Building & Room Number:_______________ |
Date of Audit:______________________ |
Department:___________________________ |
Auditors(s):________________________ |
Lab Supervisor:________________________ |
| 1. Safety Equipment | Working | Accessible | Last checked |
| a. fume hoods | ______________ | ______________ | ______________ |
| b. biological hoods | ______________ | ______________ | ______________ |
| c. eye washes | ______________ | ______________ | ______________ |
| d. showers | ______________ | ______________ | ______________ |
| e. fire extinguisher(s) | A B C D | ______________ | ______________ |
| 2. House-keeping | Yes | No |
| a. emergency numbers posted by telephone? | _____ | _____ |
| b. food, beverages and appliances absent from the laboratory? | _____ | _____ |
| c. food absent from chemical refrigerators and vice versa? | _____ | _____ |
| d. bench tops clean and unobstructed? | _____ | _____ |
| e. laboratory doors closed? | _____ | _____ |
| f. floors, aisles and exits unobstructed? | _____ | _____ |
| g. outside hallways uncluttered? | _____ | _____ |
| 3. Chemical Storage | Yes | No |
| a. all containers appropriately labeled? | _____ | _____ |
| b. chemicals stored appropriately (incompatibles separated)? | _____ | _____ |
| c. no flammables in unapproved refrigerators? | _____ | _____ |
| d. liquid chemicals equipped with secondary containment? | _____ | _____ |
| e. flammable liquids within allowable quantities? | _____ | _____ |
| f. gas cylinders secured and stored appropriately? | _____ | _____ |
| g. empty and full cylinders separated? | _____ | _____ |
| 4. Waste Management | Yes | No |
| a. chemical wastes labeled appropriately? | _____ | _____ |
| b. chemical wastes tightly capped? | _____ | _____ |
| c. incompatible chemicals separated? | _____ | _____ |
| d. liquid chemicals equipped with secondary containment? | _____ | _____ |
| e. weekly chemical waste inspections documented (where required)? | _____ | _____ |
| f. sharps disposed in proper containers? | _____ | _____ |
| g. special bags used for autoclaving waste? | _____ | _____ |
| h. red waste bags used for infectious waste? | _____ | _____ |
| i. broken glass disposed in labeled container? | _____ | _____ |
| j. radioactive materials disposed in approved containers? | _____ | _____ |
| 5. Mechanical Equipment | Yes | No |
| a. guards in place (fans, centrifuges, drive belts)? | _____ | _____ |
| b. belts/pulleys in good condition? | _____ | _____ |
| 6. Electrical Equipment | Yes | No |
| a. grounded? | _____ | _____ |
| b. fitted with overload protection device? | _____ | _____ |
| c. outlets located outside of hoods? | _____ | _____ |
| d. motors intrinsically safe (where appropriate)? | _____ | _____ |
| e. cords in good condition? | _____ | _____ |
| f. current carrying parts not exposed? | _____ | _____ |
| g. GFIs on outlets within 6 feet of a sink? | _____ | _____ |
| h. electrical cords out of foot traffic areas? | _____ | _____ |
| 7. Paper Work | Yes | No |
| a. training records available? | _____ | _____ |
| b. training records current? | _____ | _____ |
| c. training records complete (for all employees)? | _____ | _____ |
| d. Incident Report forms available (for work-related illnesses and injuries)? | _____ | _____ |
| e. MSDSs accessible? | _____ | _____ |
| f. Chemical Hygiene Plan accessible? | _____ | _____ |
| g. written laboratory-specific SOPs available? | _____ | _____ |
| h. staff knows the laboratory safety officer? | _____ | _____ |
| i. Hazardous Chemical Waste Management Guidebook accessible? | _____ | _____ |
| j. Radiation Protection Manual accessible? | _____ | _____ |
Comments:
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