WH DEALERSHIP PROGRAM AUDIT.

• Dealer name

• Audit title (Program Audit/CDK/month-year)

• Document No.

• Conducted on (date/time)

  Date

• Dealers Contact (name/email)

• Prepared by

• Have you installed your Safe T First written program on your computer (CD)?

  Yes

  No

  N/A

• Where is your written Safe T First program (Backup CD) kept?

  STF Binder

  Office Dealership

  Corporate Office

• Does the dealership conduct monthly building safety inspection?

  yes

  no

• Who conducts inspections?

• When are they done?

• Are the monthly inspections kept in the Safety T First Binder or on the Global Share Drive

  Yes

  No

  N/A

• Is there a procedure for making sure recommendations on the safety inspection are actually implemented?

  Yes

  No

  N/A

• The procedure is handled by

  Handled by Safe T First Supervisor

  Handled by each department manager

  Other

• If an OSHA inspector, or any other regulatory agent inspector arrives, is it your procedure to notify the Safety Director?

  Yes

  No

  N/A

• Are all Managers aware of the policy?

  Yes

  No

  N/A

• What is your policy?

• Does the dealership have a procedure for soliciting safety concerns and addressing them? Please select all that apply:

  Select Employee Meetings Open Door Policy Call Association Locked Suggestion Box

  • Employee Meetings
  • Open Door Policy
  • Call Association
  • Locked Suggestion Box

• Does the dealership provide new employee orientation?

  Yes

  No

• How is the new hire orientation handled? Please choose:

  Prior to start date

  On the first day

  Other

• Does the dealership provide an employee handbook?

  Yes

  No

  N/A

• Does the dealership have a written Emergency Evacuation Plan that includes a Map?

  Yes

  No

  N/A

• Are all employees aware of Emergency Action Plan Action Proceduces?

  Yes

  No

  N/A

• Are Emergency Evacuation Maps and Procedures posted in all departments?

  Yes

  No

  N/A

• Are Emergency Telephone Numbers posted in each department where they can be readily found in an emergency? ( 911 MSDS provider, poison control, etc.)

  Yes

  No

  N/A

• Is the dealership within 4 MINUTES OF AN EMERGENCY FACILITY,or no are there at least two employees on each shift currently qualified to render first aid ?

  Yes

  No

• Employees names

• Do all designated first aid responders receive annual training for blood borne pathogens, training every two years for CPR and every three years for First Aid, and been offered hepatitis vaccinations?

  Yes

  No

  N/A

• Is Proper documentation of training, certification and vaccinations or waiver of vaccinations maintained?

  Yes

  No

  N/A

• What is the Facility's name

  Yes

  No

  N/A

• What type of Emergency Notification System is used by the dealer?

  Select Air Horn Whistle PA System Voice Fire Alarm Other

  • Air Horn
  • Whistle
  • PA System
  • Voice
  • Fire Alarm
  • Other

• Other:

• Does the dealership have a designated meeting place?

  Yes

  No

  N/A

• Emergency Evacuation meeting location is?

• Are all employees aware of this location?

  Yes

  No

  N/A

• Is someone designated and responsible for accounting for employees/customers in the event of an emergency which requires evacuation of the building?

  Yes

  No

  N/A

• Employee responsible:

• Back up employee:

• Are Emergency Evacuation Drills conducted at least once a year?

  Yes

  No

  N/A

• Date of last fire drill:

  Date

• Which of the following is the dealership's policy regarding fire extinguisher use?

  All Employees are instructed not to use fire extinguishers

  Everyone is trained on an annual basis

  Key people are trained annually and others are instructed not to use

• Does someone visually inspect fire extinguishers monthly (every 30 days) and is this inspection documented on the tag attached to each fire extinguisher? (29 CFR 1910.157)

  Yes

  No

  N/A

• Employee responsible:

• Does the dealership have the required maintenance performed on their rechargeable fire extinguishers by a qualified company?

  Yes

  No

  N/A

• Company name?

• Date of annual inspection/maintenance?

  Date

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Have you made the request and/or does the local fire department inspect your fire prevention practices?

  Yes

  No

  N/A

• Date of last inspection:

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• If the dealership has fire doors are they kept closed?

