Workplace Inspection - Leamington

• Leamington Inspection Date:

  Date

• Add signature

  Sign

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  Sign

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  Sign

MEZZANINE LEVEL ABOVE PRE PRESS

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / trip hazards

• Observations:

• Select No issues observed.

  • No issues observed.

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PRE PRESS

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / trip hazards
  Check for associates wearing appropriate task related PPE

• 1. Are evacuation routes clear?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Is the eye wash station functional?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Are waste containers properly labeled?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 4. Are sprinkler valves locked in the open position?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 5. Is the south electrical room clear of any stored items?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 6. Is the north electrical room clear of any stored items?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 7. Is the main electrical transformer room clear of any stored items?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 8. Is there an adequate number of energy isolating devices (eg. locks, hasps)?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Observations:

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OFFICE

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / trip hazards (eg. extension cords on floor)
  Check on the condition of floor and carpet
  Check for open desk and file drawers when not in use

• 1. Are evacuation routes clear?

  Yes

  No

  N/A

• Observations:

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• Select No issues observed.

  • No issues observed.

INK SUPPLER ROOM

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / trip hazards (eg. extension cords on floor)
  Check for open desk and file drawers when not in use

• 1. Are evacuation routes clear?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Is the eye wash station functional?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Are waste containers properly labeled?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Observations:

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PAPER CONVERTING

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / fall hazards

• Electric Pallet Truck #

• Pre-shift inspection completed?

  Yes

  No

  N/A

• Inspected By:

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 1. Are evacuation routes clear?

  Yes

  No

  N/A

• Yes

  No

  N/A

• 2. Are electrical panels clear of any obstructions?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Is hearing protection worn while the sheeter and trim waste collection system are operating?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Observations:

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WAREHOUSE

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / fall hazards

• Forklift Truck #

• Pre-shift inspection completed?

  Yes

  No

  N/A

• Inspected By:

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 1. Are evacuation routes clear?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Are emergency exits unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Are electrical panels unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 4. Is there an adequate number of energy isolating devices (eg. locks, hasps)?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 5. Are any of the trailer restraints in use?

  Yes

  No

  N/A

• At which dock doors are the trailer restraints in use?

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 6. Was the garbage compactor shut off switch successfully challenged?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Observations:

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FLAMMABLE STORAGE ROOM

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / fall hazards

• 1. Are evacuation routes clear?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Are waste barrels labeled and dated?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Are dispensing barrels grounded?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 4. If dispensing into metal container, is the container bonded to the dispensing barrel?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 5. If dispensing in the room, are associates wearing nitrile gloves and a face shield?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 6. Is the exhaust fan operational?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 7. Are the barrels for the RSP 300 distillation unit grounded?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 8. Is the eye wash station functional? (Outside Flammable Storage Room)

  Yes

  No

  N/A

• Select Seal Not Broken Seal Broken

  • Seal Not Broken
  • Seal Broken

• 9. Spill Kit Inspection: Status of seal? (Outside Flammable Storage Room)

  Select Seal Not Broken Seal Broken

  • Seal Not Broken
  • Seal Broken

• Observations:

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FINISHING

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / fall hazards
  Check for proper use of electrical and manual hand jacks
  Check for associates wearing appropriate task related PPE

• Electric Pallet Truck #

• Pre-shift inspection completed?

  Yes

  No

  N/A

• Inspected By:

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 1. Is the Health and Safety Policy posted at the Health and Safety Board in Finishing?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Is the Occupational Health and Safety Act (Green Book) posted at the Health and Safety Board in Finishing?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Are associates wearing hearing protection?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 4. Are evacuation routes clear?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 5. Are emergency exit doors unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 6. Are electrical panels unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 7. Is there an adequate number of energy isolating devices (eg. Locks, hasps)?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Observations:

• Add media

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PRESS ROOM

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / fall hazards
  Check for proper use of electrical and manual hand jacks
  Check for associates wearing appropriate task related PPE

• 1. Is the eye wash station functional? (7CD Feeder)

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Is the eye wash station functional? (9CD Feeder)

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Are evacuation routes clear?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 4. Are associates wearing hearing protection?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 5. Are containers properly labeled?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 6. Is there an adequate number of energy isolating devices (eg. Locks, hasps)?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 7. Are waste collection barrels grounded?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 8. Are barrels grounded at the satellite dispensing areas?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 9. If dispensing into a metal container, is the container bonded to the dispensing barrel?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 10. Are flame arresters inserted in the flammable dispensing containers?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 11. Are waste spray powder barrels identified?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 12. Is waste spray powder stored in steel barrels?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Spill Kit Inspection: Status of seal? (Outside Old Press Room)

  Select Seal Not Broken Seal Broken

  • Seal Not Broken
  • Seal Broken

• Observations:

