection form. Inspections are readily available at all times for review.
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Material storage stable; secured from falling or collapse (not projecting into aisles or into other racks)
- 1 - Material stored in racks are overhanging, product is unsafely uncontained and may roll out of racks, boxes are bumping into each other, material is spilling out of containers. Overall inventory storage needs redesigned
- 2 - Many boxes/Sheets are overhanging into aisle ways and inventory needs redesigned
- 3 - Some material is overhanging and needs relocated
- 4 - Material is stored evenly and not overhanging. Rack arms are not overloaded
- 5 - Material stored in racks are maintained by using Visual Aid's to show best practice/required storage examples, boxes are not overhanging, Racks are not damaged, Rack Arms are not overloaded, signage identifies weight ratings for each section/racking.
PIT Program
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Are you located in the US?
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Are employees who are required to drive PIT's licensed to the trucks to which they are required to drive and is the license not expired?
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Are you located in the NonUS?
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Are employees who are required to drive PIT's licensed in accordance with regulatory requirements?
Personal Protective Equipment
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Safety glasses are being worn by all persons in the warehouse at all times per the PPE Policy
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Safety Shoes are being worn by all persons required by the PPE Policy
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Gloves are being worn as required by the PPE Policy
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Face Shields are being worn as required by the PPE Policy
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Guests are provided High Vis Jackets to be worn during visits to the warehouse per the PPE Policy
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Hearing Protection is being worn as required by the PPE Policy
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Contractors wear the required PPE as required by the PPE Policy
PPE Program
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Is there a sufficient supply of PPE required by the PPE Policy available
- 1 - PPE required by the Policy is not available
- 2 - Only some of the PPE required by the Policy is available, some items are missing for use
- 3 - All PPE required by the Policy is available but is only available to be retrieved in the warehouse
- 4 - All PPE required by the Policy is readily available before entry to the warehouse
- 5 - All PPE required by the Policy is readily available before entry to the warehouse. A kan ban system exists for replenishment and is monitored. Site Leadership effectively manages and monitors prescription eyewear requirements of employees needing prescription safety glasses. Site Leadership effectively manages and monitors the safety shoe program and provides them to all employees who are required to wear them according to the PPE Policy.
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Are all employees trained to the current PPE Policy revision?
Mechanical Safeguarding
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Pneumatic nail guns and staplers are equipped with a safety mech-anism which prevents rapid fire or semi auto fire conditions
- 1 - Nail guns or staplers have the safety mechanisms bypassed and can be made to "rapid fire"
- 2 - Some nail guns and staplers are purchased without the safety mechanism in place
- 3 - Nail guns are without the safety mechanism, but staplers have them and cannot be rapid fired
- 4 - Nail guns and staplers are purchased with the safety mechanism already in place
- 5 - Screws and drills are used in lieu of nail guns and staplers are used only to seal cardboard shipping tubes with the appropriate flattening mechanism to prevent staple points to cause cuts
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Guards provided on all moving machinery and are situated within 1/8" of pinch points, rotating sliding, moving parts, cutting edges
- 1 - Guards are missing from machinery
- 2 - Some guards are present, but are not suitable for guarding against possible incidents
- 3 - Some machines have guarding, but some machines are either without guards or needs appropriate guards installed
- 4 - All machines are guarded appropriately
- 5 - Machines are guarded and visual management is posted with the machine identifying best practices for usage.
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Gas cylinders for PIT's are stored in a UL rated storage unit
- 1 - Gas cylinders are not controlled and are shut off valves are not verified as closed on PIT's when not in use
- 2 - Gas cylinders are not controlled and not contained in a UL storage unit
- 3 - Gas cylinders are controlled and contained in a UL storage unit
- 4 - Gas cylinders are controlled and contained in a UL storage unit. A vendor service provides a cyclical PM schedule to ensure empties are removed and replaced with full cylinders.
- 5 - Gas cylinders are not present at the facility
Electrical Hazards
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Lockout Devices are relevant to equipment type and fully stocked
- 1 - No Lockout Devices are present
- 2 - Only 1 type of Lockout Device is present and is uncontrolled (Willful Violation)
- 3 - Inadequate numbers of lockout devices are present but are controlled
- 4 - All equipment is matched with a lockout device and all lockout devices are controlled.
- 5 - Lockout Devices are managed and included as part of the startup inspection and 6s checklist cleanup. LOTO boards/lockers are managed as part of a 5s program and a kan ban system exists for replacements. Lockout Devices are tagged as to which equipment they are designed to lock out.
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Electrical panels and outlet boxes are covered, labeled, and accessbile
- 1 - Electrical panels and outlet boxes are cracked, damaged, covers missing, exposed, blocked, unlabeled, and dusty/dirty
- 2 - Electrical panels and outlet boxes are covered, but not labeled, are dusty/dirty, and/or blocked
- 3 - Electrical panels are covered but are not accessible. Outlet boxes are covered. Some panels and boxes are dirty and dusty.
- 4 - Electrical panels are covered and labeled with the correct signage notating type of hazard, magnitude of the hazard, Danger signs as appropriate, barricades are placed correct distances, panels are clean and not blocked. Outlet boxes are covered, labeled and clean
- 5 - Electrical panels are covered and labeled with the correct signage notating type of hazard, magnitude of the hazard, Danger signs as appropriate, barricades are placed correct distances, panels are clean and not blocked. Outlet boxes are covered, labeled and clean. All electrical drops and outlets are labeled back to their position in the panel that powers them.
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Electrical wiring and connectors are insulated and not exposed or broken
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Hard wired equipment has an emergency shut off and is tied back to its supply panel
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Extension cords are not substituted for permanent wiring
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All electrical tools are grounded
Hazard Communication
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Safety Data Sheets (SDS) are on file
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Containers are labeled with correct Hazard Communication
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Employees are trained on Hazard Communication and Global Harmonization
Exterior
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Is snow on the ground?
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Are Ice and snow cleared from walkways?
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Are Walkways/Exit Routes clear, unobstructed, and free of trip hazards?
- 1 - Walkways are not clear, concrete slabs are broken and needing repair, debris is littered across the walkway, exterior stairs are not identified and are in need of repair
- 2 - Walkways are not clear, some debris is causing trip hazards, exterior stairs are in need of repair
- 3 - Debris is causing trip hazards and need to be contained
- 4 - Walkways are clear, identified by yellow striping where necessary
- 5 - Walkways and exterior stairs are identified with yellow striping as necessary, debris is managed as part of a 5s system utilizing Accountability boards
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Is the parking lot kept free of debris?
- 1 - Parking lot is littered with debris and is in need of repair, Future Metals materials/debris is littered around the parking lot, no communication exists between Future Metals and Landlord where applicable to resolve issues.
- 2 - Parking lot is littered with debris and no communication exists between Future Metals and Landlord where applicable
- 3 - Parking Lot has some debris
- 4 - Parking Lot does not have debris
- 5 - Parking Lot may or may not have some debris but there is a system of cleanup for Future Metals as part of a 5s program and communication to the Landlord when necessary for them to handle (Snow removal, maintenance items, etc.)
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Is security lighting functioning properly?
- 1 - No security lighting exists
- 2 - Some security lighting is not functioning or is not functioning consistently (i.e. flickering)
- 3 - Some security lighting is not functioning consistently
- 4 - Security lighting is functioning appropriately
- 5 - Security lighting is functioning in accordance with a security camera system
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Can the building be easily accessed by the fire department? Are fire lanes accessible and posted?
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Are the fire department hose connections kept clear, accessible and have caps?
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Do you have a dumpster roll-off?
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Does the dumpster have a lid that is put on the roll-off at end of shift?