UCSB Equipment Repair & Maintenance Facility Self-Inspection - Injury and Illness Prevention Program

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1	DFSS - Environmental Health & Safety
2	UCSB SELF-INSPECTION CHECKLIST: EQUIPMENT REPAIR & MAINTENANCE FACILITY
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4	Under California law (OSHA Injury and Illness Prevention Program), and UCSB campus policy #5400, campus supervisors are responsible for ensuring regular safety inspections are documented.
5	The list provided may not contain every possible hazard, but is a generalized set of guidelines.
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8	Department/work unit: __________________________________________________________________________________________________________________________________
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10	Building: ________________________________________________________________________ Room: ______________________________________________________
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12	Inspector name: _______________________________________________________________________________________________________________________________________
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14	Inspector email: _____________________________________________________ Inspector phone: _______________________________________________________________
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16	Inspection date: _____/ _____/ ________
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19	0.0	REVIEW OF PRIOR ACTION ITEMS
20	Item #	Item	Yes	No	N/A	NOTES (Include Room # and Description)	CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
21	0.1	All previously identified action items have been corrected and noted on the corresponding inspection form.
22	0.2	Previously identified issues are not recurring.
23	*** If issues are recurring, a new corrective action must be opened in each inspection. If issues have recurred more than 3 times, greater action must be taken to prevent the recurrence.
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25	1.0	EMERGENCY
26	Item #	Item	Yes	No	N/A	NOTES (Include Room # and Description)	CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
27	1.1	The emergency flip-chart is updated with building specific information, and is posted in in the shop.
28	1.2	Supervisor has ensured all required employee emergency and safety training is completed and documented; including fire prevention, emergencies, spill control and machine specific training.
29	1.3	Emergency eyewash and shower station is available, free of debris/dust/dirt, functions properly, water runs clean, and has functioning caps covering the spouts.
30	1.4	Emergency eyewash and showers provide a minimum of 15 minutes of continuous flush.
31	1.5	First Aid supplies are readily available.
32	1.6	First Aid supplies are relevant to the potential hazards in the area.
33	1.7	First Aid Supplies are free from expired items.
34	1.8	Automated External Defibrillator (AED) unit/s is/are readily available.
35	1.9	AED is current (not retired by the manufacturer or recalled).
36	1.10	AED is free from expired items.
37	1.11	AED is in good working order.
38	1.12	Staff are trained to respond appropriately to emergency situations.
39	1.13	Employees know all accidents and injuries must be reported to their supervisor/s, and documented through the online incident reporting system.
40	1.14	Is there anything else relating to Emergency Preparedness that needs attention at this time? Please note in the comments.
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42	2.0	FACILITY & HOUSEKEEPING
43	Item #	Item	Yes	No	N/A	NOTES (Include Room # and Description)	CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
44	2.1	Floors are clean, smooth, dry, free of debris, oil and/or liquids, and is clear of slip/trip/fall hazards.
45	2.2	All areas are cleaned regularly.
46	2.3	Birds are removed from buildings as quickly as possible, and bird messes are cleaned up immediately.
47	2.4	Doors and windows are clean, operational, and fit adequately to exclude rodents.
48	2.5	Lighting is adequate for use. Lamps are protected/screened from damage, lamps are working and fixtures are in place.
49	2.6	Boiler inspections are conducted, and "permit to operate" is current and posted on or near the boiler.
50	2.7	There is adequate outside air to protect from carbon monoxide from tailpipe exhaust systems.
51	2.8	Floor drains are connected to the sewer (with approval from sewer authority) or are equipped with an approved oil-water clarifier/separator or tight tank.
52	2.9	Oil-water clarifier/separators are cleaned at least once per year.
53	2.10	Drinking water is readily available.
54	2.11	No food is consumed in the shop area.
55	2.12	Is there anything else relating to Facility and Housekeeping that needs attention at this time? Please note in the comments.
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57	3.0	PERSONAL PROTECTIVE EQUIPMENT (PPE)
58	Item #	Item	Yes	No	N/A	NOTES (Include Room # and Description)	CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
59	3.1	Employees are provided with the correct PPE for each job.
