"Area-Specific Self-Inspection Checklist"

"Area-Specific Self-Inspection Checklist"
September 13, 2012
LMC Webinar: “Find It & Fix It: Getting Started on Mock OSHA Inspections”
Self-Inspection Checklists
Checklists serve as reminders of what to look for and as records of what has been covered. They give
self-inspections direction. Without checklists, inspectors can miss things they should see or be unsure,
after inspecting an area, that they have covered everything they intended to cover.
A hazard observed during an inspection must be recorded, even though it is not part of the checklist.
No one sample of a self-inspection form or format is suitable for all employers or all hazards. Each
employer must customize the checklist forms to the specific areas in their operations. Failure to do so
will give the organization a false analysis and therefore false assessment of the hazards workers are
exposed to in the work/ living environment.
Table of Contents
Area Specific
Page
Area Interior Inspection
2
Exterior and Security Inspection
4
Cafeteria/ Dining Room & Kitchens/ Food Service Areas
5
Office Areas –
Includes:
7
Shop Inspection –
Includes:
Work Areas / Furnace Rooms / Ladders / Postings /
Stairways and Walkways - Indoor and Outdoor
9
General Maintenance Areas / Vehicle Maintenance Areas /
Chemical Storage / Compressed Gas / PPE
Life Safety Inspection –
Includes:
Means of Egress / Safety Signage / Fire Extinguishers /
Automatic Sprinklers / Alarms / Ventilation
13
Construction / Renovation Inspection
16
Machine Guarding
17
Electrical Systems
19
Recommendations and comments are provided for loss control and risk exposure improvement purposes only in conjunction with the insurance program
referenced in this communication. They are not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or
imply in the making of these recommendations and comments that all sites were reviewed or that all possible hazards were noted. The final responsibility for
conducting safety, loss control and risk management programs must rest with the insured.
General Safety Self-Inspection Checklist
Location
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Date
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Completed By
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OK
Action Date
General Area Interior Inspection
Needed Corrected____________________________________________________________________
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_______ _________ Floors are clean of debris.
_______ _________ Floors are clean of spills; wet floors (example, fresh mopped) are clearly
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_______ _________ Floors are, so far as possible, in a dry condition.
_______ _________ Inspect for presence of rodents, insects & other vermin.
_______ _________ Places of employment, passageways, storerooms, bathrooms, break-rooms
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_______ _________ Combustible materials are kept away from sources of flame (gas heaters,
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_______ _________ A 3’ clearance is provided around all heating equipment.
_______ _________ A 3’ clearance is provided around all transformers.
_______ _________ Floors are free of protrusions or objects that pose a trip hazard: frayed
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_______ _________ Oil and gas fired devices are equipped with flame failure controls that will
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_______ _________ Lights bulbs are replaced when burned out.
_______ _________ Illumination is appropriate for the type of work conducted in the area.
_______ _________ Pits, wells, shafts and floor openings are appropriately covered or otherwise
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_______ _________ Every stairway floor opening is guarded by a standard railing on all exposed
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_______ _________ A handrail protects every flight of stairs with 4 or more risers and the
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_______ _________ Loading dock edge is marked.
_______ _________ In areas where corrosive liquids or materials are handled there is a means
marked with a caution sign.
and service rooms are clean, orderly and in a sanitary condition.
etc.).
carpet, curled up rugs, holes, loose boards, and nails, loose tiles, etc.
prevent flow of fuel if pilots or main burners are not working.
guarded; and the covering/guard is in good repair.
sides and it is in good repair.
handrail is in good repair.
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for quick drenching or flushing of the eyes and body. This is located
adjacent to the area-no more than 10 seconds away.
_________ There is a tag on all eyewash stations that documents the device has been
flushed every week.
_________ If an eyewash fixture is not plumbed in a capacity and flow rate standard
must be met.
_________ This minimum standard must ensure the unit delivers 0.4 gallons of water a
minute for 15 minutes.
_________ The expiration date on the water reservoir is current and outdated units are
removed and replaced.
_________ Emergency eyewash station accessibility is not blocked.
_________ Each container of hazardous substances, that is not an original container, is
labeled with at least the following information; identity of the hazardous
substance and an appropriate hazard warning.
_________ Outlets for water not suitable for drinking are clearly identified as nonpotable.
_________ Exhaust stacks and air intakes are so located that contaminated air will not
be re-circulated within a building or other enclosed area.
2
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_______ _________ The area around air intakes is free of insect, animal and bird debris.
_______ _________ Guards (or screens having openings of ½ inch or less) on personal cooling
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fans are intact or the fan is taken out of service until repairs are made.
_________ Bio-safety Cabinets are labeled, certified by the manufacturer and placed in
the room in a position where doors, windows and traffic flow will not
create turbulence at the face of the cabinet.
_________ Extension cords are only used temporarily. An order for permanent wiring
has been made where extension cords are currently used.
_________ Electrical outlets are working. (check outlet with instrument for proper
polarity and grounding)
_________ Ground fault circuit interrupters (GFCI’s) are provided on all temporary
electrical 15 and 20 ampere circuits, used during construction or
remodeling.
_________ GFCI’s are installed in outlets near water sources.
_________ No smoking areas are designated and observed.
_________ Slip resistant materials on stairs and floors are in good condition and not
showing signs of excessive wear.
