Quarterly Facility Inspection Report

Inspector

First NameLast Name

Branch

Date

MonthDayYear

A Exterior/Yard

Rows	Evaluation	Comment
A1 General appearance of grounds/landscape?
A2 Designated smoking area outside?
A3 Building exterior appearance?
A4 When working in the yard, Is a positive “Lockout/Tag out” system provided to render machines,trucks, and equipment inoperable while repairs or adjustments are being made? Are locks individually keyed and under the exclusive control of the employee? (29 CFR 1910.147)
A5 Fences, Gates and locks in good condition?
A6 Perimeter of property has no evidence of discharge of pollutants?
A7 Manhole and other confined spaces clearly marked? (1910.146 c 4)
A8 Parking area and Entrance/Exits are well lighted?
A9 Paved surfaces free of potholes, debris and other trip slip and fall hazards?
A10 Walkways and steps in good repair? (1910.124)
A11 Are step risers on stairs uniform from top to bottom? (1910.124)
A12 Are barriers and bollards painted yellow?
A13 Are steps on stairs and stairways designed to with a surface that’s renders them slip resistant? (1910.24f)
A14 Fuel Island Dispensers Hoses and Nozzles in good repair? (1910.106, NFPA#30,Local Fire Codes)
A15 Fuel Island – No Smoking and Shut off Engine signs (1910.106 (d) 7 iii, NFPA #30, Local Fire Codes)
A16 Fuel Island – Emergency Shut off clearly marked? (1910.106, NFPA #30, Local Fire Codes)
A17 Fuel Island - Adequate barrier protection? (1910.106, NFPA #30, Local Fire Codes)
A17 Fuel Island - Adequate number of Fire Ext? Charged/Tagged/inspected?(1910.106(d)7
A18 Fuel Island - Spill Kit dry and well marked? (1910.106, NFPA #30, Local Fire Codes)
A19 Fuel Trailer - Dispensers Hoses and Nozzles in good repair? (1910.106, NFPA #30, Local Fire Codes)
A20 Fuel Trailer - No leaks or signs of deterioration of tank integrity (1910.106, NFPA #30, Local Fire Codes)

B Office/Storage/FacilityAreas

Rows	Evaluation	Comment
B1 Are portable fire extinguishers kept at their designated places at all times (accessible, mounted, charged, pinned and sealed)? Is each extinguisher marked with a sign and does each sign have a corresponding extinguisher? Are annual and monthly inspections documented on the tag? Is there an adequate number of extinguishers for the prevailing fire hazards? Are extinguishers free from obstructions to access?(1910.157)
B2 Are first aid kits available and maintained? Any items expired? No oral Meds? (1910.151)
B3 Are interior lights adequate and all in working order? Do emergency lights work when tested? (NFPA 101)
B4 Is clear working space in front of an electrical panel maintained at no less than 36"? (1910.303)
B5 Are all live parts of electrical equipment operating at 50 volts or more guarded against accidental contact? Are outlet boxes in good condition? No exposed wiring. Are GFCI outlets used in wet or damp areas? (1910.303 g 2)
B6 Are panel box doors and individual electrical circuit breakers (and fueled pump switches) legibly identified? (1910.303)
B7 Are electric cords, extension cords, and trouble light of approved 3-wire ground type and in good condition? Is there any temporary wiring that should be permanent? (1910.305)
B8"Company required postings Commitment to Drug and Alcohol Free Work Place Sexual Harassment Policy Americans with Disability Act Policy First Aid Responders and CPR trained employee names"
B9"Federal Required Posting Federal 5 in 1 poster OSHA ""It's the Law"" Poster OSHA 300a Summary from Feb 1 to April 30 Evacuation Map,1910.3 Emergency Contact Numbers Fair Labor Standards Act Family and Medical Leave Act Equal Employment Opportunity Uniform Services Employment Act Invitation to Self Identify Notice of viewing Affirmative Action Plans"
B10 State and Local Requiring Position State OSHA Workers Compensation Poster State Wage and Hour (minimum wage)"
B11 Is the injury record (OSHA 300 log) maintained up to date with copies at satellite facilities? (1904.7)
B12 Is Clinic name, address, and phone number posted for after hours use?
B13 Are the site emergency exit plans posted throughout the facility? (1910.38)
B14 "Records present and complete: OSHA 300 log,Safety Meeting/training Hazard communication SARA Title II PPE/Hazard Assessments,SPCC/SWPPP Plans Accident and Injury Data Facility Inspections"
B15 Are aisle ways and passageways kept clean and in good repair and are there no obstructions across aisle ways that could create a hazard?
B16 Are floor openings and platforms or workstations 48" or higher guarded by a cover, a guardrail, or equivalent on all sides?
B17 Are changes of direction or elevations readily identifiable? (painted Yellow)
B18 Are stairs adequately lighted, treads and risers uniform from top to bottom, have appropriate handrails and slip resistant surfaces (1910.24 f)
B19 Are "No Smoking" signs posted through the facility if required by State and Local Law? Designated smoking area outside?
B20 Are automatic sprinkler fusible links clean, unpainted and undamaged? Is the minimum vertical clearance between automatic sprinklers and material below them at least 18 inches (36 inches for bales)?
B21 Is the sprinkler header marked with a tag indicating inspection and service in the last 12 months? (1910.159)
B22 Are emergency exit doors functioning and not locked from the inside? (1910.36 d)
B23 Are exits marked with appropriate signage? (1910.37 b 2) Are interior doors leading to areas that could be mistaken for an exit, marked "Not an Exit" (1910.37 b 5)
B24 Are toilets and washing facilities clean and sanitary with warm water and soap, and means of hand drying?
B25 Are lunch rooms, and break rooms kept clean?
B26 Is ventilation system functioning adequately?
B27 Is bump test checklist up to date on all H2S moniotors?

