PLANILHA

LEVANTAMENTO AMBIENTAL

REVISADO 2013

ANLISE DE RISCOS DO POSTO DE TRABALHO

PARA ELABORAO DO PPRA/PCMSO e LTCAT

IDENTIFICAO DA EMPRESA
Empresa: __________________________________________________________________________________
Endereo: __________________________________________________________________________________
CNPJ: _____________________________________________________________________________________
Bairro: _____________________________________________________________________________________
Gerente de Unidade: _________________________________________________________________________
Telefone: ___________________________________________________________________________________
DATA DO LEVANTAMENTO: ________/________/____________.
N. de Funcionrios na empresa: ___________ ( _____________________________)
Funo

Numero

_______________________________________________________/___________________________
_______________________________________________________/___________________________
_______________________________________________________/___________________________
_______________________________________________________/___________________________
_______________________________________________________/___________________________
_______________________________________________________/___________________________
_______________________________________________________/___________________________

Obs.
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_____________________________________________________________________________________________________________

PLANILHA

REVISADO 2013

LEVANTAMENTO AMBIENTAL
EDIFICAES:

Administrativa ( )

Operacional ( )

Agrcola ( )

Setor: _____________________________________________
Descrever o Local de Trabalho:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Riscos
F Q B E A

Funo

Descrio das atividades:

1
2
3
4
5
6
7
8-

dB (A)

LUX

T. Exposio

PLANILHA
LEVANTAMENTO AMBIENTAL
EDIFICAES:

Administrativa ( )

Operacional ( )

REVISADO 2013

Agrcola ( )

Setor: _____________________________________________

Descrever o Local de Trabalho:

____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

Riscos
B E

Funo

dB (A)

Descrio das atividades:

1
2
3
4
5
6
7
8-

EDIFICAES:

Administrativa ( )

Operacional ( )

Agrcola ( )

LUX

T. Exposio

PLANILHA
LEVANTAMENTO AMBIENTAL

REVISADO 2013

Setor: _____________________________________________
Descrever o Local de Trabalho:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

Riscos
B E

Funo

dB (A)

Descrio das atividades:

1
2
3
4
5
6
7
8-

EDIFICAES:

Administrativa ( )

Operacional ( )

Agrcola ( )

LUX

T. Exposio

PLANILHA
LEVANTAMENTO AMBIENTAL

REVISADO 2013

Setor: _____________________________________________
Descrever o Local de Trabalho:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

Descrio das atividades deste setor:

F

Riscos
B E

Funo

dB (A)

Descrio das atividades:

1
2
3
4
5
6
7
8-

EDIFICAES:

Administrativa ( )

Operacional ( )

Agrcola ( )

LUX

T. Exposio

PLANILHA

REVISADO 2013

LEVANTAMENTO AMBIENTAL

Setor: _____________________________________________

Descrever o Local de Trabalho:

____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

Riscos
B E

Funo

dB (A)

LUX

T. Exposio

Descrio das atividades:

1
2
3
4
5
6
7
8-

OBSERVAES
Verificar as Condies de Segurana no Armazenamento dos
Produtos?

Sim ( ) No ( )

PLANILHA
LEVANTAMENTO AMBIENTAL

H extintores em quantidade adequada?

Caso afirmativo, eles esto devidamente sinalizados e dentro do prazo
de validade?
Os funcionrios possuem treinamento de preveno e combate
incndio ?
Os funcionrios que transportam os Produtos (Agrotxicos e
Veterinrios) aos clientes tm o Curso de Cargas Perigosas?
Existe fiao exposta podendo gerar risco de choque e/ou curto
circuito?

Sim ( ) No ( )
Sim ( ) No ( )
Sim ( ) No ( )

Sim ( ) No ( )

O painel eltrico est sinalizado?

Sim ( ) No( )

As tomadas esto identificadas com suas respectivas voltagens?

Sim ( ) No ( )

Os produtos de limpeza esto armazenados em rea isolada?

Sim ( ) No ( )

O piso est defeituoso podendo gerar risco de acidente?

Sim ( ) No ( )

As prateleiras esto em perfeito estado?

Sim ( ) No ( )

Falta proteo em outros equipamentos, gerando risco de acidente?

Sim ( ) No ( )

Caso afirmativo, especificar o equipamento:

Existe vazamento de gua?

Sim ( ) No ( )

Os monitores esto com protetores de tela?

Sim ( ) No ( )

Tem Ficha de EPI

Sim ( ) No ( )

Tem alguma Placa de Segurana do Trabalho

Sim ( ) No ( )

H estoque de EPIs

Sim ( ) No ( )

REVISADO 2013