_________ Anti-fatigue mats are in good repair and don’t represent a trip hazard.
_________ Circuit breakers are clearly labeled, easily accessible and the door is
closed.
_________ No ignitable materials are near the panel and the panel is protected from
physical damage.
_________ There is a minimum of 36” maintained between top of storage and ceiling or
roof joist in un-sprinklered buildings.
_________ Floor drains or scuppers are clear of obstruction.
_________ Sprinkler and standpipe connections are clearly marked.
_________ The area around them is kept clear of obstructions.
_________ Exit doors are kept clear and unlocked during hours of operation.
_________ Lifting equipment is inspected on a scheduled basis and written records are
maintained.
_________ Vehicles used to transport employees are equipped with headlights, brakes,
horns, mirrors, windshields and turn signals and they are in good repair.
_________ A fully charged fire extinguisher is maintained in each transport vehicle.
_________ Storage on ledges, in corners, tops of cabinets, tops of lockers, radiators
has been eliminated.
_________ Storage of items is at least 4 inches off the floor.
_________ Storage areas are neat and maintain 4 feet of unobstructed aisle space.
_________ Storage of chemicals is below shoulder level to prevent injury of spills to
eyes.
_________ Racking in storage areas is free from broken or bent shelves and is set on
solid legs.
_________ Emergency lights: a functional test is conducted on the lights every 30
days for 30 seconds. Lights should be fully operational during the entire
test.
_________ Emergency lights: an annual test is conducted for 1.5 hours each year.
Lights should be fully operational during the entire test.
_________ The constant pressure actuation switch, reversing edge switch, pressure
relief mechanism or 3 button control switch is operable on all overhead or
sliding doors that have sufficient weight or closing force to cause crushing
injury to employees. (test with a 2X4)
_________ Overhead doors are provided with a functional channel lock or an electric
switch lockout.
_________ Bed Levers are stored beneath beds when not in use to prevent trip hazard.
_________ Illumination in all areas meets acceptable levels MN OSHA 5205.0120.
_________ Check ceiling tiles and walls etc. for evidence of water leakage and mold /
fungus / mildew.
3
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
General Exterior and Security Inspection
Needed Corrected____________________________________________________________________
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_______ _________ Doorways are well lit.
_______ _________ Shrubs are pruned so they do not obstruct views of doors, windows,
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_______ _________ Guardrails and gratings are arranged around areaways and stairwells and
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they are in good repair.
_______ _________ Check your company’s lock change policy.
_______ _________ Name tags/picture ID’s are worn.
_________ Security alarms are operational-check at least every 6 months.
_________ The backup power source to the security alarm is operational.
_________ Backup power source for exterior lights is working properly.
_________ Exterior walls are free of cracks or other damage.
_________ Windows are free from cracks or broken panes.
_________ Vegetation has been cut back from the building.
_________ Combustible materials are stored away from the building.
_________ Driveways and walks are in good repair and unobstructed.
_________ The building address or identification is clearly visible.
_________ Fencing is in good repair.
_________ Gates are properly secured with working locks.
_________ Exterior lights are working and directed to eliminate shadows and blind
spots.
basement windows and roof accesses.
_________ All window ledges and roof access is secured.
_________ Door locks and deadbolts are maintained and working properly.
_________ Exterior lights have unbreakable lenses or mesh coverings.
_________ Icicles and/ or snow, etc. would not fall on people below.
_________ There is no buildup of ice in /around downspouts.
_________ Appropriate rubber mats/rugs are placed in entranceways during ice/snow
season. These are not bunched up and they are in good repair.
4
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
Cafeteria / Dining Room & Kitchens / Food Service Areas
Needed Corrected____________________________________________________________________
Cafeteria/ Dining Room
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_______ _________ Appliances are clean and in good working order: refrigerators, disposals,
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and microwaves, dishwashers, steam tables, beverage appliances, etc.
(list them specifically on the template)
_________ All appliances are grounded and the plug has not been tampered with.
_________ Food preparation, serving and eating surfaces are clean and in good repair.
_________ Furniture is clean and in good repair.
_________ Steam tables are working properly and exposure to steam burns has been
addressed.
_________ There are no frayed cords, extension cords or multiple plug adapters on
appliances.
_________ Electrical cords have not been cut, spliced or damaged in any way.
_________ Microwaves are not dented so as to emit rays while operating.
_________ Warning signs are posted that microwaves are in use.
_________ Floors are clean and there are no spill hazards.
_________ Appliances (dispensers, refrigerators, etc) do not leak fluids on to floors.
_________ No unauthorized items are in the refrigerators/ freezers (medications, blood,
specimens or body fluids).
_________ There is a Rubber mat in front of ice cube maker and it is in good repair.
_________ Bus trucks or racks used to remove soiled dishes are in good repair and the
wheels are clean and roll freely.
_________ Knives are in knife rack or specific storage area when not in use.
_________ Kevlar gloves are used with slicer and they are in good repair.
_________ Cleaning procedure for slicer is posted.
_________ Check ceiling tiles and walls etc. for evidence of water leakage and mold /
fungus / mildew.
Kitchens/ Food Service Areas
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_______ _________ Anti-fatigue mats are in good repair and don’t represent a trip hazard.
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_______ _________ Where wet processes are used drainage is maintained by using platforms,
mats or other measures.
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_______ _________ Employees wear slip resistant footwear or booties.
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_______ _________ Dietary carts are in good repair and the wheels roll freely.