C1 SHOP Personal Protection Equipment/First Aid

Rows	Evaluation	Comment
C1.1 Are protective eye and face equipment worn where required and are safety glasses worn over corrective lenses or do corrective lenses conform to ANSI Z-87.I-1968)(1910.133 a 1) (1910.133 a 3)
C1.2 Is there a supply of loaner safety glasses located at all entrance points to the shop? Are safety glass cleaning stations located in the shop?
C1.3 Are caution signs present at entrance points and at machines generating eye and face hazards, which state; "Caution Eye Protection Required"?(1910.145 c 3)(1910.133 a)(1910.252 b 2)(1910.252 b 2 iii)(1910.252 b 3)
C1.4 Is a safe passage area clearly marked by a painted yellow line?
C1.5 Are employees who are exposed to the hazards created by welding, cutting or brazing operations protected by appropriate personal protective equipment?
C1.6 Are suitable gloves, hearing protection, and protective clothing available to be worn as necessary?(1910.132 a)
C1.7 Are appropriate safety glasses face shields, tec. Used while using hand tools or abrasive wheels or equipment which might produce flying materials or be subject to breakage?(1910.132 a)
C1.8 Are respirators; clean, properly stored, and respirator program in effect? (1910.134 h 1)
C1.9 Is there a clean, accessible, functioning eyewash station in any area where hazardous or corrosive materials are used? (1910.151)
C1.10 If emergency showers are present - are they clean, operable and accessible? (1910.151 c)
C1.11 Are first aid kits available and maintained? Any items expired? (1910.151 b)

C2 SHOP Fire Protection

Rows	Evaluation	Comment
C2.1 Are portable fire extinguishers kept at their designated places at all times (accessible, mounted, charged, pinned and sealed)? Is each extinguisher marked with a sign and does each sign have a corresponding extinguisher? Are annual and monthly inspections documented on teh tag? Are there an adequate number of extinguishers for the prevailing fire hazards? Are extinguishers free from obstructions to access?(1910.157)
C2.2 Have all Fire Extinguishers been inspected and serviced within the past 12 months by a licensed Fire Protection Company?(1910.151 e 3)
C2.3 Are reels and cabinets for hose systems in good working order, conspicuously identified accessible and used only as fire equipment?(1910.158. c 1)
C2.4 No Smoking Signs posted in; fuel area, battery charging area, paint booths and storage?(1910.106 b 6)
C2.5 Test Emergency lighting equipment to ensure proper working order (NFPA 101)

C3 SHOP Electrical/Lighting

Rows	Evaluation	Comment
C3.1 Are interior lights adequate and all in working order?
C3.2 Is clear working space in front of an electrical panel maintained at no less than 36"? (1910.303 i)
C3.3 Are all live parts of electrical equipment operating at 50 volts or more guarded against accidental contact? Are outlet boxes in good condition? No exposed wiring. Are GFCI outlets used in wet or damp areas? (1910.303 g 2)
C3.4 Are panel box doors and individual electrical circuit breakers (and fueled pump switches) legibly identified? (1910.303 f)
C3.5 Are electric cords, extension cords, and trouble light of approved 3-wire ground type and in good condition? (1910.304 f) (1910.305 a 2 iii c)
C3.6 Are overhead doors and controls in good working order? (1910.305 g 1 iii)
C3.7 Are outlet boxes in good condition? Are all outlets grounded? Are GFCI outlets used in wet or damp areas? (191.305 b) (1910.303 g2) (1910.304 f 5 iv b)
C3.8 Is a positive "Lockout/Tag out" system provided to render machines, trucks and equipment inoperable while repairs or adjustments are being made? Are locks individually keyed and under the exclusive control of the employee. Is there a means of identifying the individual who placed the lock (tag)? (1910.147)
C3.9 Is the Hazard Communication Program complete and are the Material Safety Data Sheets present and available? Is the Chemical Inventory present and complete? (1910.1200 e 1 i) (1910.1200 g 10)