  Yes

  No

  N/A

• Are fire rating tags visible on all doors (not painted over)?

  Yes

  No

  N/A

• If the dealership has rolling fire doors, have they been inspected by a qualified company within the last 12 months?

  Yes

  No

  N/A

• Name of Company:

• Date of last inspection

  Date

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Does the building have an automatic sprinkler system?

  Yes

  No

• Is it inspected annually by a qualified company?

  Yes

  No

  N/A

• Company name:

• Date of last inspection:

  Date

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• If the dealership has an installed, mechanical fire alarm system, is it tested annually if supervised, or every two months if non-supervised, and test records kept on site?

  Yes

  No

  N/A

• Name of Company:

• Date of last inspection:

  Date

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Does your dealership perform Back Flow Test asper your local township?

  Yes

  No

  N/A

• Who performs electrical repairs or maintenance on equipment at the dealership?

  Select Sub Contractor Employees

  • Sub Contractor
  • Employees

• Does the dealership have a stocked lockout/tagout supply box?

  Yes

  No

  N/A

• Where is it located?

• Are specific procedures for lockout/tagout activities documented and filed?

  Yes

  No

  N/A

• Are only trained and authorized employees performing lockout/tagout procedures?

  Yes

  No

  N/A

• Are specific manufacturer servicing and maintenance guidelines followed when electrical work is being performed?

  Yes

  No

  N/A

• Are specific procedures followed for maintaining customer keys/remote starters while working on vehicles?

  Yes

  No

  N/A

• Is a program in place for regular housekeeping and floor maintenance in all areas of the facility (i.e., floor striped and/or regular degreasing/cleaning, entrance mats inspected & replaced, etc.)?

  Yes

  No

  N/A

• Who is responsible for this? Please choose:

  Select Sub Contractor Employees

  • Sub Contractor
  • Employees

Underground Storage Tanks

• Do you have underground storage tanks (UST)?

• Are UST fill ports properly labeled (symbols/colors/tank tags)?

  Yes

  No

  N/A

• Are the petroleum USTs (except for fuel oil tanks used for heating) equipped with overfill, spill and corrosion protection (upgrades required by 12/98) (40 CFR 280.21)?

  Yes

  No

  N/A

• For USTs, are leak detection (every 7days) and inventory monitoring (every 10 days) completed, and are records maintained?(40 CFR 280; 6 NYCRR 613.5)

  Yes

  No

  N/A

• Individual responsible:

• Where are required records kept? Please choose;

  Select STF Binder Office Dealership Corporate Office

  • STF Binder
  • Office Dealership
  • Corporate Office

• If tank tightness tests are required, is the proper testing being completed? ( will be noted on PBS certificate ) (40 CFR 280.43; NYCRR 613.5)

  Yes

  No

  N/A

• Company name:

• Date of last inspection:

  Date

• Where are required records kept? Please choose:

  Select STF Binder Office Dealership Corporate Office

  • STF Binder
  • Office Dealership
  • Corporate Office

Chemical Storage Tanks

• Chemical Bulk Storage (such as antifreeze, windshield solvent) is regulated starting at 185 gallons above ground and any amount under ground.

• Does the dealership store hazardous substances such as anti-freeze (ethylene glycol), windshield solvent in (ASTs) of 185 Gallons or Greater or any size UST? (6 NYCRR 595,596,597,598)

  Yes

  No

  N/A

• Has a spill prevention report (SPR) been prepared and properly certified?

  Yes

  No

  N/A

• Are ASTs properly labeled with the contents, tank ID#, working capacity and design capacity?

  Yes

  No

  N/A

• Has a formal hazard evaluation been conducted to determine that specific Personal Protective Equipment (PPE) needs are matched to specific operations?

  Yes

  No

  N/A

• Is the evaluation signed, dated and filed in the Safe T First Binder for each department (service, bodyshop, detail)?

  Yes

  No

  N/A

• Which department is not in the Safe T First Binder?

  Select Service Bodyshop Detail Undercoating/Bedliner

  • Service
  • Bodyshop
  • Detail
  • Undercoating/Bedliner

• Is specific Personal Protective Equipment readily accessible to employees? <br>Safety Glasses, Hearing Protection, Respirator, etc...