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_______ _________ Knives are sharp and in good condition.
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_______ _________ Doors on cold storage rooms are provided with an inside release
mechanism, which will release the latch and open the door even if it’s
padlocked or otherwise locked on the outside; and these release
mechanisms are in good repair.
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_______ _________ Walk-in refrigerator safety devices are fully operational, such as alarm
systems or bypass devices.
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_______ _________ Screen mesh guard is in place over blower fans in walk in refrigerators.
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_______ _________ The light in the walk in refrigerator is working.
5
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_______ _________ Doors that swing in both directions and are located between rooms where
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there is frequent traffic are provided with viewing panels in each door and
these viewing panels are clean and free of obstructions.
_________ All storage racking is secured. Items over 5lbs are on lower shelves; items
less than 5 lbs. Can be stored higher.
_________ Monthly inspection for faulty equipment has been completed and
documented on all pieces of equipment.
_________ Meat slicers are guarded and the guards are used when the machine is in
use.
_________ Guards are in place and used over garbage disposals.
_________ Gas intakes for gas burners are properly adjusted.
_________ There is no dust accumulation behind or under the range.
_________ Grease filters and range exhaust hoods are cleaned at least once a week.
_________ Ceramic broiler burners are free from cracks.
_________ Each container of hazardous substances, that is not an original container, is
labeled with at least the following information; identity of the hazardous
substance and an appropriate hazard warning.
6
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
General Office Areas
Needed Corrected____________________________________________________________________
Work Areas
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_______ _________ Doors and hallways clear and free of obstructions.
_______ _________ Extension cords are only used temporarily. An order for permanent wiring
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_______ _________ Electrical panels are working and cleared from any obstruction. The panel
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_______ _________ Fire extinguishers are up to date on monthly and annual inspections and
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_______ _________ No smoking areas are designated and observed.
_______ _________ Only approved containers are used for disposal of smoking materials or
has been made where extension cords are currently used.
door is closed unless in use.
documented as such on inspection cards.
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used as ashtrays.
_________ Storage areas are tidy and have good access to articles.
_________ There is no unauthorized storage of chemicals or flammables in general
storage areas.
_________ Office fixtures and furniture are in good repair.
_________ Office machines are in good repair and electrical cords are grounded.
_________ There are no frayed, cut or spliced cords and the ground prong is intact.
_________ Appliance and office machine cords are out of the way from becoming a trip
hazard.
_________ Check ceiling tiles and walls etc. for evidence of water leakage and mold /
fungus / mildew.
Stairways & Walkways - Indoor and Outdoor
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_______ _________ Stairways and landings are free of clutter and in good repair.
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_______ _________ Railings are in good repair.
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_______ _________ Exits are clearly marked.
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_______ _________ The emergency power supply is operating.
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_______ _________ Aisles and walkways are marked as appropriate.
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_______ _________ Wet surfaces are covered with non-slip materials.
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_______ _________ There is safe clearance for walking in aisles where motorized or mechanical
handling equipment is necessary.
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_______ _________ Materials and equipment are stored in such a way that sharp projectiles will
not interfere with the walkway.
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_______ _________ Changes of direction or elevation are readily identifiable.
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_______ _________ There is adequate headroom provided for the entire length of any aisle or
walkway.
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_______ _________ Standard guardrails are provided wherever aisle or walkway surfaces are
elevated more than 30 inches above any adjacent floor or the ground.
Postings
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_______ _________ The OSHA 2203 workplace poster and the EEOC’s Americans With
Disabilities poster are displayed in a prominent location where all
employees are likely to see it.
7
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_______ _________ All OSHA citations for this area are displayed near where the violation
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_______ _________ Emergency telephone numbers are posted where they can be readily found
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_______ _________ Emergency telephone numbers are up to date.
_______ _________ There are postings where employees may be exposed to any toxic
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_______ _________ Danger and caution postings are in good repair and easily visible.
_______ _________ A list of hazardous substances, harmful physical agents, and infectious
occurred. (if applies)
in case of emergency.
substances or harmful physical agents that indicate caution or danger.
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agents are immediately available in the employee work area. The list can
be for the whole workplace or particular to that specific work area.
_________ Each container of hazardous substances, that is not an original container, is
labeled with at least the following information; identity of the hazardous
substance and an appropriate hazard warning.
_________ Equipment or work areas that specifically generates harmful physical agents
shall be labeled with the name of the physical agent and the appropriate
hazard warning (ex. Noise, heat, radiation, etc.)
_________ Locations of emergency eyewash and drench showers are posted.
_________ Locations of fire extinguishers are clearly marked.
_________ Material safety data sheets are posted in areas that are available to
employees.
_________ Signs concerning “exiting from buildings”, room capacities, floor loading,
exposures to x-ray, microwave or other harmful radiation or substances
are posted where appropriate.
_________ Fire evacuation procedures are posted.
_________ Tornado shelter areas are posted.
_________ The OSHA Summary of Occupational Illness and injuries is posted in the
month of February.
_________ A sign is adjacent to all elevators stating that in case of fire the elevator will
not operate and exit stairways should be used.
Furnace/ Boiler Room
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_______ _________ Combustible and flammable materials are kept away from sources of flame
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(gas heaters, etc.).
