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SAFETY OBSERVATION REPORT

Location: IUPUI Chancellors Home Inspector: Shane Stuller


Gen. Cont.: F.A. Wilhelm Supervisor: Roberto Tellez Date: 10/03/2013
Item

Hazardous Waste Management

Category Critical Violation Important Favorable


Corr. Action

Waste storage dumpster properly lined and ACM bags taped and sealed for
disposal. No breakage, rupture or leakage found on bags.
Item

Hazardous Waste Management

Category Critical Violation Important Favorable


Corr. Action

ACMs and surfaces kept adequately wet to control asbestos emissions. Materials
kept wet until collected for disposal.
Item

Personal Protective Equipment

Category Critical Violation Important Favorable


Corr. Action

Employees using portable hand grinders wearing appropriate eye and face
protection. All other PPE appropriate, as well. Guards in place on grinders.
Item

Scaffolds

Category Critical Violation Important Favorable


Corr. Action

Proper access for all levels of scaffolding. Scaffolding equipped with attached
ladder that extends at least 36 above upper working level and platform access
points equipped with appropriate swinging guardrail gate.

*After all corrective action is completed, please sign and date below, and return to the safety office.

Signature: Date:
Loss Prevention Disclaimer
Safety and health are the responsibility of your management. Our visits are intended to assist management. These suggestions were developed from conditions observed at the time of our visit. They do
not necessarily include every possible loss potential, violation of code, statute or regulation or exception to good practice, and are not a substitute for ongoing loss prevention programs designed and
implemented by your management.

12 West Vermont Street, Indianapolis, IN 46204


P 317.871.8155 F 317.871.8148
www.safetyresources.com

Page 1 of 5
SAFETY OBSERVATION REPORT
Page 2
Item

Housekeeping

Category Critical Violation Important Favorable


Corr. Action

All scaffold platforms / walking-working surfaces kept free of excess debris. All
means of egress readily accessible.
Item

Containment

Category Critical Violation Important Favorable

Proper setup of decontamination area. Warning signs posted to warn of hazards


Corr. Action

and deter unauthorized entry and provided with fire extinguisher. Separate
changing areas provided on each side of the containment for females and males.
* Decontamination area not provided with first aid kit or containment sign-in/out
log. Addressed with supervisor.
Item

Electrical

Category Critical Violation Important Favorable


Corr. Action

Electrical power station protected against potential weather and water.


Recommend safety signage to caution others of presence of electrical hazards.
Item

Containment

Category Critical Violation Important Favorable


Corr. Action

Decontamination shower provided with hot & cold water. Shower not supplied with
soap or shampoo.

*After all corrective action is completed, please sign and date below, and return to the safety office.

Signature: Date:

Loss Prevention Disclaimer


Safety and health are the responsibility of your management. Our visits are intended to assist management. These suggestions were developed from conditions observed at the time of our visit. They do
not necessarily include every possible loss potential, violation of code, statute or regulation or exception to good practice, and are not a substitute for ongoing loss prevention programs designed and
implemented by your management.

12 West Vermont Street, Indianapolis, IN 46204


P 317.871.8155 F 317.871.8148
www.safetyresources.com

Page 2 of 5

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