Title Page
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Type of Facility
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Name of Facility
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State/EPA ID Number #
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NAICS Code:
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Location
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Conducted on
1. SYSTEM ADMINISTRATION
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1.1 Is there a visitor sign in sheet?
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1.2 Is there a visitor orientation?
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1.3 Are Safe Work Procedures and Policies available, completed and documented?
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1.4 Are Accident / Incident, Hazard Report forms easily accessible, available, and used?
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1.5 Are EPS biennial reports maintained for at least three years from the due date?
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1.6 Does the generator have copies of waste analysis, test results, or other determination for the last three years since TSDF verification?
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1.7 Does the TSDF have all the required EPA permits for authorizing the types of waste they can accept and the treatment, storage and/or disposal activities that they can conduct?
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1.8 Has there been a recent EPA inspection completed? (Need 2 per year) Or do they have an on-site EPA inspector?
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1.9 Have any types of problems or violations were found from the EPA or OSHA? Has the facility been operating in compliance with its permit conditions and within OSHA regulations?
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1.10 If problems or violations were found during past inspections, has the facility corrected these or in progress of correcting them?
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1.11 Current TRIR and DART scores as well as the previous 3 years:
2. SIGNAGE
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2.1 Is signage at the waste facility entry adequate & clearly visible?
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2.2 Does internal signage clearly define where to place particular types of waste and associated hazards?
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2.3 Does signage reflect its intent and use (e.g. fire extinguishers, safety showers, spill kits)?
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2.4 Is required OSHA safety information clearly displayed on staff notice boards?
3. WASTE LOCATIONS
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3.1 Is there enough space for vehicles / trucks to unload and load waste at the site?
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3.2 Are roads within the facility adequate for frequency of use and the types of vehicles / plant used?
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3.3 Are waste locations tidy, orderly, and marked to show seperation?
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3.4 Is a suitable containment structure installed to define boundaries and provide containment?
4. AMENITIES
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4.1 Is the facility clean, orderly, and sufficient for the volume of the workforce?
5. FIRE AND EMERGENCiES
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5.1 Are emergency evacuation plans posted prominently?
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5.2 Is there a documented and up to date contingency plan for the facility?
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5.3 Does the contingency plan include arrangements with the local fire departments, police<br>departments, hospitals, contractors and state and local emergency response teams?
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5.4 Does the contingency plan include a response plan for fires, explosions or any<br>unplanned sudden of non-sudden release of hazardous waste or hazardous constituents<br>to air, soil, or surface water?
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5.5 Does the contingency plan include an up-to-date list of all emergency equipment, their<br>capabilities and location of each?
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5.6 Does the contingency plan include an evacuation plan for facility personnel with signals<br>and rally points?
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5.7 Does the contingency plan include an up-to-date list of names, addresses and phone<br>numbers (office and home) of all persons qualified to act as emergency coordinator?
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5.8 Are the emergency coordinators listed in the order in which they assume responsibility?
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5.9 Do employees have a ready means of communication either through radio or phone (E.g. fixed or mobile) to contact emergency services or seek assistance?
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5.10 Is waste volume controlled to minimize fire risks within the facility?
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5.11 Is the facility equipped with fire extinguishers, fire control, spill control, decontamination, and other special equipment?
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5.12 Are first responders easily identified (E.g. notice board), training up to date, and recorded?
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5.13 Are the emergency showers and eye wash stations inspected and maintained?
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5.14 Are fire extinguishers / fire fighting equipment inspected and maintained?
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5.15 Are various emergency drills practiced annually and documented?
6. SECURITY
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6.1 Is access to the site adequately supervised to minimize security threats?
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6.2 Can the waste facility be secured after hours?
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6.3 Is the facility properly barricaded to prevent easy access from surrounding land?
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6.4 Does the facility have a security system/company in use?
7. CHEMICALS/WASTE
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7.1 Are Gorilla Glue signed profiles with the facility up to date and accurate?
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7.2 Descriptions on manifest or BOLs similar to waste stream description for all appropriate Gorilla wastes?
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7.3 Are Gorilla manifests properly completed?
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7.4 Are Gorilla manifests properly signed and returned within 90 days of completion?
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7.5 Are copies of Gorilla manifests maintained for at least 3 years for wastes shipped offsite?
- Yes
- No
- Not Observed/Cited
- Not Applicable
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7.6 Is a one-time or every-time written LDR notification present for the waste stream(s) from Gorilla?
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7.7 Are all Gorilla LDRs correct and maintained for 3 years after TSD verification?
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7.8 Are Safety Data Sheets (SDS) available and easily accessible for workers?
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7.9 Is SDS available for all hazardous substances for workers?
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7.10 Are SDSs current? (within 5 years of profile filing date)
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7.11 Are hazardous materials/wastes clearly and correctly labelled and marked?
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7.12 Are chemicals correctly stored and adequately protected?
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7.13 Are gas cylinders stored upright, out of direct sunlight and secured?
8. GROUNDS
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8.1 Are roads easily accessible and in good repair for on-site vehicles?
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8.2 Are vehicle, plant and pedestrian flow clearly defined?
9. MATERIAL HANDLING
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9.1 Are there practical measures implemented to manage material handling practices?
10. ELECTRICAL
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10.1 Is there a hazardous energy control policy for the facility?
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10.2 Is locking and tagging conducted by competent/trained persons?
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10.3 Are high voltage panels marked appropriately and electrical hazards minimized?
11. PLANT AND EQUIPMENT
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11.1 Is applicable equipment at the facility inspected and maintained?
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11.3 Is PPE available and used when required?
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11.4 Is the PPE provided suited to the tasks undertaken?
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11.5 Are tools/equipment clean and in good repair for employee use?
12. TRAINING
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12.1 Are employees familiar with proper handling of hazardous waste and emergency<br>response procedures?
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12.2 Is personnel training conducted by a person trained in hazardous waste management<br>procedures?
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12.3 Is the training program designed to ensure that the contingency plan is covered along<br>with all the emergency procedures, equipment and emergency systems?
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12.4 Have new employees been trained within six months after the date of their employment?
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12.5 Have employees been given annual retraining?
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12.6 Does the facility have records documenting training completed by facility personnel required by OSHA, EPA, etc.?
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12.7 Are training records for former employees kept for at least three years from the date the employee last worked at the facility?
Other Findings
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Other notable risk/hazard condition(s)
Auditor Acknowledgements
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Name of The Gorilla Glue Company Auditor
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Select date
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Accompanying Waste Hauler Representative
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Select date
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Representative of Disposal Facility being Audited
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Select date