_________ A 3’ clearance is provided around all heating equipment.
_________ Furnace and boiler rooms are locked.
_________ Furnace and boiler rooms are free from combustible materials.
_________ Outside air is provided to all indoor workrooms at the rate of 15 cubic feet
per minute, per person.
_________ Check ceiling tiles and walls etc. for evidence of water leakage and mold /
fungus / mildew.
Ladders
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_______ _________ Metal and wooden ladders are in a good, useable condition: no damage to
rungs, locking mechanisms, foot treads or joints between steps. Side
rails are tight, all hardware and fittings are securely attached and
moveable parts are operating freely without binding or undue play.
_______ _________ Non-slip safety feet are provided on each metal or rung ladder.
_______ _________ Ladder rungs and steps are free of grease and oil.
_______ _________ Portable metal ladders are marked with signs reading “Caution” – do not
use around electrical equipment” or equivalent wording.
8
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
General Shop Inspection
Needed Corrected____________________________________________________________________
Maintenance Area(s)
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_______ _________ Compressors are properly guarded, maintained, clear of combustibles and
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_______ _________ Good housekeeping practices in general.
_______ _________ Steam boilers, other pressure vessels, elevator motors and generators are
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_______ _________ Oil and gas fired devices are equipped with flame failure controls that will
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_______ _________ Doors, aisle-ways and walkways are clear and free of obstructions, spills
well ventilated.
on a scheduled maintenance program.
prevent flow of fuel if pilots or main burners are not working.
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and debris.
_________ Storage of chemicals or flammables is in approved safety cabinet.
_________ Flammable storage cabinets are labeled “Flammable – Keep fire Away”.
_________ Flammable liquids such as gasoline are kept in approved safety cans.
_________ Machinery and equipment is kept clean.
_________ Machinery and equipment are on a regular maintenance schedule.
_________ Overhead hoist and lifting equipment are on a regular maintenance
schedule.
_________ Grinders, saws and similar equipment are provided with safety guards that
effectively guard the point of operation.
_________ Power tools are used with the correct shields, guards, or attachments
recommended by the manufacturer.
_________ Safety cans are used for dispensing flammable or combustible liquids at
point of use.
_________ “No Smoking” rules are enforced in areas involving storage and use of
hazardous materials.
_________ All chemical containers are marked with the contents name and hazard.
_________ All MSDS sheets are available on chemicals used/store on site.
_________ Combustible scrap, debris, and waste materials (oily rags, etc.) are stored in
covered metal receptacles and removed from the work site promptly.
_________ Rotating or moving parts of equipment are guarded to prevent physical
contact.
_________ All racking is secured.
_________ Heavy items are stored below waist level. Lighter items (5 lbs. or less) can
be stored above shoulder height.
_________ All chemicals are in labeled and approved containers.
_________ All flammables are stored in approved storage cabinets.
_________ All chemicals and hazardous materials have MSDS sheets.
_________ All containers containing chemicals are labeled as to contents.
_________ All tools that have developed mushroomed heads during use are taken out
of service until reconditioned or replaced.
_________ Broken or fractured handles on hammers, axes and similar equipment are
taken out of service until replaced.
_________ Worn or bent wrenches are replaced regularly.
9
_________ Tool handles are wedged tightly in the head of all tools.
_________ Tool cutting edges are kept sharp.
_________ Tools are stored in a dry secure place where they won’t be tampered with.
_________ Portable circular saws are equipped with guards above and below the base
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_______ _________ Rotating or moving parts of equipment are guarded to prevent physical
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_______ _________ All cord-connected, electrically-operated tools and equipment are effectively
shoe.
contact and the guards are in good repair.
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grounded or of the approved double insulated type.
_________ Effective guards are in place over belts, pulleys, chains, sprockets, and on
equipment such as air compressors, etc.
_________ Pneumatic and hydraulic hoses on power operated tools are free of
deterioration or damage.
_________ The work rest on an abrasive wheel is kept adjusted to within ¼ inch of the
wheel.
_________ The adjustable tongue on the top side of the grinder is used and kept
adjusted to within ¼ inch of the wheel.
_________ Side guards cover the spindle, nut, flange and 75% of the grinding wheel
diameter.
_________ Bench and pedestal grinders are permanently mounted.
_________ Each grinder has an individual on and off control switch that is in good
working order.
_________ New abrasive wheels are visually inspected and ring tested before being
mounted.
_________ Splashguards are mounted on any grinders that use coolant to prevent the
coolant from reaching the employee.
_________ Cleanliness is maintained around grinders.
_________ Compressed gas cylinders have no signs of deep rust or defects.
_________ Only approved apparatus (torches, regulators, pressure reducing valves,
acetylene generators, manifolds) used for welding cutting & brazing.
_________ There is adequate ventilation where welding or cutting is performed.
_________ Outside air is provided to all indoor workrooms at the rate of 15 cubic feet
per minute, per person.
_________ Quarterly carbon monoxide testing is completed and levels are acceptable
for environments whenever internal combustion engines are operated
indoors.
_________ Check ceiling tiles and walls etc. for evidence of water leakage and mold /
fungus / mildew.
Vehicle Maintenance Area
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_______ _________ Compressed air for cleaning is under 30 psi with approved safety tips.
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_______ _________ Storage of chemicals or flammables in approved safety cabinet.
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_______ _________ Storage cabinets labeled “Flammable – Keep fire Away”.
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_______ _________ It is prohibited to fuel an internal combustion engine with a flammable liquid
while the engine is running.