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MAINTENANCE

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / fall hazards
  Check for associates wearing appropriate task related PPE

• 1. Are electrical panels unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Are containers properly labeled?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Observations:

• Add media

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OUTSIDE WALKABOUT

• 1. Is the propane storage cage locked?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Are emergency exterior exits unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Is there compliance to the designated smoking areas?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Observations:

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EXTERNAL WAREHOUSE

• Inspection Date:

  Date

• Add signature

  Sign

• Add signature

  Sign

• Observe for unsafe work practices
  Check for poor housekeeping
  Check for slip / fall hazards
  Check for proper use of electrical and manual hand jacks
  Check for associates wearing appropriate task related PPE

• Forklift Truck #

• Pre-shift inspection completed?

  Yes

  No

  N/A

• Inspected By:

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• First Aid Kit Inspected?

  Yes

  No

  N/A

• Date of Last Inspection?

  Date

• Fire Extinguisher #

• Date of Last Inspection?

  Date

• Charged?

  Yes

  No

  N/A

• Accessible?

  Yes

  No

  N/A

• 1. Is the Health and Safety Policy posted at the Health and Safety Board?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Is the Occupational Health and Safety Act (Green Book) posted?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 3. Are evacuation routes clear?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 4. Are emergency exit doors unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 5. Are electrical panels unobstructed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 6. Is there an adequate number of energy isolating devices (eg. locks, hasps)?

  Yes

  No

  N/A

• Yes

  No

  N/A

• 7. Is the trailer restraint in use at Door # 10?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 8. Is the trailer restraint in use at Door # 11?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 9. Is the propane storage cage locked?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 10. Was the previous month's racking inspection completed?

  Yes

  No

  N/A

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Date of Inspection?

  Date

• Emergency light inspection: Men's washroom

• Emergency light inspection: Lunch room

• Emergency light inspection: Ladies' washroom

• Emergency light inspection: Exit Door

• Inspection of eye wash station

• Observations:

MSDS COMPLIANCE

• 1. Product Identification:

• Which department is the product used?

  Select MSDS Office Pre Press Press Room Finishing Warehouse Paper Converting Maintenance Plant Wide

  • MSDS
  • Office
  • Pre Press
  • Press Room
  • Finishing
  • Warehouse
  • Paper Converting
  • Maintenance
  • Plant Wide

• Is the MSDS logged?

  Yes

  No

  N/A

• Is the MSDS current?

  Yes

  No

  N/A

• Date on MSDS

  Date

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• 2. Product Identification:

• Which department is the product used?

  Select MSDS Office Pre Press Press Room Finishing Warehouse Paper Converting Maintenance Plant Wide

  • MSDS
  • Office
  • Pre Press
  • Press Room
  • Finishing
  • Warehouse
  • Paper Converting
  • Maintenance
  • Plant Wide

• Is the MSDS logged?

  Yes

  No

  N/A

• Is the MSDS current?

  Yes

  No

  N/A

• Date on MSDS

  Date

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

FIRST AID KIT INSPECTION

• Location?

  Select Office Pre Press First Aid Room Finishing New Press Room Warehouse Old Press Room Paper Converting

  • Office
  • Pre Press
  • First Aid Room
  • Finishing
  • New Press Room
  • Warehouse
  • Old Press Room
  • Paper Converting

• Date of last inspection?

  Date

• Observations:

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

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FIRE EXTINGUISHER INSPECTION

• Which department?

  Select Fire Extinguisher Office Pre Press Press Room Maintenance Room Finishing Warehouse Paper Converting External Warehouse Mezzanine Ink Supplier

  • Fire Extinguisher
  • Office
  • Pre Press
  • Press Room
  • Maintenance Room
  • Finishing
  • Warehouse
  • Paper Converting
  • External Warehouse
  • Mezzanine
  • Ink Supplier

• Fire Extinguisher #

• Date of last inspection?

  Date

• Charged?

  Yes

  No

  N/A

• Accessible?

  Yes

  No

  N/A

• Observations:

• Which department?

  Select Fire Extinguisher Office Pre Press Press Room Maintenance Room Finishing Warehouse Paper Converting External Warehouse Mezzanine Ink Supplier

  • Fire Extinguisher
  • Office
  • Pre Press
  • Press Room
  • Maintenance Room
  • Finishing
  • Warehouse
  • Paper Converting
  • External Warehouse
  • Mezzanine
  • Ink Supplier

• Fire Extinguisher #

• Date of last inspection?

  Date

• Charged?

  Yes

  No

  N/A

• Accessible?

  Yes

  No

  N/A

• Observations:

• Select Rating: A Rating: B Rating: C

  • Rating: A
  • Rating: B
  • Rating: C

• Add media

  Media