  Yes

  No

  N/A

• Method of distribution:

  Safe T First Supervisor

  Parts

• Are all applicable employees trained to use this protective equipment, and is documentation maintain and kept in the Safe T First binder?

  Yes

  No

  N/A

• Does the dealership maintain records of repairing or replacing Personal Protective Equipment?

  Yes

  No

  N/A

• Is the PPE log kept in the STF Binder?

  Yes

  No

  N/A

• In regards to such important items as safe-lifting and PPE usage, are employees observed and corrected and/or retrained as needed?

  Yes

  No

  N/A

• Are hybrid services performed at your dealership?

  Yes

  No

  N/A

• Are techs that perform service on hybrid vehicles trained by their manufacturer?<br>

  Yes

  No

  N/A

• What is the dealership policy for dielectric glove issuance and usage?

  Issued only to trained employees

  Issued to all service employees

• Do the hybrid techs wear dielectric gloves while performing their tasks?

  Yes

  No

  N/A

• Who does your dielectric glove certifications?

  DiVal

  Elwood

  Supplied by Manufacturer

  Other

• Name of Company:

• Last inspection date?

  Date

• Name of company that picks up your waste oil. Please choose:

  Select Safety-Kleen Noco Crystal Clean Other Eco Maxx

  • Safety-Kleen
  • Noco
  • Crystal Clean
  • Other
  • Eco Maxx

• Does the dealership retain a signed copy of manifest records for at least three years? [NYSDEC 6 NYCRR 372.2 (C)(1)(i)]

  Yes

  No

  N/A

• Where are they kept?

  Safe T First Binder

  Corporate Office

  Parts

  Other

• Other

• Does the dealership have in writing that the recycler is authorized to deliver the waste(s) to the facility on the manifest and is a copy kept n the Safe T First binder? [NYSDEC 6 NYCRR 372.2(b)(2)(ii)]

  Yes

  No

  N/A

• Does the dealership have in written documentation that the designated treatment, storage or disposal facility for the particular waste(s) shipped has the capacity to accept the hazardous waste set forth on the manifest and will assure the ultimate disposal method is followed? [NYSDEC 6 NYCRR SEC. 372.2 (b)(2)(i)]

  Yes

  No

  N/A

• How does the dealership dispose of used oil filter? (Must drain for at least 24 hours as required by EPA)

  Discard (Dumpster)

  Crush and discard

  Recycle

  Crush and recycle

• Does the dealership have a septic system or dry well?

  Yes

  No

• Does the dealership avoid using the floor drains? <br>NOTE: The EPA prohibits you from using floor drains if you have a septic system or dry well.

  Yes

  No

  N/A

• Does the dealership have a sewer system?

  Yes

  No

• Does the dealership have written approval from the locality/agency to discharge the substances you use or generate into the system? (e.g. anti freeze, car wash substances)

  Yes

  No

  N/A

• Does the dealership utilize an oil/water seperator?

  Yes

  No

• Is the oil/water separator pumped out regularly by an authorized recyler?

  Yes

  No

  N/A

• Name of company. Please choose:

  Select Safety-Kleen Noco Crystal Clean Other Eco Maxx

  • Safety-Kleen
  • Noco
  • Crystal Clean
  • Other
  • Eco Maxx

• How often?

  Once a year

  Twice a year

  Every 2 years

  When needed

• Hows does the dealership dispose of fluorescent light bulbs?

  Select Dumpster Recycle Vendor

  • Dumpster
  • Recycle
  • Vendor

• Name of Company:

• If the dealership generates oily rags, are they stored in a closed, non-combustible container and appropriately recycled?

  Yes

  No

  N/A

• Does the dealership accept waste oil for disposal by the public at no charge?

  Yes

  No

  N/A

• Does the dealership use EPA certified technicians in air conditioning service, as required by EPA? Are copies of certification maintained in the Safe T First binder for all air-conditioning repairs? (can carry a $5M fine per work order)

  Yes

  No

  N/A

• Does the dealership recycle used anitfreeze?

  yes

  no

• Name of company. Please choose:

  Select Safety-Kleen Noco Crystal Clean Other Eco Maxx

  • Safety-Kleen
  • Noco
  • Crystal Clean
  • Other
  • Eco Maxx

• How often?

