Monthly Facility Inspection Report

Branch

Inspector

Date

MonthDayYear

Office/Shop/Yard.Forklift *

	Evaluation	Comment
A1 General appearance of grounds/landscape?
A2 Fences, Gates and locks in good condition?
A3 Perimeter of property has no evidence of discharge of pollutants?
A4 Parking area and Entrance/Exits are well lighted?
A5 Are interior lights adequate and all in working order?
A6 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)
A7 Have all Fire Extinguishers been inspected and serviced within the past 12 months by a licensed Fire Protection Company?(1910.151 e 3)
A8 Is clear working space in front of all electrical panels maintained at no less than 36"? (1910.303)
A9 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) Is there a clear pathway free of obstructions maintained in front of and leading to exits?
A10 Are first aid kits available and maintained? Any items expired? (1910.151 b)
A11 Is SDS book available to employees, complete and updated? (1910.1200)
A12 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)
A13 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?
A14 Is there a clean, accessible, functioning eyewash station in any area where hazardous or corrosive materials are used? (1910.151)
A15 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)
A16 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) Have all ladders been inspected?
A17 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)
A18 Are overhead Gantry Cranes inspected daily and monthly? Has a certified inspection and service been performed in the past 12 months by a licensed professional?
A19 Is an examination of industrial trucks/forklifts made at least daily and after each shift and is a vehicle condition report completed? (1910.178 q 7)
A20 Are powered industrial trucks driven by trained and authorized personnel only? (1910.178 i)

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Facility Inspection Report Monthly