4638 20210429 10 23 18 Sci-Ims-P-10.2 Form 2 Page 1 Rev. 02 Ehs Non-Conformity or Safety Observation Checklist Form

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Health, Safety and Environment (HSE) Audit Report

Location : GMI

Date : 15-Feb-08

Team : Compliance Officer

Audit
Category
:

Max Score % of
Section Description N/A
Score Achieved Score

Please refer to adidas-Salomon HSE Guidelines


1 Management #REF! #REF! #REF!
2 Architectural Considerations #REF! #REF! #REF!
3 Alarm System / Emergency / File #REF! #REF! #REF!
4 First Aid #REF! #REF! #REF!
5 Storage of Hazardous Chemicals #REF! #REF! #REF!
6 Hazardous Chemicals in production #REF! #REF! #REF!
7 Threshold Limit Values #REF! #REF! #REF!
8 Colour Coding / Labeling #REF! #REF! #REF!
9 Compressed Gas / Cylinders #REF! #REF! #REF!
10 General Equipment / House Keeping / Electricity #REF! #REF! #REF!
11 Machinery #REF! #REF! #REF!
12 Waste Management #REF! #REF! #REF!
13 Waste Water #REF! #REF! #REF!
14 Emission Control #REF! #REF! #REF!
15 Dormitories #REF! #REF! #REF!

16 Sanitation and Hygiene – Toilets, Dining and Kitchen Facilities #REF! #REF! #REF!

TOTAL : #REF! #REF! #REF!


BEST PRACTICE :

Capacity Building Needed: YES NO


(Tick the appropriate box)

Signed by : Reviewed by :

_____________________ __________________________________
SoE Manager Regional SoE Manager / Head of SoE

Version Section / Topic Date Authorised by: Start Date

V6 Whole system 08 Aug, 02 Barry Tang 12 Aug, 02


V5 Whole system 18 Apr, 01 Barry Tang 18 Apr, 01

653413292.xls 1 of 10 Summary
Date Of Inspection:

EHS Non-confromity or Observation Checklist


RATING
Sect 1 Management Comments
Y N
Management

Does the facility has a written Health & Safety Policy ?


1
Is the policy signed and dated by top management of the facility?

2 Does the facility has a Health & Safety Coordinator


Does the Health & Safety Coordinator has a written job
3
description?
Does the facility has documentation of boiler & pressure vessel
4
inspections on file and posted ?

5 Are boiler/ pressure vessel inspection documents up to date?

Does the facility has documentation of elevator inspections on file &


6
posted?
7 Are elevator Inspection documents up to date?
Does the facility has documentation of monitoring and test results
8
(i.e report test of a waste water treatment plant?
9 Are monitoring / test results up to date?

10 Does the facility has an incident/accident log?

11 Is the incident / accident log reviewed by management monthly?

12 Is there any documentation of First Aid Training?

Sect 2 Architectural Considerations


A Roofs, Ceilings & Mezzanines Roofs, Ceilings & Mezzanines

1 Is the facility structurally sound and well maintained externally?

Is the loading capacity for upper floors sufficient for any machinery
2
installed?
Do storage racks have adequate strength to support any designed
3
loads?
Are chains ( 30 and 60cm high ) across loading docks when not in
4
use?
Are aisles clearly marked with arrow (white arrow with green
5
background) pointing to the exit?

B Emergency Exits (White arrow with green background) Emergency Exits


Is there sufficient directional and exit signs to ensure that all exit
1
routes are clearly indicated?
Are exit signs clear and visible with text & pictogram and text in
2
English and native language?

Are the designated assembly areas outside the buildings


3 positioned so it not to obstruct emergency services , i.e. fire
brigade, ambulance ?

Do all work areas have at least two exits (Note: <Minimum of two
4
stairways required from each floor if > 30 persons on the floor)?

5 Is furthest exit less than 60m from worker(s)?


6 Are all exit doors unlocked from inside?
7 Do all exit doors open outwards?

8 Are surfaces inside and outside exit doors are at the same level?

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N
Is the total width of the escape routes (in metres) adequate for the
9 number of workers normally present?
(See table 2B of HSE Guidelines )

C Stairs Stairs
Are handrails present in areas if there are more than 4 steps?
1
Both sides of stairway and handrails are at least 60 cm high?