  Once a year

  Twice a year

  Every 2 years

  When needed

• Does the Dealership dispose it into a public sewage treatment system with the prior approval of the treatment plant operator, as required by the NYSDEC?

  yes

  no

• Do you have a process for inspecting jacks at least every 6 months? (29 CFR 1910.244)

  yes

  no

• Are all lifts inspected at least annually?

  Yes

  No

  N/A

• Contractor Name:

• Date of last inspection

  Date

• Do all lifts have safety latches, or are high jacks used for all repairs?

  Yes

  No

  N/A

• Are all employees trained annually on lift safety and operation?

  Yes

  No

  N/A

• Do employees use fork lifts, backhoes, bobcats, etc? (ANSI A92.5-1992)

  Yes

  No

• Are employees trained in safe use and do they use proper safety equipment, such as seatbelts?

  Yes

  No

  N/A

• Is training (drivers test) updated every three (3) years?

  Yes

  No

  N/A

• Does the equipment have brakes (capable of stopping with a full load), seat belts, rollover protective structures, an audible alarm, a reverse signal alarm, and guards for scissors points? (CFR 1926.602)

  Yes

  No

  N/A

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Who is responsible for snow and ice removal for walks/stairs/ramps/entrance areas?

• How is snow and ice removal accomplished in lot areas? Please choose one or more.

  Select Contractors automatically Contractors as needed/on-call only By employees other

  • Contractors automatically
  • Contractors as needed/on-call only
  • By employees
  • other

• Does the dealership have an up-to-date chemical inventory list?

  Yes

  No

  N/A

• Does the dealership have an MSDS/SDS for each chemical on the list?

  Yes

  No

  N/A

• Who is responsible for maintaining the inventory list and MSDS/SDS? Please choose one or more

  Select Parts Service Bodyshop Detail Other Sales Dept

  • Parts
  • Service
  • Bodyshop
  • Detail
  • Other
  • Sales Dept

• Please input department and name

Employee name/Dept.

• How does the dealership organize and keep MSDS/SDS? Please choose:

  Binders

  ON-Line system

  Other

• If using an on-line system, Are MSDSs directly accessible through every PC in the dealership (i.e. is there an icon/link on every computer desktop?

  Yes

  No

  N/A

• Which filing method(s) is used? Select all that apply:

  Select OEM Book Non- OEM book Alphabetical by Manufacturer Alphabetical by product name Other

  • OEM Book
  • Non- OEM book
  • Alphabetical by Manufacturer
  • Alphabetical by product name
  • Other

• List other

• Does the dealership maintain labels on all transfer/secondary containers and original containers that labels have come off of?

  Yes

  No

  N/A

• Is there a dealership procedure for identifying Hazmat (e.g. airbags, cans of gasoline) and ensuring that shipments of Hazmat are reviewed by trained personnel before shipment?

  Yes

  No

  N/A

• Is at least one employee HAZMAT certified/trained in proper labeling and shipping? (Toyota/Dodge)

  Yes

  No

  N/A

• Who is certified?

• From where did he/she receive certification?<br>

  NFADA/GCADA

  Hazmat U

  Other

• When does certification expire?

  Date

• Are the Hazmat training records maintained for three years and filed with STF Binder and/or in the trained employee's files?

  Yes

  No

  N/A

• Are shipping papers properly filled out and signed (e.g., description, limited quantity, weight, correct spelling)? (49 CFR 172.204(d), 172.202, 172.303(b))

  Yes

  No

  N/A

• Are shipping papers maintained for one year?

  Yes

  No

  N/A

• Have manufacturer's instructions for handling airbags been obtained, and are they followed?

  Yes

  No

  N/A

• If the dealership is transporting materials of trade (e.g., gasoline cans), is the driver made aware of the nature of the Hazmat and are the packages properly marked and secured? (Max. Material of trade 440lbs.)

  Yes

  No

  N/A

• Bodyshop Program Management: Please check if yes

• Have you installed your Safe T First written program on your computer (CD)?

  Yes

  No

  N/A

• Where is your written Safe T First program (Backup CD) kept?

  STF Binder

  Office Dealership

  Corporate Office

• Does the dealership conduct monthly building safety inspection?