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_______ _________ If carbon monoxide is present, signs are posted and work procedures are in
place to ensure adequate ventilation.
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_______ _________ Combustible scrap, debris, and waste materials (oily rags, etc.) are stored in
covered metal receptacles and removed from the work site promptly.
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_______ _________ Safety cans are used for dispensing flammable or combustible liquids at
point of use.
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_______ _________ “No Smoking” rules are enforced in areas involving storage and use of
hazardous materials.
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_______ _________ All chemical containers are marked with the contents name and hazard.
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_______ _________ All MSDS sheets are available on chemicals used/store on site.
10
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_______ _________ Check ceiling tiles and walls etc. for evidence of water leakage and mold /
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_______ _________ Outside air is provided to all indoor workrooms at the rate of 15 cubic feet
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_______ _________ Ventilation is provided in all repair garages housing 6 or more vehicles
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_______ _________ Quarterly carbon monoxide testing is completed and levels are acceptable
fungus / mildew.
per minute, per person.
driven by internal combustion engines.
for environments whenever internal combustion engines are operated
indoors.
Chemical Storage (for locations with greater than 120 gallons of flammable liquids onsite)
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_______ _________ In areas where corrosive liquids or materials are handled there is a means
for quick drenching or flushing of the eyes and body. This is located
adjacent to the area-no more than 10 seconds away.
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_______ _________ There is a tag on all eyewash stations that documents the device has been
flushed every week. Or if bottled water is used there is an expiration date
and outdated bottles are removed and replaced.
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_______ _________ All solvent wastes and flammable liquids are kept in a fire resistant, covered
container until they are removed from the worksite.
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_______ _________ Fuel gas cylinders and oxygen cylinders are separated by distance, fire
resistant barriers, etc. while in storage.
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_______ _________ All containers over 30 gallons are stacked individually.
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_______ _________ Combustible scrap, debris, and waste materials (oily rags, etc.) are stored in
covered metal receptacles and removed from the worksite promptly.
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_______ _________ All connections on drums and combustible liquid piping are vapor and liquid
tight.
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_______ _________ Safety cans are used for dispensing flammable or combustible liquids at
point of use.
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_______ _________ “No Smoking” rules are enforced in areas involving storage and use of
hazardous materials.
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_______ _________ All chemical containers are marked with the contents name and hazard.
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_______ _________ All MSDS sheets are available on chemicals used/store on site.
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_______ _________ Storage rooms for flammable and combustible liquids have explosion-proof
lights.
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_______ _________ Storage rooms for flammable and combustible liquids have mechanical
ventilation.
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_______ _________ Approved containers and tanks are used in the storage and handling of
flammable and combustible liquids.
Compressed gases, compressed oxygen
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_______ _________ Oxygen cylinders are stored away from heating surfaces.
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_______ _________ Oxygen used outside is shielded from sunlight.
___
_______ _________ Storage of oxygen is separated from sources of ignition.
___
_______ _________ Storage of oxygen is separated from combustible/flammable materials.
___
_______ _________ Cylinders are stored in such a way so as to prevent them from creating a
hazard by tipping, falling, or rolling.
___
_______ _________ A 5-foot high minimum, non-combustible barrier separates oxygen and
acetylene cylinders or a 25-foot distance is maintained.
___
_______ _________ Cylinders are protected from mechanical injury.
___
_______ _________ Cylinder valves are protected with caps.
___
_______ _________ Cylinders are secured in upright position by use of chains or other devices.
___
_______ _________ Smoking, use of matches, lighters, etc. are prohibited in use area.
___
_______ _________ No smoking signs are posted in oxygen use area.
___
_______ _________ Compressed gas storage area is labeled as such.
___
_______ _________ Adequate signs are posted for oxygen equipment that is in use.
___
_______ _________ Only authorized personnel connect pressure-reducing valves to cylinders.
11
___
___
_______ _________ The use of grease or oil on valve threads prohibited.
_______ _________ The use of portable electrical equipment (drills, saws) prohibited when
___
___
___
___
___
___
___
___
___
_______
_______
_______
_______
_______
_______
_______
_______
_______
___
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___
_______
___
_______
oxygen is in use.
_________ Cylinders are removed from heat producing sources.
_________ The administration of oxygen is properly supervised.
_________ Only approved equipment is used for administration.
_________ Repairs and alterations are made only by authorized staff.
_________ Cylinders are legibly marked to clearly identify the gas contained in them.
_________ Valve protectors are on cylinders when they are not in use.
_________ Compressed gas cylinders are kept away from sources of heat.
_________ Compressed gas cylinders are not stored by elevators or stairs.
_________ Empty compressed gas cylinders are appropriately marked and their valves
are closed.
_________ Compressed gas cylinders, cylinder valves, couplings, regulators, hoses
and apparatus are free of oily or greasy substances.
_________ Suitable fire extinguishing equipment is available for immediate use near
compressed gas cylinders.
_________ Fuel gas cylinders and oxygen cylinders are separated by distance, fire
resistant barriers, etc. while in storage.
Personal Protective Equipment (PPE) Standard 1910.132, Eye & Face Protection 1910.133
___
_______ _________ Personal Protective Equipment is clean / sanitized.
___
_______ _________ Personal Protective Equipment is in good repair.
___
_______ _________ All eye & face protection is ANSI approved; i.e. it has an ANSI number
assigned and visible. (ANSI Z87.1-1989 incorporated by reference)
___
_______ _________ Eye and face PPE is distinctly marked to facilitate identification of the
manufacturer.
