Facility Inspection Checklist

Facility Inspection Checklist Inspector:

DOCID#

Date:

 This inspection inspection checklist checklist monitors the the compliance activities activities at the facility facility.. It also serves as a hazard assessment to current activities. The inspection shall be completed in all areas areas of the facility, including warehouse and oce areas as it is applicable. Issues shall be summarized summarize d on the last page. Corrections Corrections will be made and documented completion completion date on the summary page. All corrections are epected to be completed in a timely manner.

REVIEW OF PRIOR  Ye  Ye No N/ Comments CORRECTIONS s A Have all identifed issues been o!!eted and noted on t"e #!evious $ailit% ins#etion summa!%& A!e all o!!etions o$ #!eviousl% identifed issues still e'etive and not !eu!!in(& ))I$ issues a!e !eu!!in( a o!!etive ation must be o#ened* E+ER,ENCY -I,HTIN,

Ye s

No

N/ A

Comments

E+ER,ENCY   Ye  Ye PREPARE0NESS s A!e all al1a%s and aisle a%s $!ee o$ obst!utions& A!e all e.its $!ee o$ sto!a(e and lutte!& A!e stai!ells and o!!ido!s $!ee o$ sto!a(e and lutte!& A!e all em#lo%ees t!ained on Eme!(en% Evauation P!oedu!es& A!e all em#lo%ees aa!e o$ t"e #!o#e! meetin( loation in t"e event o$ an eme!(en%& A!e all mate!ials sto!ed in !a1s !a##ed and stable to #!event $allin(& Is t"e Fi!st Aid abinet $ull% sto1ed&

No

N/ A

Comments

All e.it si(ns illuminated and !emain illuminated "en batte!% tested& All e.it si(ns $!ee o$ dama(e&

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: ! of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

E+ER,ENCY  PREPARE0NESS Is t"e f!e ala!m #anel indiatin( an ala!m ondition& A!e all manual #ull stations unobst!uted and aessible& Is t"e!e an%t"in( else !elatin( to eme!(en% #!e#a!edness t"at needs attention at t"is time& FIRE E2TIN,3ISHERS

DOCID#

 Ye s

No

N/ A

Comments

Ye s

No

N/ A

Comments

A!e all e.tin(uis"e!s in t"ei! desi(nated loation& A!e all e.tin(uis"e!s lea!l% identifed it" a all mounted si(n& A!e all e.tin(uis"e!s seu!el% mounted to t"e all& A!e all e.tin(uis"e!s easil% aessible and $!ee o$ obst!utions& Is t"e last annual ins#etion it"in t"e #ast 45 mont"s& A!e ins#etion ta(s u!!ent it" initial and date o$ ins#etion& A!e all seals and tam#e! #ins in #lae& A!e all e.tin(uis"e!s $!ee o$ dama(e6 o!!osion6 lea1a(e o! lo((ed no77les& 0o all #!essu!e (au(es indiate t"e e.tin(uis"e!s a!e !ead% $o! use& A!e all sta' membe!s t!ained on f!e e.tin(uis"e! use& 0o all sta' membe!s 1no "e!e t"e e.tin(uis"e!s a!e loated& Is t"e!e an%t"in( else t"at needs attention at t"is time& Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: , of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

EYEWASH

Ye s

No

N/ A

DOCID#

Comments

A!e t"e!e a#s ove!in( t"e eme!(en% e%eas"& Is t"e eme!(en% e%eas" $!ee o$ dust6 di!t6 and ot"e! deb!is& 0oes t"e eme!(en% e%eas" $untion #!o#e!l% "en tu!ned on& )Initial t"e ta( on t"e eme!(en% e%eas" a$te! ins#etion -A00ERS

Ye s

No

N/ A

Ye s

No

N/ A

Comments

A!e an% ste#s dama(ed& 0oes t"e ladde! o#e!ate $!eel% u#on o#enin(/losin( o! e.tendin(& Is t"e!e an% visible o!!osion on t"e ladde!& W"en aessin( landin(s6 does t"e ladde! e.tend at least 89: be%ond t"e landin(& A!e all em#lo%ees usin( ladde!s t!ained in -adde! Sa$et%&

FOR;-IFTS

Comments

A!e #!e
Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: - of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

HA=AR0O3S +ATERIA-S

DOCID#

Ye s

No

N/ A

Comments

Ye s

No

N/ A

Comments

A!e S0Ss available on all "a7a!dous mate!ials in t"e $ailit%& A!e all S0Ss !eadil% available $o! all em#lo%ees& A!e all em#lo%ees t!ained on "o to loate6 !ead and unde!stand an +S0S s"eet& >Ha7a!d Communiations? A!e all li@uids sto!ed in t"e a##!o#!iate ontaine!s& A!e all HW/3W ontaine!s labeled it" t"e ontents and an aumulation sta!t date& A!e all #e!sonnel e@ui##ed it" ade@uate PPE $o! t"ese mate!ials& A!e all s#ill 1its loated in t"e o!!et a!ea& A!e all s#ill 1its $ull% sto1ed it" t"e needed e@ui#ment& Is t"e!e an%t"in( else !elatin( to "a7a!dous mate!ials t"at needs attention at t"is time& HO3SE;EEPIN, A!e all a!eas leaned on a !e(ula! basis& A!e all al1a%s a!e at least 89 in"es and $!ee o$ ot"e! items t"at ould ause a t!i##in( "a7a!d&

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: . of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