  Yes

  No

  N/A

• Who conducts inspections?

• When are they done?

• Are the monthly inspections kept in the Safe T First Binder?

  Yes

  No

  N/A

• Where do you keep safety training records?

  STF Binder

  Office Dealership

  Corporate Office

• Has the Safe T First Supervisor completed the Safe T First employee training within the last 3years?

  yes

  no

• Have all dealership employees had NFADA SAFE T FIRST training?

  yes

  no

• If no, approximately how many employees currently need training?

• Is Safe T First follow-up/refresher training conducted every 3 years?

  Yes

  No

  N/A

• Is there a procedure for making sure recommendations on the safety inspection are actually implemented?

  Yes

  No

  N/A

• The procedure is handled by

  Handled by Safe T First Supervisor

  Handled by each department manager

  Other

• If an OSHA inspector, or any other regulatory agent/inspector arrives, is it your procedure to notify the Safe T First Manager and contact NFADA?

  Yes

  No

  N/A

• Are all Managers aware of the policy?

  Yes

  No

  N/A

• What is your policy?

• Does the dealership have a procedure for soliciting safety concerns and addressing them? Please select all that apply:

  Select Employee Meetings Open Door Policy Call Association Locked Suggestion Box

  • Employee Meetings
  • Open Door Policy
  • Call Association
  • Locked Suggestion Box

• Bodyshop Emergency Action?

• Does the Dealership have a written Emergency Evacuation Plan that includes a Map?

  Yes

  No

  N/A

• Are all employees aware of Emergency Evacuation Procedures/

  Yes

  No

  N/A

• Are Emergency Evacuation Maps and Procedures posted in all departments?

  Yes

  No

  N/A

• Are Emergency Telephone Numbers posted in each department where they can be readily found in an emergency? ( 911 MSDS provider, poison control, etc.)

  Yes

  No

  N/A

• What type of Emergency Notification System is used by the dealer?

  Select Air Horn Whistle PA System Voice Fire Alarm Other

  • Air Horn
  • Whistle
  • PA System
  • Voice
  • Fire Alarm
  • Other

• Does the dealership have a designated meeting place?

  Yes

  No

  N/A

• Emergency Evacuation meeting location is?

• Are all employees aware of this location?

  Yes

  No

  N/A

• Is someone designated and responsible for accounting for employees/customers in the event of an emergency which requires evacuation of the building?

  Yes

  No

  N/A

• Employee responsible:

• Back up employee:

• Are Emergency Evacuation Drills conducted at least once a year?

  Yes

  No

  N/A

• Date of last fire drill

  Date

• If the dealership is not within 4 MINUTES OF AN EMERGENCY FACILITY, are there at least two employees on each shift currently qualified to render first aid ?

  Yes

  No

  N/A

• Employees names

• Do all designated first aid responders receive annual training for blood borne pathogens, training every two years for CPR and every three years for First Aid, and been offered hepatitis vaccinations?

  Yes

  No

  N/A

• Is Proper documentation of training, certification and vaccinations or waiver of vaccinations maintained?

  Yes

  No

  N/A

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• If you utilize ASTs, and there is a reasonable expectation that a release from these tanks could reach a body of water, or tank capacity exceeds 10,000 gallons, are these tanks provided with a secondary containment? (6 NYCRR 613.6)

  Yes

  No

  N/A

• Bodyshop Fire Extinguishers: Please check if yes

• Which of the following is the dealership's policy regarding fire extinguisher use?

  All Employees are instructed not to use fire extinguishers

  Everyone is trained on an annual basis

  Key people are trained annually and others are instructed not to use

• Does someone visually inspect fire extinguishers monthly (every 30 days) and is this inspection documented on the tag attached to each fire extinguisher? (29 CFR 1910.157)

  Yes

  No

  N/A

• Employee responsible:

• Does the dealership have the required maintenance performed on their rechargeable fire extinguishers by a qualified company?

  Yes

  No

  N/A

• Company name?

• Date of annual inspection/maintenance?

  Date

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Have you made the request and/or does the local fire department inspect your fire prevention practices?

  Yes

  No

  N/A

• Date of last inspection:

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Bodyshop Building System: Please check if yes

• If the dealership has fire doors are they kept closed?