___
_______ _________ Goggles or face shields are provided and worn where there is danger of
flying particles, liquid chemicals, acids or caustic liquids, chemical gases
or vapors, potentially injurious light radiation or corrosive materials.
___
_______ _________ Side shields are provided on safety glasses where there is a danger of
flying particles.
___
_______ _________ Individuals that wear corrective lenses have eye protection that either
incorporates the prescription or can be worn over the prescription lenses.
___
_______ _________ Approved safety glasses are required to be worn at all times in areas where
there is a risk of eye injuries such as punctures, abrasions, contusions or
burns.
___
_______ _________ Protective aprons, gloves, shields, or other means are provided against
cuts, corrosive liquids and chemicals.
___
_______ _________ Hand protection is provided and used for exposures to hazards such as skin
absorption of harmful substances, severe cuts or lacerations, severe
abrasions, punctures, chemical burns, thermal burns, and harmful
temperature extremes.
___
_______ _________ Reusable PPE (face shields, utility gloves, goggles) are clean, free from
damage and are in good working order.
12
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
General Life Safety Inspection
Needed Corrected____________________________________________________________________
Means of Egress (exit)
___
_______ _________ Means of egress are continuously maintained free of all obstructions or
___
_______ _________ No furnishings, decorations, or other objects are placed so as to obstruct
___
___
_______ _________ A readily visible sign marks all exits.
_______ _________ Any door, passage, or stairway which is neither an exit nor a way of exit
impediments to full, instant use in the case of fire or other emergency.
exits, access thereto, egress therefrom, or visibility thereof.
___
_______
___
___
_______
_______
___
_______
___
_______
___
_______
___
___
___
_______
_______
_______
access, and which is so located or arranged as to be likely to be mistaken
for an exit, is identified by a sign reading "Not an Exit" or similar
designation. Or is identified by a sign indicating its actual character, such
as "To Basement," "Storeroom," "Linen Closet," or the like.
_________ A sign reading "Exit", or similar designation, with an arrow indicating the
directions, is placed in every location where the direction of travel to
reach the nearest exit is not immediately apparent.
_________ Every exit sign is suitably illuminated.
_________ Where stairs exit directly into any areas where vehicles may be operated,
adequate barriers and warnings are provided to protect employees from
stepping into path of traffic.
_________ A permanent means of access and egress is provided to elevated storage
and work surfaces.
_________ All elevated surfaces (beneath which people or equipment/machinery could
be exposed to falling objects) are provided with standard 4 inch toe
boards.
_________ Material on elevated surfaces is piled, stacked or racked in a manner to
prevent it from tipping, falling, collapsing, rolling or spreading.
_________ Fire evacuation procedures are posted.
_________ Tornado shelter and fire evacuation locations are posted.
_________ Special needs (such as visual or hearing impaired) for employees, visitors,
have been addressed.
Safety Signage 1910.145
___
___
_______ _________ All safety signs are in good repair and clearly visible.
_______ _________ “Bio hazard” biological hazard warning signs / labels are used to signify the
___
_______
___
___
___
_______
_______
_______
actual or potential presence of a biohazard and to identify equipment,
containers, rooms, materials, or combinations thereof, which contain, or
are contaminated with, viable hazardous agents.
_________ “Caution” signs. The background is yellow and the panel black with yellow
letters. Any letters used against the yellow background are black.
_________ “Danger” signs. The colors are red, black, and white.
_________ A sign identifies all “Confined Space” entry areas.
_________ Safety instruction signs are posted where there is a need for general
instructions and suggestions relative to safety measures.
13
___
_______ _________ Accident prevention tags are applied to equipment as a temporary measure
___
_______ _________ “Do Not Use” or “Do Not Start” tags contain a signal word and a major
___
message. Tags are affixed as close as safely possible to their respective
hazards by a positive means such as string, wire, or adhesive that
prevents their loss or unintentional removal.
_______ _________ If a 3 button control switch is used with a overhead or sliding door there is
placard adjacent to the switch that reads “Warning-To Prevent
Entrapment - Do Not Start door Downward Unless Doorway Is Clear”.
_______ _________ The switch itself is within sight of the doorway.
to identify a hazardous condition.
___
Fire Extinguishers CFR 1910.157
___
_______ _________ Portable fire extinguishers are maintained in a fully charged and operable
condition and kept in their designated places at all times except during
use.
___
_______ _________ Portable fire extinguishers are visually inspected each month and the
inspection tag is up to date.
___
_______ _________ Portable fire extinguishers are subjected to an annual maintenance check.
(Stored pressure extinguishers do not require an internal examination.)
___
_______ _________ There is a record of the annual maintenance date that is retained one year
after the last entry or the life of the shell, whichever is less.
___
_______ _________ Fire extinguishers that require a periodic hydrostatic test are sent to an
outside vendor. The frequency of this is determined by the type of
extinguisher so follow the vendors recommendations.
___
_______ _________ There is a written record that the required hydrostatic testing of fire
extinguishers has been performed.
___
_______ _________ The record includes the date of the test, the signature of the person who
performed the test and the serial number, or other identifier, of the fire
extinguisher that was tested.
___
_______ _________ These records are kept until the extinguisher is hydrostatically re-tested or
until the extinguisher is taken out of service, whichever comes first.