2 Are steps not more than 19 cm high?

3 Are steps even and made of non-slip material?


4 Are steps adequate in width (see table 2a of HSE Guidelines)?

D Aisles Aisles
Are aisles free of tripping hazards, clearly marked with directional
1
sign (white arrow, green background)?
2 Are aisles unobstructed?
3 Are floors on aisles are made of non-slip materials?
4 Are aisles have more than 2 m height clearance (head room)?
5 Are aisles larger than 1.1 m wide?

E Elevators (Hoist) Elevators


1 Is load capacity ( no. of people, Kg, lbs) clearly displayed?

2 Are doors fitted with interlocking devices and function properly?

Are warning signs "in case of fire/emergency do not use" posted


3
next to the elevators?
Do the elevators (hoist) have a valid license issueed by
4
government department or competent person.

Sect 4 First Aid

A Clinic Clinic

Is the clinic suitably equipped in compliance with the HSE


1
Guidelines (beds, first aid materials, medicines)?
2 Are screens / curtains provided to allow privacy?
Is there any means of communicating directly with a doctor or
3
hospital (Telephone)?

4 Is there system in place to check expiration dates of medicine?

Are sufficient number of employees trained in First Aid by a


5
recognised organisation, such as Red Corss?

6 Is there an adequate procedure for the disposal of clinical waste?

7 Does the facility has personnel trained in First Aid ?

B First Aid Kits First Aid Kits

Are first aid kits available in all work areas (1 per every 100
1
workers) ?
2 Do the first aid kit provide adequate protection from dirt & water ?

Are first aid kits clearly idea easily accessible, identified and/or
3
unlocked?

Are all first aid kits inspected monthly. Restocked as required after
4
use / All materials are not expired.

Are first aid kits adequately stocked and appropriate for work
5
areas?
Is there an suitably equipped "first aid bag" readily available to take
6
to any accident site?

Sect 5 Chemical Storage Area

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N

Chemical Storage Area (Room / Cabinet) Chemical Storage Area

Are appropriate warning signs displayed?


1
(e.g. no smoking, toxic, corrosive)
2 Is there an effective ventilation system ?

3 Are doors constructed to resist a fire for at least 30 minutes?

Is there an effective secondary containment system for liqiud


4
chemicals?
5 There should be no floor drain in the chemical warehouse?
6 Are all drums, containers, dispensers clearly labeled?
7 Are all drums/containers kept closed when not in use?
8 No evidence of chemical spillage?
Is eye wash facility well maintained and available within 30m of
9
where chemicals are stored?
Are chemical stocks in mixing rooms kept to a maximum of not
10
more than 1 days supply?

11 Is there effective separation of toxic and flammable chemicals?


For areas greater than 2000 sq. meter, is there at least 50 kg
12
wheeled fire extinguisher available?
13 Is an inventory of ALL stored chemicals maintained and available?
Are ALL MSDSs (Material Safety Data Sheet) posted prominently
14
in areas where chemicals are stored?
15 Has lightning protection been installed for the chemical warehouse?

Sect 6 Hazardous Chemicals in Production


Hazardous Chemicals in
Production
Are CSDSs (Chemical Safety Data Sheets) posted prominently in
1
areas where chemicals used?

2 Do the CSDS relate to all chemicals being used?

3 Are workers receiving bi-annual training in safe chemical handling?

Are eye wash facilities well maintained and available within 30m of
4
where chemicals are used?

Where chemicals are used, does appropriate PPE (Personal


5
Protection Equipment) provided and used as required?

Are mandatory warning signs related to chemicals posted clearly


6
and prominently where they are being used ?

There should be no evidence of smoking be found in areas where


7
chemicals are used?

There should be no sign of spillage of chemical where chemicals


8
are used / stored?
*
Are chemicals at work stations covered / partially covered (dip
9
stands, glue bowls etc)?

Are local extraction systems in place where Volatile Organic


10
Compounds (VOC) / dust emitted are a factor?

Is the effectiveness of local extraction systems monitored by air


11
quality testing?

Are the extraction systems for VOC / dust explosion proof and
12
those for dust and solvents separated and color-coded?

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N

Are appropriate measures to minimize chemical exposure are in


13
work place ?

Sect 7 Threshold Limit Values


Threshold Limit Values

Is dust concentration in air belows the Threshold Limit Values


1
(TLV)?

Is there any measure taken to reduce Volatile Organic Compounds


2
(VOC) emission in workplace below the TLV?