  Yes

  No

  N/A

• Are fire rating tags visible on all doors (not painted over)?

  Yes

  No

  N/A

• If the dealership has rolling fire doors, have they been inspected by a qualified company within the last 12 months?

  Yes

  No

  N/A

• Name of Company:

• Date of last inspection

  Date

• Are they records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Does the building has a automatic sprinkler system?

  Yes

  No

  N/A

• Is it inspected annually by a qualified company?

  Yes

  No

  N/A

• Company name:

• Date of last inspection:

  Date

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• If the dealership has an installed, mechanical fire alarm system, is it tested annually if supervised, or every two months if non-supervised,and test records kept on site?

  Yes

  No

  N/A

• Name of Company:

• Date of last inspection:

• Are the firm alarm system test documents kept in the STF binder?

  Yes

  No

  N/A

• If the department has an installed, Fire Suppression System, is it tested annually?

  Yes

  No

  N/A

• Name of Company:

• Date of last inspection:

• Are the Fire Suppression System test documents kept in the STF binder?

  Yes

  No

  N/A

• Bodyshop Lockout/Tagout: Please check if yes

• Who performs electrical repairs or maintenance on equipment at the dealership?

  Select Sub Contractor Employees

  • Sub Contractor
  • Employees

• Does the dealership have a stocked lockout/tagout supply box?

  Yes

  No

  N/A

• Where is it located?

• Are specific procedures for lockout/tagout activities documented and filed?

  Yes

  No

  N/A

• Are only trained and authorized employees performing lockout/tagout procedures?

  Yes

  No

  N/A

• Are specific manufacturer servicing and maintenance guidelines followed when electrical work is being performed?

  Yes

  No

  N/A

• Are specific procedures followed for maintaining customer keys/remote starters while working on vehicles?

  Yes

  No

  N/A

• Bodyshop Floor Maintenance: Please check if yes

• Is a program in place for regular housekeeping and floor maintenance in all areas of the facility (i.e., floor striped &/or regular degreasing/cleaning, entrance mats inspected & replaced, etc.)?

  Yes

  No

  N/A

• Who is responsible for this? Please choose

  Select Sub Contractor Employees

  • Sub Contractor
  • Employees

• Bodyshop Personal Protective Equipment: Please check if yes

• Has a formal hazard evaluation been conducted to determine that specific Personal Protective Equipment (PPE) needs are matched to specific operations?

  Yes

  No

  N/A

• Is the evaluation signed, dated and filed in the Safe T First Binder for each department (service, bodyshop, detail)?

  Yes

  No

  N/A

• Which department is not in the Safe T First Binder?

  Select Service Bodyshop Detail Undercoating/Bedliner

  • Service
  • Bodyshop
  • Detail
  • Undercoating/Bedliner

• Is specific Personal Protective Equipment readily accessible to employees? <br>Safety Glasses, Hearing Protection, Respirator, etc...

  Yes

  No

  N/A

• Method of distribution:

  Safe T First Supervisor

  Parts

• Are all applicable employees trained to use this protective equipment, and is documentation maintained and kept in the Safe T First Binder?

  Yes

  No

  N/A

• Does the dealership maintain records of repairing or replacing Personal Protective Equipment?

  Yes

  No

  N/A

• Is the PPE log kept in the STF binder?

  Yes

  No

  N/A

• In regards to such important items as safe-lifting and PPE usage, are employees observed and corrected and/or retrained as needed?

  Yes

  No

  N/A

• Are hybrid services performed at your dealership?

  Yes

  No

  N/A

• Are techs that perform service on hybrid vehicles trained by their manufacturer?<br>

  Yes

  No

  N/A

• What is the dealership policy for dielectric glove issuance and usage?

  Issued only to trained employees

  Issued to all service employees

• Do the hybrid techs wear dielectric gloves while performing their tasks?

  Yes

  No

  N/A

• Who does your dielectric glove certifications?

  DiVal

  Elwood

  Supplied by Manufacturer

  Other

• Name of Company:

• Last inspection date?

  Date

• Bodyshop Respiratory Protection: Please check if yes

• Who is the Respirator Program Administrator?