___
_______ _________ Interior stand pipes and valves are inspected regularly.
___
_______ _________ Outside hydrants are flushed at least once a year and are on a routine
preventative maintenance schedule.
___
_______ _________ Fire doors are in good operating condition and operate as intended.
___
_______ _________ Fire doors are unobstructed and protected against obstructions, including
their counterweights.
___
_______ _________ Fire door fusible links are in place.
___
_______ _________ Appropriate fire extinguishers are mounted within 75 feet of outside areas
containing flammable liquids, and within 10 feet of any inside storage
area for such materials.
___
_______ _________ All fire extinguishers are easily accessible and their locations are clearly
designated.
Automatic Sprinkler CFR 1910.159 (contact property insurer for more details)
___
_______ _________ Automatic sprinkler systems are continuously maintained in reliable
operating condition at all times.
___
_______ _________ Automatic sprinkler system water control valves, air and water pressure is
checked weekly/periodically as required.
___
_______ _________ The maintenance of automatic sprinkler systems is assigned to responsible
persons or to a sprinkler contractor and a record of the maintenance is
kept up to date.
___
_______ _________ Metal guards protect sprinkler heads if exposed to the possibility of physical
damage.
___
_______ _________ The proper clearance of 18 inches is maintained below and around sprinkler
heads.
14
___
_______ _________ Periodic inspections and tests are made on a quarterly basis to assure
___
_______ _________ A main drain flow test is performed on each system annually and there is a
___
_______ _________ The inspector's test valve is opened at least annually to assure that the
___
_______ _________ Conduct proper “acceptance tests” on sprinkler systems and record the
___
___
___
___
___
___
_______
_______
_______
_______
_______
_______
proper maintenance.
record of this. (Required more frequently in some municipalities)
sprinkler system operates properly.
dates of such tests.
_________ Fire control sprinkler heads are clean.
_________ Sprinkler control valves are secured in the open position.
_________ The main sprinkler control valve is accessible.
_________ All valves supplying air or water to the system are open.
_________ Spare sprinkler heads and a sprinkler head wrench are readily accessible.
_________ Other-list specifically on the template.
Alarms
___
_______ _________ The fire alarm system is tested bimonthly and documentation is made that
___
_______ _________ A test of the reliability and adequacy of non-supervised employee alarm
the test has been completed.
___
___
___
systems is made every two months and documentation is made that the
test has been completed.
_______ _________ A different actuation device is used in each test of a multi-actuation device
system so that no individual device is used for two consecutive tests.
_______ _________ Test all alarms, detectors and pull station.
_______ _________ Special needs (such as visual or hearing impaired) for employees, visitors,
have been addressed.
Ventilation / HVAC System
___
_______ _________ The system is checked on a regular basis (annual) for the need to clean or
decontaminate mold or other fungal/bacterial growth including:
 Outside air intakes
 Fans & coils
 Condensate pan & drain pans
 Mixing chamber
 Filters & filter racks
 Supply, return & exhaust ducts
 Internal fiberglass insulation
 Turning vanes
___
_______ _________ Routine mechanical system maintenance is performed.
15
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
Construction / Renovation Inspection
Needed Corrected____________________________________________________________________
Do not count on the contractor to take care of these safety issues!!!
___
_______ _________ Exposures to dusts and fumes are controlled. (this may require industrial
hygiene sampling)
___
_______ _________ Local ventilation has been provided.
___
_______ _________ Temporary barricades are in place to restrict traffic-both pedestrian and
vehicle.
___
_______ _________ No smoking signs are posted in spray areas, paint rooms, paint booths and
paint storage areas.
___
_______ _________ Containers of chemicals are labeled and MSDS’s are available for all
chemicals brought on site.
___
_______ _________ If an eyewash fixture is not plumbed in a capacity and flow rate standard
must be met. This minimum standard must ensure the unit delivers 0.4
gallons of water a minute for 15 minutes. The expiration date on the
water reservoir is current and outdated units are removed and replaced.
___
_______ _________ Emergency response information has been provided to contractor personnel
in the event of a fire, tornado or chemical spill.
___
_______ _________ Good housekeeping is maintained.
___
_______ _________ Walkways are clearly marked.
___
_______ _________ Appropriate “Danger” signs are posted.
___
_______ _________ Warning signs are posted in areas where Asbestos is being disturbed and
all asbestos containing waste is labeled as such. (old floor tiles, old
roofing, old insulation)
___
_______ _________ Warning signs are posted in areas where lead is being disturbed and all
lead containing waste is labeled as such.
___
_______ _________ The contractors have provided appropriate PPE to their employees.
___
_______ _________ Emergency lights: a functional test is conducted on the lights every 30
days for 30 seconds. Lights should be fully operational during the entire
test.
___
_______ _________ Emergency lights: an annual test is conducted for 1.5 hours each year.
Lights should be fully operational during the entire test.
16
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
Machine Guarding CFR 1910.212
Needed Corrected____________________________________________________________________
___
_______ _________ One or more methods of machine guarding is provided to protect both the
___
_______
___
_______
___
_______
___
_______
___
_______
___
_______
___
_______
___
_______
___
_______
operator and other employees in the machine area from hazards such as
those created by point of operation, ingoing nip points, rotating parts,
flying chips and sparks. Examples of guarding methods are barrier
guards, two-hand tripping devices, electronic safety devices, etc.