HO3SE;EEPIN,

Ye s

No

N/ A

DOCID#

Comments

A!e all oo!s $!ee o$ li@uids to avoid t!i#s and $alls& Is e@ui#ment !etu!ned to t"ei! #!o#e! sto!a(e loation "en not in use to avoid a t!i##in( "a7a!d& C"e1 OBe a!ea* Is t"e!e NO si(ns o$ s#ills Is t"e!e NO deb!is o! (a!ba(e A!e a!eas neat/o!(ani7ed& C"e1 outside o$ a!e"ouse* Is t"e!e NO si(n o$ s#ills lea! NO deb!is o! (a!ba(e& C"e1 inside o$ Wa!e"ouse* Is t"e!e no si(n o$ s#ills a!eas a!e neat/o!(ani7edD NO ontaine!s lea1in(& All ontaine!s lea!l% labeled& Flammable mate!ials su" as a!dboa!d and #a#e! a!e sto!ed aa% $!om f!e "a7a!ds and not aumulated t"!ou("out t"e a!e"ouse& Tools a!e sa$el% seu!ed and sto!ed "en not in use& A!e t"e!e an% ot"e! "ouse1ee#in( issues t"at need to be add!essed&

E-ECTRICA-

Ye s

No

N/ A

Comments

No i!uit b!ea1e!s !e(ula!l% t!i##in(& No e.tension o!ds used $o! a #e!manent o#e!ation& A!e all #lu(s and o!ds in (ood ondition& A!e all e.tension o!ds #lu((ed into a (!ounded outlet "en in use&

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: / of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

DOCID#

No elet!ial sit"es6 sit" #lates o! !ee#tales6 !a1ed6 b!o1en o! "ave e.#osed ontats& 0o all elet!ial #anels "ave a su!!oundin( s#ae o$ 8 $eet lea!& A!e all elet!ial i!uit b!ea1e!s identifed& A!e t"e!e an% ot"e! elet!ial issues t"at need attention at t"is time&

PERSONA- PROTECTIVE E3IP+ENT Is t"e!e ade@uate PPE $o! all ob t%#es on site& 0o all #e!sonnel !e@ui!in( #!es!i#tion sa$et% (lasses "ave t"em& A!e all #e!sonnel t!ained in t"e #!o#e! use o$ all PPE as !e@ui!ed b% t"ei! ob>s?& Is si(na(e dis#la%ed in a!eas "e!e PPE is !e@ui!ed& A!e em#lo%ees ea!in( #!o#e! $ootea! in ao!dane it" PPE !e@ui!ements& A!e em#lo%ees ea!in( (loves ea! !e@ui!ed b% t"e tas1s& A!e t"e!e an% ot"e! PPE issues t"at need to be add!essed at t"is time&

 Ye s

No

N/ A

Comments

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: 0 of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

RESPIRATORY PROTECTION A!e em#lo%ees "o use !es#i!ato!s6 volunta!il%6 t!ained& A!e !es#i!ato!s sto!ed in a sealed ba(& A!e !es#i!ato!s dis#osed o$  "en soiled& A!e !es#i!ato!s used ao!din( to t"e NIOSH !atin(s& A!e t"e!e an% ot"e! Res#i!ato! issues t"at need to be add!essed at t"is time& -E,A- G OTHER RE3IRE+ENTS A!e ontaine!s it" batte!ies6 b!o1en lam#s6 b!o1en CRT (lass6 o! PC ballasts losed it" lids& A!e all 3nive!sal Wastes labeled it" a 3nive!sal Waste label& Is t"e Aumulation Sta!t 0ate flled
 Ye s

 Ye s

No

No

N/ A

N/ A

DOCID#

Comments

Comments

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: 1 of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

SEC3RITY

Ye s

No

N/ A

DOCID#

Comments

A!e all ent!% a%s seu!ed $!om unaut"o!i7ed aess& A!e su!veillane video ame!as in o!1in( o!de!& A!e video !eo!din( devies in o!1in( o!de! and sto!in( video ao!din(l%& A!e t"e!e an% ot"e! seu!it% issues to be add!essed&

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: 2 of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

Ot"e! E@ui#ment +aintenane

Wo!1i n(

!o1  en

N/ A

DOCID#

Comments

Elet!i 0!ill 0!ill P!ess Pallet a1s Fans Tables -adde!s -i("tin( Ca!ts Sto!a(e Ra1s Sto!a(e Cabinets 0um#e! ins Com#ute! E@ui#ment T!u1 Stands C"o1 lo1s Ha!d 0!ive S"!edde! Poe! Tools Ai! Tools

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: 3 of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist

Ai! Com#!esso!

Ye s

No

N/ A

DOCID#

Comments

Was t"e ai! om#!esso! d!ained o$ uid& Is uid d!ain $!om t"e ai! om#!esso! a#tu!ed& A!e all belt (ua!ds in #lae& Is t"e #!essu!e (au(e in o!1in( o!de!& Is t"e o#e!atin( #!essu!e it"in manu$atu!e!Js s#eifations& Is t"e sa$et% valve in o!1in( o!de!& A!e t"e!e an% lea1s in t"e lines&

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: ! of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+

Facility Inspection Checklist Date of Review:

DOCID#

Mgmt Reviewer:

3nsa$e ondition o! o!1 #!atie

Pe!son Assi(ned

Co!!etive Ations

0ue 0ate

Resolutio n 0ate

!

2

3

4

"

#

$

Owner: Management Representative Revision Date:

Publishe Revision: !" P$%&: !! of 11

Paper ocuments not stampe 'controlle( are not o))icial an shoul not be relie on" $lways veri)y the o))icial version o) this proceure in a controlle copy in the online &*+M+