C4 SHOP Walking and Working Surfaces

Rows	Evaluation	Comment
C4.1 Are floor opening and platforms or workstations 48" or higher guarded by a cover, a guardrail, or equivalent on all sides? (1910.23 c 1)
C4.2 Are grates or covers over floor openings such as floor drains, secured? (1910.23 a 8 iii)
C4.3 Are step risers on stairs uniform from top to bottom? (1910.24) Are steps on stairs and stairways designed to provide a surface that renders them slip resistant?(1910.24 f)
C4.4 Are aisles and passageways kept clear and marked as appropriate? (1910.22 b)
C4.5 Are wet surfaces cleaned up or coverd with non-slip materials? (1910.22 a 2)
C4.6 Are changes of direction or elevations readily identifiable? (painted Yellow)
C4.7 Are aisles and walkways protected from potential hazards of adjacent work areas? Are aisles and passageways kept clean and in good repair and are there no obstructions across aisles that could create a hazard? (1910.176a)
C4.8 Are floor loading capacity limits posted for 2nd floor storage?(1910.22d) Are there toe boards and guard rails for second floor storage?(1910.23 e 4)
C4.9 Is the exit pathway clearly marked by signs from all points within the working area? Are doors which could be mistaken for an exit identified with signs which read, "Not an Exit"? (1910.37b)
C4.10 Where mechanical handling equipment is used, are there sufficient safe clearances allowed for aisles, at loading docks, through doorways and wherever a turn or passage must be made?
C4.11 Does the storage of material not create a hazard - stacked , blocked, interlocked and limited in height to ensure they are stable and secured against sliding or collapse? (1910.176b)
C4.12 Manhole and other confined spaces clealry marked? (1910.146 c 2)

C5 SHOP Ladders

Rows	Evaluation	Comment
C5.1 Are portable ladders in good condition with slip proof feet and no cracks, paint or splinters on the rungs? (1910.26 c) Are fixed metal ladders painted or treated to resist corrosion and rusting? (1910.27)
C5.2 Is the fixed ladder's clearance distance at least 36 inches between the nearest permanent object and the center line of the rungs?
C5.3 Are all bolts or rivets properly secured? (1910.179 j 3 ii)
C5.4 Is there a documented Inspection program with annual certifications and monthly inspections in file? (1910.179j) (1910.179m)
C5.5 Is the load rating clearly marked on each side of the crane? (1910.179 b 5)

C6 SHOP Flammables/Liquid Storage

Rows	Evaluation	Comment
C6.1 Are only approved metal storage cans used for flammable liquids, including gasoline? Are all containers marked as to contents? (1910.106 d)
C6.2 Are flammable and combustible liquids (fuels, solvents, paints, etc.) stored in a UL/FM approved flammable storage cabinet? (1910.106 d 3)
C6.3 When transferring flammable/combustible liquids are containers grounded and bonded? (1910.106 b 6)
C6.4 Parts washer is in good working order, with fusible link attached and no obstructions for lid closure? Protective gloves and eye protection available? (CCR article 36)
C6.5 Are drums of petroleum products kept in secondary containment?
C6.6 Are spills cleaned up in the liquid storage areas?
C6.7 Are closeable containers provided for soiled rag disposal? (1910.106 h 8 iii)
C6.8 Is pressure washer in good working order? (hoses, vent and fuel lines)
C6.9 No Smoking signs, adequate ventilation, eye and face protection and no spark or flame sources in battery charging/storage areas?
C6.10 Is MSDS book available to employees, complete and updated? (1910.1200)

C7 SHOP Compressors

Rows	Evaluation	Comment
C7.1 Do all compressors prominently display a sign stating "Caution - this machine starts automatically" (CCR 3320)
C7.2 Are compressors equipped with pressure relief valves, pressure gauge, and spring-loaded safety valves, a totally enclosed belt drive system, and are air filters installed and maintained on the compressor intake? (CCR 3320)
C7.3 is pressure reduced to 30 p.s.i. for cleaning? (1910.242 b)