_________ All portable, power-driven circular saws having a blade diameter greater
than 2 in. are equipped with guards above and below the base plate or
shoe. The upper guard covers the saw to the depth of the teeth, except
for the minimum arc required to permit the base to be tilted for bevel cuts.
The lower guard covers the saw to the depth of the teeth, except for the
minimum arc required to allow proper retraction and contact with the
work.
_________ The lower guard automatically and instantly returns to the covering position
when the tool is withdrawn from the work.
_________ All hand-held powered circular saws having a blade diameter greater than 2
inches, electric, hydraulic or pneumatic chain saws, and percussion tools
without positive accessory holding means are equipped with a constant
pressure switch or control that will shut off the power when the pressure
is released.
_________ All hand-held gasoline powered chain saws are equipped with a constant
pressure throttle control that will shut off the power to the saw chain when
the pressure is released.
_________ Gasoline powered chain saw use has specific PPE requirements – Chaps,
face, head, hearing protection, and cut resistant footwear or boot covers.
_________ All hand-held powered drills, tappers, fastener drivers, horizontal, vertical,
and angle grinders with wheels greater than 2 inches in diameter, disc
sanders with discs greater than 2 inches in diameter, belt sanders,
reciprocating saws, saber, scroll, and jig saws with blade shanks greater
than a nominal one-fourth inch, and other similarly operating powered
tools are equipped with a constant pressure switch or control, and may
have a lock-on control provided that so turnoff can be accomplished by a
single motion of the same finger or fingers that turn it on.
_________ All other hand-held powered tools, such as, but not limited to, platen
sanders, grinders with wheels 2 inches in diameter or less, disc sanders
with discs 2 inches in diameter or less, routers, planers, laminate
trimmers, nibblers, shears, saber, scroll, and jig saws with blade shanks a
nominal one-fourth of an inch wide or less, may be equipped with either a
positive "on-off" control, or other controls as described by paragraph
(a)(2)(i) and (ii) of this section, CFR 1910.212.
_________ Abrasive wheels are used only on a machine provided with safety guards as
defined in paragraph (c) (1) through (4) of this section, CFR 1910.212.
_________ Power lawnmowers of the walk-behind, riding-rotary, and reel power
lawnmowers designed for sale to the general public meets the design
17
___
_______
___
___
_______
_______
___
_______
___
_______
___
_______
___
___
_______
_______
specifications in "American National Standard Safety Specifications for
Power Lawnmowers".
_________ All power-driven chains, belts, and gears are positioned or otherwise
guarded to prevent the operator's accidental contact therewith, during
normal starting, mounting, and operation of the machine.
_________ A shutoff device is provided to stop operation of the motor or engine.
_________ There is a power shut-off switch within reach of the operator’s position at
each machine.
_________ The non-current-carrying metal parts of electrically operated machines are
bonded and grounded.
_________ Foot-operated-switches are guarded or arranged to prevent accidental
actuation by personnel or falling objects.
_________ Manually operated valves and switches controlling the operation of
equipment and machines are clearly identified and readily accessible.
_________ All emergency stop buttons are colored red.
_________ All moving chains and gears are properly guarded.
18
General Safety Self-Inspection Checklist
Location
__________________________________
Date
__________________________________
Completed By
____________________________________
OK
Action Date
Electrical CFR 1910.217
Needed Corrected____________________________________________________________________
___
_______ _________ Electrical equipment has been approved for safety by Underwriters
___
_______ _________ The minimum clear working space in front of electric equipment such as
Laboratory (UL) or another OSHA approved body.
___
_______
___
_______
___
_______
___
___
_______
_______
___
___
___
___
_______
_______
_______
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___
_______
___
_______
___
___
___
___
___
_______
_______
_______
_______
_______
switchboards, control panels, switches, circuit breakers, motor controllers,
relays, and similar equipment may not be less than 3 feet. Distances are
measured from the live parts if they are exposed, or from the enclosure
front or opening if the live parts are enclosed.
_________ Use an instrument to test weather outlets have proper polarity and
grounding.
_________ Electrical appliances such as vacuum cleaners, polishers, vending
machines, etc. are grounded.
_________ Employees are only allowed to bring in appropriately grounded equipment
to their rooms or apartments.
_________ All extension cords being used have a grounding conductor.
_________ Extension cords are temporary only and a work order has been submitted to
hard wire in an appropriate alternative.
_________ No multiple plug adapters are in use.
_________ Check exposed wiring and cords for frayed or deteriorated insulation.
_________ Flexible cords and cables are free from splices or taps.
_________ Appliance and office machine cords are out of the way from becoming a trip
hazard.
_________ All disconnecting switches and circuit breakers are labeled to indicate their
use and / or the equipment served.
_________ All electrical enclosures such as switches, receptacles, junction boxes, etc.
have tight fitting covers or plates.
_________ All unused openings (including conduit knockouts) in electrical enclosures
and fittings are closed with appropriate covers, plugs or plates.
_________ Electrical panels have 3’ of clearance around them at all times.
_________ Electrical rooms are free from combustible storage.
_________ Electrical panels are cool to the touch.
_________ Electrical panels are free from evidence of burning.
_________ GFCI’s have been installed on all circuits in proximity to wet areas.
September 13, 2012
LMC Webinar: “Find It & Fix It: Getting Started on Mock OSHA Inspections”
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