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CEHS, Center for Environmental Health and Safety


Environmental Health and Safety Compliance Report
 

 
[FrontPage Save Results Component]
Date: Dept:
Time: Bld/Room:
LocID: Resp Person:
Safety Rep: Date Submitted:
Person Completing This Form:
E-Mail:
Eye protection used?
Protective clothing used?
Gloves used?
Feet entirely covered?
Chemical spill kit available?
Area clean and free from spills?
Food/Drink forbidden in laboratory?
Training requirements met?
Aisles uncluttered and w/o tripping hazard?
Exit ways free and unobstructed?
Fire extinguishers available and unobstructed?
Fire extinguisher types appropriate to hazards?
Eyewash stations available and working?
Shower available and accessible?
Plugs grounded on electrical equipment?
Machine guards on shafts, pulleys, etc?
Warning signs posted?
Gas cylinders properly secured?
Containers securely closed?
No containers compromised?
Containers properly labeled?
Current chemical inventory available?
Peroxide formers dated when rcvd and disposed or tested after expiration?
Flammables away from sources of ignition?
Chemicals stored at or below eye level?
Shelves fitted with containment devices?
Chemicals segregated/stored properly?
Glass bottles stored above or off of floor?
Chemical Hygiene Plan Available?
Pickup request forms submitted for chemical waste?
Proper storage and disposal of sharps?
BSC certification?
Exposure Control Plan?
MUA for Biologicals?

Comments:

 

 

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Center for Environmental Health and Safety
Phone: 618-453-7180
E-mail: info@cehs.siu.edu