Are pollutants in air monitored by competent person or local


3
authority,

There should be no banned chemical is used or stored in the


4
factory.

Sect 8 Signs/Colour Coding / Labeling


Signs/Colour Coding /
Labeling

Are signs / notices logically & intelligently displayed? They are


1 sufficient to provide information required, in correct , appropriate
languages & colours.

Have all outdated (incorrect) signs removed. (Are no invalid


2
(incorrect) signs on display)?

Are signs large enough to be seen from a distance and the clear
3
instruction ?

Are signs made of corrosion and weather- resistance materials,


4
securely & prominently displayed?

Are all essential safety signs illuminated in dark areas or where


5
they need to be visible during hours of darkness, in fog or smoke?

Are all illuminated safety signs tested at least monthly and records
6
kept?

Sect 10 General Equipment / House Keeping / Electricity

A Use of electricity Use of electricity


Are cables used suitably insulated and protected on all trailing
1
leads and extension boxes?

2 Are weather proof sockets provided for outdoor connections?

Are electrical distribution boxes kept locked with the emergency


3
switch exposed?

Were any unauthorised connections and dangerous joints


4
observed?

5 Are generators installed suitably earthed?

6 Are cables adequately suspended to avoid being damaged?

7 Are cables maintained in sound and properly serviceable manner?

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N
Is a licensed electrician resident on site for the maintenance of
8
electric installation and equipment?

Are updated copies of electricians qualifications/certificates etc,


9
kept on file?

Are all electrical equipment maintenances carried out properly


10
recorded?

11 Are all portable electrical tools inspected before and after use?

Are all portable electrical tools double insulated or adequately


12
earthed?

General Equipment –
B General Equipment – Housekeeping Electrical Hazards
Housekeeping Electrical Hazards

Is access to high voltage areas restricted to authorised personnel


1
only?

Are “Danger: High Voltage” warning signs clearly displayed around


2
high voltage areas?

Are warning signs restricting access to High Volyage areas clearly


3
displayed?

Are high voltage areas and generator rooms clean and tidy with no
4
material storage?

Is access to generator areas restricted to authorised personnel


5
only? Are warning signs posted?

Is adequate noise protection provided for workers working in


7
generator rooms? Are hearing protection warning signs displayed?

8 Are all electrical junction boxes are closed and undamaged?

9 Is electrical wiring suitablly insulated?

10 Is there no evidence of patched / taped wire connections?

11 Are electrical wires heat protected where necessary?

12 Is electrical wiring suitably protected against mechanical damage?

On non-double insulated machinery has adequate means of


13
eathing been provided?

Are workers provided with necessary protective equipment (PPE),


14
and trained in the correct use of PPE?

14 Is lightning protection provided for all areas?

Are lights and switches used in chemical storage areas


15
(warehouses etc.)and dusty areas explosion proof?

C Lighting Lighting
Are lighting levels adequate (300-1000 Lux in work areas) and
1
distributed evenly?

2 When installing lighting system, is glare elimination condidered?

When installing lighting system, are shadows and harsh contrasts


4
considered?

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N

D Housekeeping
1 Is the factory maintained in a clean and tidy manner?

Are there arrangements to remove rubbish and debris, e.g. rubbish


2
bin, rubbish container, etc.

Is there arrangement to remove production waste effectively and


3 regularly? e.g.rubbish collection points which are accessible by
rubbish trucks.

4 Are passageway kept clear of obstructions?

5 Are walkways level, non-slip and in good condition?

Sect 11 Machinery Machinery


Is the risk of personal injury from dangerous machinery controlled
by adequate
(a) two handed operation switches
(b) guards
1
(c) minimized gaps
(d) emergency stops
(e) protective gloves
(f) warning signs

Are fan blades adequately guarded. (Mesh / screen holes <12mm


2
in diameter)?

Is the risk of burns from hot surfaces is controlled by adequate


(a) two handed operation switches
3 (b) guards
(c) protective gloves
(d) warning signs?

Are all conveyor belt gears, drive shafts and belts adequately
4
guarded?

Where necessary, is suitable eye protection provided and used to


5
reduce the risk of eye injuries?

Is the risk of injuries from dust inhalation controlled by local


6
ventilation?

Are air compressor areas clean and tidy and free from material
7
storage?

Is adequate noise protection provided for compressors, (Housed


8 separately, outside or boxed), embroidery machines, roughing
machinery, other noisy machinery?

