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Safety Inspection
Division
*
Choose Division
Great Lakes
Midwest
Mountain States
Location
*
Crystal Lake - Production
Valders - Field
Valders - Production
Waukesha - Field
Waukesha - Machinery
Location
*
Albany
Field
Rosemount
Sealant
Wells
Location
*
West Division Field
West Division Plant
West Division Sealant
Area
*
Inspector's Initials
*
General & Housekeeping / Storage
Tools stored as required
*
OK
Needs Attention
Workplace clean and orderly
*
OK
Needs Attention
No mesh, rebar or scrap on floor
*
OK
Needs Attention
Floors are free of oil and debris and swept with sweeping compound
*
OK
Needs Attention
Material does not stick out of dumpsters or are overflowing
*
OK
Needs Attention
Emergency Preparedness / Fire Protection
Are extinguishers clearly marked and unobstructed by equipment or materials?
*
OK
Needs Attention
Emergency exit doors are accessible
*
OK
Needs Attention
Emergency eyewash stations accessible
*
OK
Needs Attention
Electrical panels accessible
*
OK
Needs Attention
Emergency exit lighting operable
*
OK
Needs Attention
First Aid cabinets stocked and accessible
*
OK
Needs Attention
Hazard Communication
Are all chemical containers properly labeled?
*
OK
Needs Attention
Chemical stored appropriately (35 gallon and up grounded / bonded?)
*
OK
Needs Attention
Bulk chemical containers have adequate spill containment
*
OK
Needs Attention
Do you know where the SDS binders are located?
*
OK
Needs Attention
Where do you get a new chemical label?
*
OK
Needs Attention
Powered Equipment & Machinery
Safeguards in place and in working order
*
OK
Needs Attention
Interlocks in place as required and function properly
*
OK
Needs Attention
E-stop red, with yellow halo behind
*
OK
Needs Attention
Machine function as intended by the manufacturer
*
OK
Needs Attention
Angle guards in place
*
OK
Needs Attention
Electrical
Are extension cords used for temporary use only?
*
OK
Needs Attention
Are electrical cords in good condition, free of cuts, frays splices and exposed wiring and correct replacement plug end used.
*
OK
Needs Attention
Third prong plug intact
*
OK
Needs Attention
Cords out of aisles
*
OK
Needs Attention
GFCI protection used in extension cord or connection.
*
OK
Needs Attention
Lockout / Tagout (If observed)
Is lockout tagout used during service and maintenance?
*
OK
Needs Attention
Lockout lock used company issued
*
OK
Needs Attention
Is there a lockout lock used for every person performing service or maintenance
*
OK
Needs Attention
Compressed Gases and Welding
Are compressed gas cylinder secured with chain or cage
*
OK
Needs Attention
Are fuel and oxygen tanks stored 20 feet apart or burn wall used when tanks are not in use.
*
OK
Needs Attention
Are flash back arrestors being used on both oxygen and fuel lines
*
OK
Needs Attention
Are cylinders, hoses, regulators and torches in good condition
*
OK
Needs Attention
Cranes, Hoists, Chains, and Slings
Safety latch functions properly
*
OK
Needs Attention
Equipment inspected prior to use
*
OK
Needs Attention
Capacity tags and stamped in place as required
*
OK
Needs Attention
Employees use safe work practices around raised loads
*
OK
Needs Attention
Signal person uses correct signal if applicable
*
OK
Needs Attention
Personal Protective Equipment
All personnel are wearing hearing protection and/or dual hearing protection when required
*
OK
Needs Attention
All personnel are wearing safety glasses, steel-toed boots, hard hat, and Hi Vis clothing as required
*
OK
Needs Attention
All personnel cutting, brazing, torching or grinning are wearing safety glasses and a face shield
*
OK
Needs Attention
Workers’ clothing free of holes and duct tape
*
OK
Needs Attention
Gloves are not worn when working with rotating equipment
*
OK
Needs Attention
Personal Protective Equipment
Personnel operating powered industrial vehicles trained by Safety Department
*
OK
Needs Attention
Daily pre-shift inspection completed on powered industrial vehicles
*
OK
Needs Attention
Operator wearing seat belt when operating
*
OK
Needs Attention
Operator uses horn at appropriate places
*
OK
Needs Attention
Operator uses three point of contact when mounting and dismounting vehicle
*
OK
Needs Attention
Ladders and Fixed Ladders
Ladders inspected before each use
*
OK
Needs Attention
Ladders in good condition, rungs, rails, feet, spreader bar
*
OK
Needs Attention
The correct ladder is used for the application: Extension or straight ladder for leaning, step ladder open as intended
*
OK
Needs Attention
Defective ladders are marked out of service and destroyed
*
OK
Needs Attention
Fly of ladder not being used separately
*
OK
Needs Attention
Stairs
Free of debris, water, oil
*
OK
Needs Attention
Railing in place
*
OK
Needs Attention
Guard rail in place on one open side
*
OK
Needs Attention
Stairwell well lit
*
OK
Needs Attention
Nothing stored under open stair well
*
OK
Needs Attention
Waste
Chemical containers capped when not in use
*
OK
Needs Attention
Waste containers properly labeled and properly stored
*
OK
Needs Attention
Waste containers sent to warehouse collection point
*
OK
Needs Attention
Waste disposed of in accordance with local, state and federal laws
*
OK
Needs Attention
Empty chemical containers crushed and disposed of per company policy
*
OK
Needs Attention
Walking Working Surfaces
Walking/working surfaces and storage areas free of potential slip/trip/fall hazards.
*
OK
Needs Attention
Spills of liquids and fluids cleaned up promptly and signage used to warn of slip/fall hazards?
*
OK
Needs Attention
Materials stored properly to avoid falling.
*
OK
Needs Attention
Walkways and passageways free of potholes, cracks, etc.
*
OK
Needs Attention
Entrances into high traffic areas properly signed
*
OK
Needs Attention
Stairs designed with treads and risers evenly spaced and in good condition
*
OK
Needs Attention
Open-sided edges or other fall hazards more than four feet protected by handrails, guardrails or covers?
*
OK
Needs Attention
Guardrails designed with top rail (42 inches), midrail (22 inches) and toe board in place no greater than ¼ inch from floor and in place where tools and equipment could fall to level below.
*
OK
Needs Attention
Guardrails secure and capable of withstanding 200 force pounds
*
OK
Needs Attention
Floor mats are flat, not curling
*
OK
Needs Attention
Fall protection is used when there are open-sided edges when work is required over four feet
*
OK
Needs Attention
Work floors are free of water, oil, snow, ice, etc.
*
OK
Needs Attention
Holes in floors / platforms, etc. greater than two inches are properly covered and marked “HOLE”
*
OK
Needs Attention
Strand, rebar, and wire mesh, stored out of aisles and runways
*
OK
Needs Attention
Employees trained in walking and working surface safety
*
OK
Needs Attention
All Pass or Fail
*
Pass
Fail
If any of the above criteria have been marked as "Needs Attention", please mark this as failed.
Comments
This checklist must be completed daily.
If equipment is found to be unsafe, ask maintenance to lock and tag out. Complete a work order request.
No equipment shall be operated with a leak in the fuel system.
Name
This field is for validation purposes and should be left unchanged.