60	3.2	Employees have documented training on the correct usage of PPE.
61	3.3	Employees are required by the department to wear the appropriate PPE for each job.
62	3.4	Is there anything else relating to PPE that needs attention at this time? Please note in the comments.
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64	4.0	HAZARD COMMUNICATION / CHEMICAL BEST MANAGEMENT PRACTICES
65	Item #	Item	Yes	No	N/A	NOTES (Include Room # and Description)	CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
66	4.1	Physical copies of Safety Data Sheets (SDS) are readily available.
67	4.2	Documented safety training on chemical use and Safety Data Sheets (SDS) is provided to employees prior to using any new or unfamiliar chemicals.
68	4.3	Inventory is rotated with a First In - First Out (FIFO) method of product usage.
69	4.4	Appropriate spill control materials are available on site.
70	4.5	A current chemical inventory has been completed, and has been provided to Environmental Health and Safety.
71	4.6	Primary and secondary chemical containers (not the original containers holding a chemical) are in good condition, and are labeled in accordance with the Globally Harmonized System (GHS) standard.
72	4.7	Secondary containment is provided for chemicals, batteries, and any hazardous waste in storage.
73	4.8	Flammable and combustible chemicals (in excess of 10 gallons) are stored in appropriately fire-rated containers and cabinets; away from heat, ignition, electrical equipment or sources of static electricity, machinery with moving parts, areas for mixing chemicals, and highly trafficked walkways and gathering areas.
74	4.9	Hazardous waste items are properly labeled with UCSB Hazardous Waste stickers; including chemical name, and the date placed into storage.
75	4.10	Solvent parts cleaner is closed.
76	4.11	If using OzzyJuice, the OzzyMat is replaced as needed and disposed of appropriately.
77	4.12	The department works with EH&S to remove hazardous chemical waste in a timely manner.
78	4.13	Parts cleaner is labeled with material name and hazard type.
79	4.14	If a flammable solvent is used, the parts cleaner has a fusible link that locks shut in case of fire.
80	4.15	Parts cleaner is registered with the state environmental agency (if required).
81	4.16	Refrigerant recovery machines are licensed by US EPA.
82	4.17	Refrigerant recovery operators are certified by US EPA.
83	4.18	Antifreeze is labeled and recycled or disposed of properly.
84	4.19	Self-closing spigots and nozzles are used for dispensing fluids from bulk containers.
85	4.20	Employees return and dispose of empty containers (chemicals, spray cans, lubricants etc.) prior to using new supplies.
86	4.21	Chemicals are poured and/or mixed in well-ventilated areas.
87	4.22	Drained waste fluids such as waste oil, antifreeze, and solvents are appropriately separated in storage drums or tanks.
88	4.23	Waste oil is removed on a schedule, and storage of waste oil does not exceed 90 days.
89	4.24	Oil filters are punctured and drained prior to being recycled.
90	4.25	Oily shop rags are placed in sealed, labeled metal containers and are disposed of regularly and properly.
91	4.26	Oily absorbents are disposed according to state regulations.
92	4.27	Is there anything else relating to Hazard Communication / Chemical Best Management Practices that needs attention at this time? Please note in the comments.
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94	5.0	MATERIALS AND WASTE STORAGE
95	Item #	Item	Yes	No	N/A	NOTES (Include Room # and Description)	CORRECTIVE ACTION COMPLETED (date, WO# if applicable)
96	5.1	Flammable and hazardous liquids are stored in containers that are either approved by the U.S. Department of Transportation, or by the State Fire Marshal, or listed and labeled by the National Registration of Testing Laboratory (UL-Listed).
97	5.2	Lids are tight-fitting and sealed, and bungs are closed.
98	5.3	Containers, tanks, and flammables cabinets are labeled with the name and material they hold (example; waste oil, lubricants, etc.) and the type of hazard they present.
99	5.4	Flammables are stored in an approved and labeled flammables storage cabinet.
100	5.5	Waste storage area is labeled and limits of the area are marked.