Is the risk of foot injuries controlled by the use reinforced footwear


9
where workers work with heavy objects?

Are noise levels in work areas acceptable? Have noise survey


10
been conducted?

Are all safety devices inspected / serviced regularly and are written
11
records maintained?

3 Are work areas adequately ventilated (fans, windows)?

Sect 12 Waste Collection / Treatment

1 Does the factory have a Waste Management Programme?

2 Does the programme include waste segregation and re-cycling?

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N
3 Are sufficient, suitable waste containers provided?

4 Are closed chemical waste containers prevent of any spillage?

Are garbage containers closed and the garbage area regularly


5
sanitized?

Sect 12 Waste Collection / Treatment

1 Does the factory have a Waste Management Programme?

2 Does the programme include waste segregation and re-cycling?

3 Are sufficient, suitable waste containers provided?

4 Are closed chemical waste containers prevent of any spillage?

Are garbage containers closed and the garbage area regularly


5
sanitized?

Sect 13 Waste Water Treatment Waste Water Treatment

1 Does the factory have a waste water treatment plant?

Is there any mechanical, biological & chemical treatment facilities in


2
the factory

3 Are all discharges within allowable limits?

Are discharges test annually and records of test results kept for at
4
least five years?

Sect 14 Emission Control Emission Control

Are dust extractors fitted with filters and/or extraction systems fitted
1
with separators (e.g. cyclones)?

Are steps taken to minimised Volatile Organic Compounds (VOCs)


2
in air?

Are noise emissions from the plant equipment within allowable


3
limits?

4 Are all emissions within allowable limits issued by local authority?

Sect 16 Sanitation and Hygiene Toilets, Dinning and Kitchen Facilities

A Kitchen Kitchen
1 In general is kitchen clean, sanitary and odor-free?

Are kitchen staff given half-yearly medicals check (particularly tests


2
for transmittable diseases such as hepatitis and typhoid)?

3 Are floors in kitchen kept free of grease (no hazards of slipping)?

4 Are refrigeration facilities available in kitchen?

Are meats (i.e.poultry, pork, beef) segregated, wrapped or kept in


5
covered container in refrigerators or freezers?

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N
Are refrigerators and freezers maintained at the correct
6
temperatures?

7 Are food preparation surfaces clean, free of cracks, cuts etc?

Are chopping boards clean, free of impacted food, and sterilised


8
after use?

Are there sufficient tables /chairs inside canteen or eating facilities


9
provided under a roof (protected from weather)?

10 Are kitchen staff given regular training in food hygiene?

Do factory medical staff (If any) conduct regular kitchen hygiene


11
inspections and are records kept?

Are all preparation knives kept clean, sharp ,rust free and are
12
correctly stored?

Are all steam cooking systems well maintained and in good


13
condition?

Are all electrical appliances in good condition and suitable for use
14
in kitchens?

Where gas cooking systems are used, are there an emergency


15 shut off valves for the gas supply installed, serviced and tested
regularly and records kept?

Does potable water available or water treatment facilities available


16
for water used in cooking?

Are washing / sterilization facilities available for eating utensils


17
(pots / pans, silverware, plates etc.) ?

Is systems in place to ensure food prepared in canteen is fresh /


18
hygienic?

19 Are dry food stores clean and free of vermin?

20 Are all dry foods correctly stored and elevated from the floor?

21 Do all kitchen personnel wear hats or hair nets?

Has a competent person been adequately trained to provide first


23
aid for ijuries caused by steam, hot oils or fats or boiling water?

B Bathrooms / Toilets Bathrooms / Toilets

1 There are no restrictions placed on access to toilets.

Is number of toilet sufficient for both men and women, according to


2
the standard listed in HSE Guidelines?

The bathroom facilities are clean and generally free of


3
odors?

4 Are the bathroom facilities well ventilated?

All toilets, sinks & showers have running water and are in good
5
operation

6 Is soap / liquid soap available in the toilet?

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020


Sect 1 Management Comments
Y N
7 Is toilet paper available?

8 Is paper towels or hot-air hand dryers available?

9 Do showers have hot & cold water available from a single tap?

Inspected By: Reviewed By


Pollution Control Officer/Safety Officer Assistant EHSS Manager
(Siganture over printed Name) (Siganture over printed Name)

Approved By:
Factory Manager
(Siganture over printed Name)

SCI-IMS-P-10.2 Form 2 page 1 Revision 02/02 20 2020

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