JEMS Weekly Safety Inspection Report Shop

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Training

• Is training provided for each person newly assigned to a job?

  Yes

  No

  N/A

• Does initial training include a thorough review of hazards and accidents associated with the job?

  Yes

  No

  N/A

• Is adequate instruction in the use of personal protective equipment provided?

  Yes

  No

  N/A

• Is training for the use of emergency equipment provided?

  Yes

  No

  N/A

• Other:

  Yes

  N/A

• Deduct point?

  Yes

  No

Personal Protective Equipment

• Clothing in good condition and suitable for task being performed

  Yes

  No

  N/A

• Hard hats worn and maintained as required

  Yes

  No

  N/A

• Hearing protection worn as required

  Yes

  No

  N/A

• Eye protection worn as required, in proper manner

  Yes

  No

  N/A

• Proper foot protection worn for job performed

  Yes

  No

  N/A

• Work gloves worn as required

  Yes

  No

  N/A

• Face shield and googles worn as required

  Yes

  No

  N/A

• Fire retardant clothing, if required, in good condition

  Yes

  No

  N/A

• 6' height exposure rule being observed

  Yes

  No

  N/A

• Respirators, gloves, chemical, resistant garments?

  Yes

  No

  N/A

• Other

  Yes

  N/A

Work Process

• Are repetitive motion tasks properly paced and kept to a minimum?

  Yes

  No

  N/A

• Are the material safety data sheets placed in locations accessible to all employees?

  Yes

  No

  N/A

• Are hazards identified by signs and tags?

  Yes

  No

  N/A

• Have all trucks, forklifts and other equipment been inspected and maintained?

  Yes

  No

  N/A

• Are lockout or tagout procedures in place and followed?

  Yes

  No

  N/A

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

• Deduct point?

  Yes

  No

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

Fire Emergency Procedures

• Are special purpose extinguishers clearly marked?

  Yes

  No

  N/A

• Is there a clear fire response plan posted for each work area?

  Yes

  No

  N/A

• Do all the workers know the plan?

  Yes

  No

  N/A

• Are drills held regularly?

  Yes

  No

  N/A

• Are fire extinguishers chosen for the type of fire most likely in that area?

  Yes

  No

  N/A

• Are there enough extinguishers present to do the job?

  Yes

  No

  N/A

• Are extinguishers properly mounted and easily accessible?

  Yes

  No

  N/A

• Are all extinguishers fully charged and operable?

  Yes

  No

  N/A

Means of Exit

• Are there enough exits to allow prompt escape?

  Yes

  No

  N/A

• Do employees have easy access to exits?

  Yes

  No

  N/A

• Are exits unlocked to allow egress?

  Yes

  No

  N/A

• Are exits clearly marked?

  Yes

  No

  N/A

• Are exits and exit routes equipped with emergency lighting?

  Yes

  No

  N/A

Hoisting and Lifting Equipment

• Chain falls, come-a-longs, and chokers in good physical condition

  Yes

  No

  N/A

• All equipment in apparent good mechanical condition

  Yes

  No

  N/A

• Softeners used as required

  Yes

  No

  N/A

• Proper rigging techniques used

  Yes

  No

  N/A

• Rigging is protected from cutting, burning, and welding operations

  Yes

  No

  N/A

• Rigging is protected from chemical exposure

  Yes

  No

  N/A

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

Vehicles and Mobile Equipment

• Daily document equipment inspections have been performed

  Yes

  No

  N/A

• Lights, brakes, horns, and alarms working properly

  Yes

  No

  N/A

• Seat belts provided and used

  Yes

  No

  N/A

• Properly maintained; no leaks, drips, or smoke

  Yes

  No

  N/A

• Proper equipment for the job being performed

  Yes

  No

  N/A

• Operators license or certifications as required

  Yes

  No

  N/A

• Fire extinguishers on forklifts

  Yes

  No

  N/A

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

Tools and Equipment

• Electrical cords and plugs in good condition

  Yes

  No

  N/A

• Tools are maintained In a safe condition

  Yes

  No

  N/A

• Tools have guards as supplied by the manufacturer

  Yes

  No

  N/A

• Tools are properly carried and stored

  Yes

  No

  N/A

• Pneumatic / hydraulic hose connections properly stored

  Yes

  No

  N/A

• Proper tools used for the job performed

  Yes

  No

  N/A

• Bench grinder: work rest properly adjusted and wheels dressed

  Yes

  No

  N/A

• Broken / defective tools are secured to prevent use

  Yes

  No

  N/A

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

Fire Protection

• Flammables stored properly

  Yes

  No

  N/A

• Oxygen and combustibles separated

  Yes

  No

  N/A

• Containers labeled

  Yes

  No

  N/A

• Fire extinguisher properly located and inspected

  Yes

  No

  N/A

• Flash arresters installed

  Yes

  No

  N/A

• Compressed gas cylinders properly stored and maintained

  Yes

  No

  N/A

• Containment of hot work and welding screens as required

  Yes

  No

  N/A

• Regulator gauges properly attached and maintained

  Yes

  No

  N/A

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

Project - Facility / Safety & Legal Documentation

• Materials safety data sheet (MSDS) Book available and current

  Yes

  No

  N/A

• Project safety policy manual available and current

  Yes

  No

  N/A

• Federal posters are in an accessible area and current

  Yes

  No

  N/A

• State posters are in a accessible area and current

  Yes

  No

  N/A

• "Posted Panel of Physician" or other WC poster is accessible and current

  Yes

  No

  N/A

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

Job & Safety Task Permits

• Applicable permits posted

  Yes

  No

  N/A

• JSA completed and correct

  Yes

  No

  N/A

• JSA and Permit procedures being followed

  Yes

  No

  N/A

• Crew members are knowledgeable about permits and JSAs

  Yes

  No

  N/A

• Other

  Yes

  N/A

• Deduct point?

  Yes

  No

IDLH ( Imminently Dangerous to Life or Health )

• IDLH violations?

  Yes

  N/A

• Deduct point?

  Yes

  No

Shop Check List

• Fire Extinguishers Checked

  All OK

  Out of Service

• Extension Cords Checked

  All OK

  Out of Service

• Power Hand Tools Checked (Drills,Screw Guns,Circular Saws,Grinders,Miter Saws,Fans,Sawzalls,ect.)

  All OK

  Out of Service

• Bathrooms and Breakrooms clean and tidy.

  Yes

  No

  N/A

• Front office bathrooms and Breakrooms clean and tidy.

  Yes

  No

  N/A

• Microwaves and Refrigerators clean.

  Yes

  No

  N/A

• Trash bins in shop area empty

  Yes

  No

  N/A

• Shipping area clean, material stacked in an orderly manner.

  Yes

  No

  N/A

• Flammable Cabinet (Gas cans,Alcohol,MEK,ect.)

  Full

  3/4 full

  1/2 full

  1/4 full

  Empty

• Yard clean, neat and orderly.

  Yes

  No

  N/A

• All employees were wearing appropriate levels of PPE.

  Yes

  No

  N/A

Pictures of Facility

• Add media

  Media

• Description of Picture(s).