PISEi Form3/art

SAMPLE WALK-THROUGH CHECKLIST ii. Add pictures

iii. Add action taken\
1. General Information
a. Description of work h. Is the work area clear?
b. Take a photo of the workplace i. Add notes
2. Floors and Other Areas ii. Add pictures
a. Are floors clean and clear of waste? iii. Add action taken
i. Add notes i. Are floors well-drained?
ii. Add pictures i. Add notes
iii. Add action taken ii. Add pictures
b. Are signs posted to warn of wet floors? iii. Add action taken
i. Add notes j. Are all air vents and filters properly maintained?
ii. Add pictures i. Add notes
iii. Add action taken ii. Add pictures
c. Signage posted to warn wet floors iii. Add action taken
i. Add notes 3. Aisles and Stairways
ii. Add pictures a. Are aisles unobstructed and clearly marked?
iii. Add action taken i. Add notes
d. Are floors in good condition (no holes, worn or loose planks or carpet ii. Add pictures
sticking up)? iii. Add action taken
i. Add notes b. Are mirrors installed at blind corners?
ii. Add pictures i. Add notes
iii. Add action taken ii. Add pictures
e. Is anti-slip flooring used where spills, moisture or grease are likely? iii. Add action taken
i. Add notes c. Are aisles wide enough to accommodate workers and equipment
ii. Add pictures comfortably?
iii. Add action taken i. Add notes
f. No protruding objects such as nails, sharp corners, open cabinet ii. Add pictures
drawers, trailing electrical wires? iii. Add action taken
i. Add notes d. Are safe loading practices used with hand and power trucks, skids, or
ii. Add pictures pallets?
iii. Add action taken i. Add notes
g. Are personal items, such as clothing and lunch boxes, in assigned ii. Add pictures
lockers or storage areas? iii. Add action taken
i. Add notes e. Is the workplace lighting adequate?
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i. Add notes iii. Add action taken
ii. Add pictures 5. Waste Disposal
iii. Add action taken a. Are there adequate numbers of containers?
f. Are stairs well lit? b. Are there separate and approved containers for toxic and flammable
i. Add notes waste?
ii. Add pictures c. Are waste containers located where the waste is produced?
iii. Add action taken d. Are waste containers emptied regularly?
g. Are stairs covered with an anti-slip tread? e. Are toxic and flammable waste chemicals handled properly?
i. Add notes
ii. Add pictures 6. Equipment and Machinery Maintenance
iii. Add action taken a. Are all equipment in good working order, with all necessary guards or
h. Are faulty stair treads repaired? safety features operational or in place?
i. Add notes b. Are tools and machinery inspected regularly for wear or leaks?
ii. Add pictures c. Are all equipment repaired promptly?
iii. Add action taken d. Are drip pans or absorbent materials used if leaks cannot be stopped at
4. Spill Control the source?
a. Are all spills wiped up quickly? e. Are all machine that splashes oil fitted with a screen or splash guard?
i. Add notes f. Are machines and tools cleaned regularly?
ii. Add pictures g. Are all tools and unused materials cleaned up after finishing a job or
iii. Add action taken before leaving the job site?
b. Are procedures followed as indicated on the material safety data sheet?
i. Add notes 7. Storage Area
ii. Add pictures a. Are storage areas safe and accessible?
iii. Add action taken b. Are all materials stacked securely, blocked or interlocked if possible?
c. Are spill absorbents used for greasy, oily, flammable or toxic materials? c. Are materials stored in areas that do not obstruct stairs, fire escapes,
i. Add notes exits or firefighting equipment?
ii. Add pictures d. Are materials stored in areas that do not interfere with workers or the
iii. Add action taken flow of materials?
d. Are used rags and absorbents disposed of promptly and safely? e. Are bins or racks provided where material cannot be piled?
i. Add notes f. Are all storage areas clearly marked?
ii. Add pictures g. Do workers understand material storage and handling procedures?
iii. Add action taken
e. Is a spill area surrounded by a barrier to prevent a spill from spreading? 8. Fire Prevention
i. Add notes a. Are combustible and flammable materials present only in the quantities
ii. Add pictures needed for the job at hand?
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b. Are combustible and flammable materials kept in safety cans during
use?
c. Are hazardous materials stored in approved containers and away from
ignition sources?
d. Are sprinkler heads clear of stored material?
e. Are fire extinguishers inspected and located along commonly travelled
routes, and close to possible ignition sources?
f. Are oily or greasy rags placed in metal containers and disposed of
regularly?

9. Completion
a. Recommendations
i. Noted deficiencies
b. Full Name and Signature of Inspector
c. Date inspected
d. Overall Rating (Pass or Fail)