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CONVEYORS
Place a check mark by all defective conditions you find from list below.
__ 1. Workers on conveyors who are not authorized and who have not received task training operating
conveyors.
__ 2. When the operator does not have a full view of the conveyor, the conveyor is not equipped with an
audible warning siren that can be sounded 30 seconds prior to starting the conveyor. (If the conveyor isn't
started at the 30-second time, another warning must be sounded and another 30-second interval allowed
before starting.)
__ 3. A conveyor being loaded or put into motion before a check is made to verify that all employees are
clear.
__ 4. Conveyors not locked out and tagged out with a "Do Not Operate" tag during repairs and when
operation is hazardous to employees performing maintenance work.
__ 5. Workers riding or walking on a moving conveyor belt.
__ 6. Adjusting skirts and scrapers while conveyor belts are running.
__ 7. Workers adjusting belts on conveyors who are not authorized and who have not received task training
in the specific pre-approved procedures
CRANES AND HOISTS
Place a check mark by all defective conditions you find from the list below.
__ 1. Overhead hoists or cranes being operated by workers without task training.
__ 2. Mobile cranes not being operated by certified crane operators.
__ 3. Pre-use inspections not being done or done properly on equipment.
a. Check controls to verify proper function.
b. Check pendant cables for cuts, kinking, or signs of wear.
c. Check swaged sockets for damage and pins for excessive wear.
d. Visually check hoist cables for fraying, kinking, crushing and twisting of the cables between the
cable and the drum.
e. Visually inspect the hook for cracks, bending or distortion.
__ 4. Malfunctioning hoist not tagged with tag describing malfunction.
__ 5. Not using a spotter when working near overhead power lines. (Neither the hoist nor any portion of the
cable can come within 10 feet of any overhead power line.)
__ 6. Exceeding the safe load limit of hoisting equipment. (Only trained and approved persons who are
completely familiar with the weight capacity at various locations and boom angles are permitted to operate
hoists.)
__ 7. Equipment with the weight capacity not prominently displayed).
__ 8. Load chains that have been lengthened or repaired.
__ 9. The hoist not positioned directly over the load.
__ 10. Swinging the hook or load when moving the hoist.
__ 11. Not pulling in a straight line (Hoist body or load chain/rope angled around something.
__ 12. After placing the hook in the lifting ring, NOT applying slight pressure to the hoist to ensure that the
lifting ring is seated in the bottom of the hook and that the hook is properly aligned.
__ 13. Between lifts, not checking to see that the rope is properly reeved on drum.
__ 14. Not attaching sufficient guide ropes to control the load.
__ 15. Not checking the intended movement path to see that it is clear of people and obstructions and that
the intended destination is ready to receive the load.
__ 16. Tampering with any part of the hoist when worker is not authorized to do so.
__ 17. Not checking brakes for excessive drift.
__ 18. Workers not positioning themselves on the pendant side of the hoist to get maximum clearance from
the load and to prevent entanglement of cables.
__ 19. Starting, stopping, or reversing a load suddenly.
__ 20. Failure to raise the load only high enough to avoid obstructions.
__ 21. Hoisting loads over workers -- not waiting until the area is clear.
__ 3. Workers not wearing extra PPE required in special work areas. Specific work areas may require the use
of goggles, gloves, aprons, or respirators.
__ 4. Areas requiring special PPE not posted or employees not instructed on the PPE they are required to
use.
__ 5. The proper face shield, goggles or protective hood must be worn over safety glasses when grinding,
welding, cutting, working with molten metal or other similarly hazardous materials.
__ 6. Company-approved hearing protection not being worn in designated areas or as required by conditions.
__ 7. Gloves being worn where they are creating a greater hazard by becoming entangled in the moving
parts of machinery.
__ 8. Machines where gloves are forbidden are not posted as such.
__ 9. Seat belts not fastened before mobile equipment is moved on plant premises.
__ 10. A Coast-Guard-approved flotation device not used while working where there is a danger of falling
into water.
__ 11. A life ring with rope attached not in the immediate area where workers are exposed to water danger.
__ 12. Respirators not used when spray painting or performing other operations that may contaminate the air
with dust or fumes and foreign particles.
__ 13. Respirators not being used in areas where MSHA has found employee overexposures to dust.
__ 14. A worker wearing a respirator that has not been fit tested, trained, or had a medical evaluation.
__ 15. Personal Fall Arrest Systems not used when there is a danger of falling.
__ 16. A safety belt being worn as a fall arrest system.
__ 17. Any employee on a walking/working surface with an unprotected side or edge which is 6 feet or more
above a lower level that is not protected from falling by the use of a guardrail system, a belt and lanyard
which prevents the person from walking over the edge, or a full-body harness and shock-absorbing lanyard.
__ 18. Employees not trained before using personal fall protection.
__ 19. A second person not tending the lifeline when bins, tanks, silos or other dangerous areas are entered.
__ 20. Floor openings not guarded by standard guardrails and toeboards or covers that are secured against
accidental displacement.
__ 21. Floor hole covers not stenciled "Hole Cover - Do not remove".
ALCOHOL AND DRUG SAFETY.
Place a checkmark for deficient policy, training, or condition.
__ 1. Company has no policy on "On Property Alcohol/Drug Use".
__ 2. Company policy does not contain the following elements (Check all that apply):
__ a. Disciplinary actions for Alcohol/Drug use on property.
__ b. Employee actions required when taking a prescription drug.
__ c. Drug and alcohol testing policy.
__ d. Training supervisors to recognize employee drug use.
__ 3. Supervisors trained to use "Employee -Fit for duty" checklist (See below).
"Red Flag" behaviors indicating possible alcohol/drug use.
__ Poor coordination and balance.
__ Inappropriate verbal response to questions.
__ Unusual tardiness or long absences from assigned tasks.
__ Smell of alcohol/drugs about the person.
__ Inappropriate emotional responses (Usually exaggerated.)
__ Observation of actual use.