Information
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Site
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Conducted on
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Prepared by
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Location
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Personnel
Housekeeping / 6S
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Work area clean?
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PROPOSED CORRECTIVE ACTION
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Work stations are well organized and no trip hazards are present.
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PROPOSED CORRECTIVE ACTION
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Circulation paths are kept clear of any item.
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PROPOSED CORRECTIVE ACTION
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Emergency equipment (eyewash, fire extinguishers) is constantly accessible.
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PROPOSED CORRECTIVE ACTION
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Emergency routes and emergency doors are kept clear of any item and fully accessible. Emergency doors are not locked.
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PROPOSED CORRECTIVE ACTION
Warning Signs
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Signs indicating required Personal Protective Equipments are in place.
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PROPOSED CORRECTIVE ACTION
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Signs indicating eyewash/safety shower, emergency exits, fire extinguishers, etc. are in place.
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PROPOSED CORRECTIVE ACTION
Personal Protective Equipment (PPE)
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Liquid chemicals are stored on secondary containment.
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PROPOSED CORRECTIVE ACTION
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PPE are appropriately stored when not in use and kept in good condition.
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PROPOSED CORRECTIVE ACTION
Environment
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Liquid chemicals are stored on secondary containment.
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PROPOSED CORRECTIVE ACTION
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Flammable chemicals are stored in flammable cabinets (or in a dedicated storage room in case of high volume) when not in use.
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PROPOSED CORRECTIVE ACTION
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Waste area is well maintained.
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PROPOSED CORRECTIVE ACTION
Warnings , signs and barricades
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Pits, overhead work, maintenance activities are properly identified and protected.
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PROPOSED CORRECTIVE ACTION
Maintenance
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Pits, overhead work, maintenance activities are properly identified and protected.
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PROPOSED CORRECTIVE ACTION
Foot protection
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Steel-toed safety shoes are used as required.
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PROPOSED CORRECTIVE ACTION
Hand protection
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Gloves are used as required.
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PROPOSED CORRECTIVE ACTION
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Gloves are not worn around rotating equipment.
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PROPOSED CORRECTIVE ACTION
Eye/face protection
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Safety goggles or face shield are used as required.
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PROPOSED CORRECTIVE ACTION
Haring protection
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Ear plugs / muff are used in identified high noise area
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PROPOSED CORRECTIVE ACTION
Respiratory protection
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Respiratory protection is used as required.
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PROPOSED CORRECTIVE ACTION
Ergonomics
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No awkward position, no excessive or overhead reach; limited bending and twisting.
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PROPOSED CORRECTIVE ACTION
Tools, equipment and machines
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Tools, equipment and machines are operating properly.
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PROPOSED CORRECTIVE ACTION
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Safety guards are in place.
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PROPOSED CORRECTIVE ACTION
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Electrical wiring in good condition
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PROPOSED CORRECTIVE ACTION
Other
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Other
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PROPOSED CORRECTIVE ACTION
Accomplishments : select one or two items for which the employees or the site should be recommended :
Q
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