• Have all applicable employees received medical evaluations and been approved to wear respirators prior to performing operations requiring respiratory protection (under coating, painting, Spraying bed liners).

  Yes

  No

  N/A

• Do employees who use respirators receive annual training on the operation, maintenance, and limitations of their respirators?

  Yes

  No

  N/A

• Are Applicable employees fit tested on the equipment they will be actually using, prior to respirator use and then anually thereafter?

  Yes

  No

  N/A

• Company name/Date

• Does the dealership have a policy prohibiting facial hair for any employees who must use respirator? (facial hair that could interfere with a proper seal is not permitted-for fit testing or for use of the respirator.)

  Yes

  No

  N/A

• Does the dealership provide respirators to employees for all jobs requiring respirators? (under coating, painting, spraying bed liners)

  Yes

  No

  N/A

• If respirators are required in the workplace, has the dealership conducted air sampling within the past 12 months to determine appropriate respirator needs?

  Yes

  No

  N/A

• Has a cartridge change schedule been established and is it followed?

  Safe

  At Risk

  N/A

• If employees wear dust masks that are not required, does the dealership provide written information on proper use? (does the dealership ensure that anyone using any respirator knows its proper use and limitations?)

  Yes

  No

  N/A

• Bodyshop Machines and Equipment: Please check if yes

• Do you have a process for inspecting jacks at least every 6 months? (29 CFR 1910.244)

  yes

  no

• Who does the inspections?

  Employee before use

  Vendor

• Contractor's name?

• Date of last inspection?

  Date

• Are all lifts inspected at least annually?

  Yes

  No

  N/A

• Contractor Name/Date of last inspection:

• Do all lifts have safety latches, or are high jacks used for all repairs?

  Yes

  No

  N/A

• Are all employees trained annually on lift safety and operation?

  Yes

  No

  N/A

• Do employees use fork lifts, backhoes, bobcats, etc? (ANSI A92.5-1992)

  Yes

  No

  N/A

• Are employees trained in safe use and do they use proper safety equipment, such as seatbelts?

  Yes

  No

  N/A

• Is training (drivers test) updated every three (3) years?

  Yes

  No

  N/A

• Does the equipment have brakes (capable of stopping with a full load), seat belts, rollover protective structures, an audible alarm, a reverse signal alarm, and guards for scissors points? (CFR 1926.602)

  Yes

  No

  N/A

• Are the records kept in the Safe T First Binder?

  Yes

  No

  N/A

• Bodyshop Hazard Communication: Please check if yes

• Does the dealership have an up-to date chemical inventory list?

  Yes

  No

  N/A

• Does the dealership have an MSDS/SDS for each chemical on the list?

  Yes

  No

  N/A

• How often is the chemical inventory list reviewed and MSDS/SDS updated?

  Yes

  No

  N/A

• Who is responsible for maintaining the inventory list and MSDS/SDS? Please choose one or more:

  Select Parts Service Bodyshop Detail Other Sales Dept

  • Parts
  • Service
  • Bodyshop
  • Detail
  • Other
  • Sales Dept

• Please input department and name

Employee naame/Dept.

• How does the dealership organize and keep MSDS/SDS? Please choose:

  Binders

  ON-Line system

  Other

• If using an on-line system, Are MSDSs directly accessible through every PC in the dealership (i.e. is there an icon/link on every computer desktop?

  Yes

  No

  N/A

• Which filing method(s) is used? Select all that apply:

  Select OEM Book Non- OEM book Alphabetical by Manufacturer Alphabetical by product name Other

  • OEM Book
  • Non- OEM book
  • Alphabetical by Manufacturer
  • Alphabetical by product name
  • Other

• List other

• Does the dealership maintain labels on all transfer/secondary containers and original containers that labels have come off of?

  Yes

  No

  N/A

• Notes:

• Items to forward to dealership:

• I, the Dealership Representative, have reviewed the attached Program Audit with the Evaluator, and have been advised of the areas where attention is recommended. Please complete/sign: Dealership Representative:

  Sign

• Auditor's Signature

  Sign

• This service has been provided by West Herr Safety and Health. For more information Contact Mark Zeisz West Herr Automotive Group Manager of Safety and Health mzeisz@westherr.com (716)202-3175 Office (716)818-5356 Mobile