Appendix E

Hazard Inspection Review

 
Acceptable ?
Electrical Hazards
Notes
 Are electrical cords in good condition w/ ground pins?   
 Are Ground Fault Circuit Interrupters installed near potentially wet locations? 
 Are all panel circuit breakers labeled as to their function? 
 Are all electrical circuits > 50 volts properly insulated or guarded? 
 Is three foot clearance maintained in front of panels? 
 Are lockout tagout procedures written and followed for each piece of equipment in the workplace? 
 Are qualified and authorized employees properly trained in electrical hazards and protective equipment? 
 Are electrical panels and circuits protected from wet conditions, unless specifically designed to be exposed? 
 Are extension cords used for temporary applications only? 
 
 
Acceptable ?
Fire and Life Safety
Notes
 Are combustibles (paper, trash, wood) minimized in and around the structure? 
 Are fire extinguishers available, inspected monthly, and unblocked? 
 Are employees trained annually in fire extinguisher use, if they are expected to use them? 
 Are emergency exits clearly marked by illuminated signs? 
 Is there an internal alarm system to notify occupants of an emergency condition? 
 Are evacuation routes posted? 
 Exit doors are not blocked or locked and they have panic hardware and are self-closing? 
 Is an emergency plan in place and have evacuation drills been conducted every 6 months? 
 Are ignition sources controlled and separated from combustibles? (Smoking, grinding, burning) 
 Is a hot work permit system in place? 
 Are suppression and detection systems tested regularly by an authorized inspector? 
 Are heating devices serviced regularly? 
 Are there provisions for emergency lighting? 
 Are walkways marked and clear? 
 
 
Acceptable ?
Flammable and Combustible Liquids
Notes
 Is a class B fire extinguisher within 50' of the liquid? 
 Is the liquid stored in a metal safety can with a self-closing lid and flash-arresting screen? 
 Are containers bonded when dispensing flammable liquids? 
 Are flammable and combustible liquids stored in approved safety cabinets or designed storage rooms when not in use?  
 Are quantities of flammables and combustibles "in use" minimized to 25 gallons or 1 shift's use?  
 Where vapors may be present, are appropriate electrical installations provided (Class I, Div 1, 2)?  
 
 
Acceptable ?
Personal Protective Equipment (PPE)
Notes
 Have requirements for PPE been reviewed for each task within the facility? (This must be documented for employers covered by OSHA) 
 Are employees complying with PPE requirements? 
 Do all PPE items meet the appropriate ANSI standard?  (They will be labeled or stamped).  
 Are employees trained on use of the PPE including fitting, sizing, inspection, and cleaning? (Required by OSHA).  
 
 
 
Acceptable ?
Respirators
Notes
 Are all respirator users (non-voluntary use) fit-tested annually? 
 Are all respirator users (non-voluntary use) trained annually?   
 If respirators are used, is a written program available and is a qualified program administrator in charge?  
 Are non-voluntary users of negative pressure masks medically cleared to use a respirator?  
 Have industrial hygiene tests been done in the areas where respirators are required, to document that the appropriate respirator has been selected?  
 Have change-out schedules for cartridge respirators been established and are employees following them?  
 Are emergency respirators inspected monthly?  
 Are users of tight-fitting respirators clean shaven? 
 
 
Acceptable ?
Noise
Notes
 Have employees been monitored for noise exposure in areas where noise is present?  
 Are engineering controls used to reduce noise in areas with noise exposures?  
 Are employees using hearing protection devices in areas where the noise levels reach 85 dab TWA?  
 If regulated by OSHA, is the noise standard (1910.95) posted in the work areas?  
 Are employees trained annually in noise exposure issues (if 85 dBA or above)?  
 Are employees given audiometric testing annually to detect changes in hearing (if 85 dBA or above)?  
 Is appropriate follow-up and counseling of the employee occurring if a threshold shift is recorded? 
 
 
Acceptable ?
Hazardous Chemicals
Notes
 Are all containers labeled as to their contents and hazards?  
 Are employees trained on the hazards of the chemicals they are working with? (Required annually if regulated by the State R-2-K)?  
 Are Material Safety Data Sheets (MSDS's) available in the workplace?  
 Is a written program on chemicals available? (OSHA and State requirement)  
 Are non-compatible chemicals separated? 
 Are any carcinogens or long-term chemical hazards present?  Have substitutes been sought?  
 Are spill controls in place?  
 Are emergency eye washes and showers available and tested weekly where corrosives may be present?  (e.g. battery acid)  
 
 
Acceptable ?
Tools and Equipment
Notes
 Are all rotating and moving parts covered by a guard or device that is in place and operable?  
 Is equipment secured to the floor (by weight or positive connection)?  
 Are tools and equipment in good repair?  
 Are warning labels and operational controls labels in place and legible?  
 Are air-lines, hoses, wires placed so as to avoid tripping?  
 Are tools being used in accordance with their intended purpose?   
 
 
Acceptable ?
Powered Equipment
Notes
 Are all powered industrial truck operators trained?  
 Are operators using seatbelts?  
 Are back-up alarms operable?  
 Is operating speed controlled?  
 Are forklifts’ forks kept low to the ground while traveling? 
 Do operators slow and sound horn at blind intersections and corners?  
 Are equipment inspections being done?  
 Is equipment used within its capacity?  
 Are persons tied-off in articulating, elevating lifts?  
 
