Walking / Working Surfaces  Line crossings, stairs, walkways, and workspaces are clear and unobstructed.  Pedestrian aisles are clearly marked and clear of obstructions.  Work Platforms are in good repair; inclines/declines properly marked.  Guardrails in place on working platforms or other floor openings as required.  All floor areas free of water, oil, debris, or other potential slip hazards.  No hoses, electrical cords, or other equipment on floors in walking areas.  Fire Safety / Emergency Equipment  Fire extinguisher and hoses properly inspected, not damaged, and accessible.  Sprinkler systems free of damage with at least 18” of clearance between sprinklers and material storage.  Emergency procedures posted as appropriate on each operator board, team area, etc.  Emergency numbers posted on all telephones.  Exit doors marked, lighted signs operational, exit path clears of obstructions.  Emergency eyewash stations properly inspected, clean and accessible.  Verify plant phones have the EMERGENCY sticker on phone. 

Walking / Working Surfaces Comments: _________________________ Observer’s Name: _________________________ Fire Safety / Emergency Equipment Comments: _________________________ Observer’s Name: _________________________

Electrical Safety & Lockout  NEW - No Extension Cords >6 foot being used in permanent applications.  Electrical panels, conduit, and other equipment in good condition.  Identify trash, paper, liquid bottles, combustibles on top of electrical cabinets  No loose or exposed wiring.  Lockout placards in place on equipment panels, energy source identifiers on control devices, placards legible and properly inspected for current years color.  Verify panel doors closed and secured (cannot be opened without tool/key).  Verify extension cords are not being overused – could an electrical receptacle be added  Verify no daisy chains (extension cord plugged into extension cord plugged into a receptacle).  Verify electrical panels are kept clear (36 inches).  Verify lockout placard for equipment has had its annual inspection (color coded sticker) Hazardous Materials  All containers have either a manufacturers label or plant transfer container label in place.  NEW-Label is legible, if hand written, marker has not warn off.  Areas that use flammable materials are properly marked, and grounding cables/straps in place as required.  Quantities and containers of flammable materials such as aerosols or paint are stored in approved flammable storage cabinets.  NEW-No combustible materials inside of flammable cabinet (paper, cardboard, gloves, pig matting, etc.)  Verify employees have been trained on the chemicals on their operations (signed operator book). 

Hazardous Materials Comments: _________________________ Observer’s Name: _________________________ Electrical Safety & Lockout Comments: _________________________ Observer’s Name: _________________________

Machinery / Equipment Safe Guards  All guards for moving equipment are in place.  Operator interface safety devices in their proper position and functioning (mats, light screens, palm buttons, etc.  Guarding for robot and automated equipment cells properly secured with nuts/bolts or provided with electrical interlocks.  E-stop controls properly identified.  NEW – Verify that any pneumatic, hydraulic, chemical, water, etc pipes are properly labeled and have direction of flow.  Operator Instructions / Safe Operating Procedures  Operator board information is current:  Chemical Information  PPE requirements  Emergency Procedures  Employee assigned to job has reviewed and signed off on job requirements on board.  NEW – Verify that the teams SOT is current and complete.  Safe operating procedures posted for power equipment/fixed tools as required.  Drivers:  Verify driver is properly wearing seat belt  Verify pre-op in completed  Verify driver is traveling in proper direction for visibility  Verify load is nestled against the back rest when transporting (material should not be transport on tips of forks)  Verify material is secured and properly stacked while being transported

Operator Instructions / Safe Operating Procedures Comments: _________________________ Observer’s Name: _________________________ Machinery / Equipment Safe Guards Comments: _________________________ Observer’s Name: _________________________

Housekeeping and Sanitation  Work areas organized and free of trash/debris.  Trash and recycling receptacles provided as required.  Verify that work benches, work cabinets, electrical panels, parts racks, and other surfaces clean of debris and dust buildup.  No obvious leaks or spills / dry floors.  HVAC vents appear well maintained.  Area restrooms are clean & properly stocked.  Hot water is available in sinks and restrooms.  Hand & Portable Tools  All tools in good repair and in proper locations.  Small tool balancers are operational with inspection tags in place  Hanging fixtures, tool rails, etc are equipped with safety cables and have been inspected.  Portable and fixed ladders and stairs have been inspected and tagged.  NEW - Are proper guards in place for rotating tools (either a mutilation socket or a rubber spindle guard)? 

Hand & Portable Tools Comments: _________________________ Observer’s Name: _________________________ Housekeeping and Sanitation Comments: _________________________ Observer’s Name: _________________________

Material Storage / Stacking  NEW-Material on pallets on high shelves is banded/wrapped.  NEW-All pull out draws are either interlocked, bolted to floor, or braced to prevent tip over.  All material storage containers are in good condition and free of visible damage.  Material racks stored next to operations or aisles are properly tiered.  Material racks that are loaded or unloaded by fork trucks or other mechanical devices are properly anchored.  Fork trucks and other mobile equipment has Operator PM completed.  Verify material is not double stacked or over 5 feet high along pedestrian aisles  Verify material is not protruding into aisles  Verify stacked material is stable  Verify stated material has at least 18” clearance from any fixed overhead structure  Verify material is not blocking doors or electrical panels Attendees

Additional Attendees: _________________________ Material Storage / Stacking Comments: _________________________ Observer’s Name: _________________________

Name: Name Name: Question Employee Do you understand the safety requirements of your job? (Chemicals, PPE, Tool/Equipment safety) Do you know the location of your group safety information? Verify that employee understands evacuation and take shelter procedures. What was your last safety talk / communication? What do you feel is the most probable injury for your group/area? Do you have any safety concerns? Give me an example of a “safe” behavior you observed today. Enhanced Safety Observation Tour Leadership / Employee Observations Name: Name Name: Question Employee Do you understand the safety requirements of your job? (Chemicals, PPE, Tool/Equipment safety) Do you know the location of your group safety information? Verify that employee understands evacuation and take shelter procedures. What was your last safety talk / communication? What do you feel is the most probable injury for your group/area? Do you have any safety concerns? Give me an example of a “safe” behavior you observed today. Enhanced Safety Observation Tour Leadership / Employee Observations

Employee Observations Comments: _________________________ Observer’s Name: _________________________ Employee Observations Comments: _________________________ Observer’s Name: _________________________

Dock Safety  NEW- Verify that trailer wheels are flush with the dock (in back position)  Verify that Key Surrender Process is being utilized  Verify that two chocks are in place  Verify trailer jack-stands are in place and snug to trailer  Verify dock lights inside/outside are working properly  Verify that the trailer manufacture date is in compliance with the trailer guidelines (10 years)  Verify orange crush zone procedures are being followed  Cranes & Hoists  Do all cranes and hoists in the area have the current inspection tag (orange/green)  Are the operator controls clearly defined and legible  Do the rail systems have the capacity ratings labeled properly  Do the rails have a secondary end stop that has the appropriate safety cable?  Are all safety cables to the rail systems in place?  If the system has a hook, does it have a safety latch / is it damaged? 

Dock Safety Comments: _________________________ Observer’s Name: _________________________ Cranes & Hoists Comments: _________________________ Observer’s Name: _________________________