C8 SHOP Welding Equipment

Rows	Evaluation	Comment
C8.1 Are welder cables, clamps and guards in good condition? (1910.254) Are torch hoses, regulators and valves equipped with anti-flash back valves? (1910.253 e iii)
C8.2 Are "Hot Work Permits" used when welding is conducted outside of designated areas? (1910.252 a 2 IV) Is the designated welding area at least 35 feet from combustible materials, spray painting, etcA? (1910.253)

C9 SHOP Compressed Gas Cylinders

Rows	Evalutaion	Comment
C9.1 Are all stored cylinders effectively secured to prevent tipping? Are Cylinder valve protector in place unless in use? (1910.253 b 2 ii)
C9.2 Are cylinders legibly marked and labeled to clearly identify the gas contained? (1910.253 b 1 ii)
C9.3 Are oxygen and acetylene (or other fuel) tanks stored separated by 20' or with a 5' high 1 half hour fire resistant wall between oxygen and fuels? (1910.253 b 4 iii)
C9.4 Are cylinders stored in areas which are protected from heat and flame, located at least 25 feet from electrical equipment and people and at least 20 feet from flammable liquids or combustible materials? (1910.253 b 2 ii)

C10 SHOP Machine Guarding

Rows	Evaluation	Comment
C10.1 Are chop saws equipped with a retracting blade guard and functioning spring return? Do they have proper feet to prevent movement while in use?(1910.212 a 1)
C10.2 Are power machines, shears, grinders, saws, drill presses, etc. properly anchored maintained and guarded? (1910.212 b)
C10.3 Do fixed grinders have side guards that cover the spindle, nut, and flange and 75% of the wheel diameter? (1910.215 a 4) Tool rests adjusted to within 1/8" ? (1910.215 a 2) Tongue guard adjusted to within 1/4" of wheel? (1910.215 b 9)
C10.4 Before new abrasive wheels are mounted, are they visually inspected and ring tested? (1910.215d)
C10.5 Is the appropriate eye protection caution sign, and full face shield located at Grinder? (1910.133a)
C10.6 Have all hazards from points of operation, ingoing nip points, rotating parts, flying chips, sparks, moving chains, gears, pulleys and belts (1910.212a), including fan blades (within 7 feet of the floor) (1910.212 a 5) been guarded?

C11 SHOP Tools and Jacks

Rows	Evaluation	Comment
C11.1 Are tools and equipment (both company and employee-owned) in good condition and used with the correct handle, shield, guard, or attachment, recommended by the manufacturer? (1910.242 a)
C11.2 Are hand tools such as chisels, punches, wrenches, etc. which are worn , bent or mushroomed during use, reconditioned or replaced as necessary? (1910.242a)
C11.3 Are appropriate handles used on files and similar tools?
C11.4 Are all cords-connected, electrically-operated tools and equipment effectively grounded or of the approved double insulated type? (1910.243 a 5)
C11.5 Are pneumatic and hydraulic hoses on power-operated tools free of deterioration or damage? (1910.243b2)
C11.6 Are all jacks and jack stands in good condition, with OEM pin and labeled with load capacity? (1910.244a)

D Forklift

Rows	Evaluation	Comment
D1 Are all nameplates and marking in place and legible on powered industrial trucks? (1910.178 a 6)
D2 Are industrial trucks kept in clean condition, free of lint, excess oil and grease? (1910.178 q 10)
D3 Is directional lighting provided on each industrial truck?
D4 Does each industrial truck have a warning horn, or other device which can be clearly heard above the normal noise in the areas where operated? Does each industrial truck have a reverse signal alarm audible above the surrounding noise level? (1910.178 a 2) Is directional signal lighting provided? (1910.178 h 2)
D5 Are the brakes on each industrial truck capable of bringing the vehicle to a complete and safe stop when fully loaded and does the parking brake effectively prevent the vehicle from moving when unattended? (1910.178 a 2)
D6 Does the forklift have a working seat belt and working strobe? (1910.178 a 2)
D7 Are powered industrial trucks driven by trained and authorized personnel only? (1910.178 i)
D8 Is an examination of industrial trucks made at least daily and after each shift and is a vehicle condition report completed? (1910.178 q 7)
D9 Are industrial trucks left in an off position when unattended or when the operator is more than 24 feet from the vehicle? (1910.178 m 5 i)
D10 Is the rated capacity of the truck clearly posted within the view of the operator? (1910.178 a 2)
D11 Do all forklifts have a mounted, inspected and pinned fire extinguisher? (1910.157 d 5)
D12 Is the overhead guard clear of obstruction, enabling the operator to view raised loads? (1910.178 e)

Comments

Facility Inspection Report Quarterly