 
Acceptable ?
Fall Hazards
Notes
 Are railing systems (toe board, mid-rail, top-rail) provided where fall hazards exist?  (4' or higher requires protection per OSHA).  
 Are railings 42" high (+/- 3")?  
 Are stairways provided with railings (4 or more risers)?  
 Are scaffold systems used with rails and fully planked?  
 Are trained persons using scaffolds?  
 Are floor openings 1" or greater covered or otherwise protected?   
 Are covered floor openings in good repair, not causing tripping hazard, secured and adequate for twice the load?  
 Are ladder safety devices (preferred) or cages provided for fixed ladders exceeding 20 feet?  
 Are ladders being used properly (Three points of contact at all times, not on top step, fully open)?  
 Are floor surfacing rated for 0.5 coefficient of friction / slip index?  
 Are absorbent walk-off mats available and in good condition at doors?  
 Are roof drains directed away from walkways?  
 Are provisions for ice removal in place and effective?  
 Are floors cleaned where oils and grease can build-up?  
 
 
Acceptable ?
Ergonomics Hazards
Notes
 Are employees performing repetitive tasks?  
 Are employees performing high-force tasks? (lifting > 50 lbs., pushing, pulling) 
 Are employees in awkward positions or situations?  
 Are employees exposed to cool environments while performing their work?  
 Have any ergonomics injuries been reported (back strains, repetitive motion disorders, etc.)? 
 Are lift assist devices available, used?  
 If injuries and hazards are present, are controls in place to reduce hazards and is an ergonomics task force working on the exposures?  
 
 
Acceptable ?
Compressed Gases / Compressed Air
Notes
 Are compressed air connections properly made? (retaining pins in place)  
 Are tools operating at recommended air pressures?  
 Are pressure tanks inspected by certified inspector and is State certificate posted?  
 Are compressed gas cylinders secured in an upright position with the valve protection cap in place and marked as to contents? 
 Are oxygen cylinders (fulls and empties) separated by 20' from gas cylinders, oils, fuels, or other hydrocarbons? (alternative fire wall separation is permitted)  
 Are gas/air lines in good condition and labeled?  
 Are pressure relief valves tested on a frequent basis?  
 Compressed air is not used for blowing off clothing?  
 Compressed air pressure is reduced to 30 PSI closed tip pressure when used for cleaning?  
 
 
Acceptable ?
Medical
Notes
 Are provisions in place for treatment of an employee's medical problem within 4 minutes?  
 Are CPR and First Certifications up to date?  
 Are Automatic External Defibrillators (AED's) available in the workplace?  
 Are first aid kits properly stocked and available? 
 Are emergency procedures and phone numbers posted in the workplace?  
 Are first aid trained personnel trained annually in blood borne disease hazards?  
 Is a bloodborne disease written program in place to cover workplace first aid personnel?  
 
 
Acceptable ?
Heavy Lifting Equipment
Notes
 Are documented inspections available? 
 Are monthly inspections of running ropes on cranes being done and documented?  
 Is all lifting equipment marked with its capacity?  
 Are proper rigging techniques used when hoisting loads?  
 Do employees know the weights of the objects they are lifting?   
 Are all slings and rigging rated and marked with a capacity tag?   
 
 
Acceptable ?
Security Issues
Notes
 Is entry into the facility secure?  Do guests and visitors have a sign-in location?  
 Do employees confront unfamiliar persons?  
 Does the company have a weapons and threat policy in place?  
 Are confidential areas secured from access?  
 Are background checks performed on employees and security personnel?  
 Are inventory and accounting procedures in place to identify loss?  
 Are alarm systems operable and in place where appropriate?  
 Are visibility mirrors used in hidden locations?  
 Are security cameras used where appropriate?  
 Has local law enforcement participated in a security assessment?   
 Is on-going training provided to employees on workplace security?  
 Are computer resources password protected and procedures in place to control access?  
 Are the facility and parking lot well lit?  
 
 
Acceptable ?
Environmental Hazards
Notes
 Have surfaces painted prior to 1970 been tested for lead content?  
 Where lead is present, is a program in place to address the handling of lead coated surfaces?  
 Have lower areas been tested for radon gas? (> 4 pci recommends remediation)  
 Is there any asbestos containing material (ACM) or presumed ACM?  Has a survey been performed to assess potential for ACM? 
 Are all facility discharges permitted? (air, water, waste)?  
 Have chemicals been surveyed for potential human carcinogenetic?  If these or OSHA regulated chemicals are used (Lead, Methylene Chloride, Cadmium, Asbestos, and others), are written programs, testing and monitoring systems in place?  
 
 
Acceptable ?
Management Elements
Notes
 Is there a certified safety committee in the workplace?  
 Is safety performance tracked?  
 Are supervisors held accountable for safety performance within their department?  
 Are detailed accident investigations conducted or accidents and near-misses documented?  
 Are employees provided with on-going safety training and awareness?  
 Are new processes and facilities designed with a safety review process?  
 Is there a chemical evaluation program that controls chemical purchasing?  
 Does upper management wear PPE and comply with safety rules?  
 Does management enforce, encourage, and demand a safe workplace?   
 Is safety performance communicated to the employees?  
 
 
Acceptable ?
Miscellaneous
Notes
 Is there adequate lighting on all shifts in all work areas?  
 Has the facility conducted a confined space survey, to determine if confined spaces are present?  If confined spaces exist, are detailed policy and procedures available and followed for entry?  
 Are HVAC systems serviced regularly?  Are areas of mold growth properly assessed by an industrial hygienist and remediated as appropriate?  
 
 
This form is not intended to identify all hazardous conditions that may occur within a workplace.  It is only a small sample of considerations that should be taken into account when assessing for workplace hazards.  A competent inspection can be provided by insurance loss control representatives, safety and health professionals with requisite experience and education, or a qualified consultant.
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