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ElectricalSafetyPolicySelfAuditChecklist
Revised:04/2008
Whereapplicable,thecorrectanswerforallquestionsisYES.NOanswersrequirecorrectiveaction.
I.QuestionsforALLDepartmentworkareas: YES NO N/A
1. Areallextensioncords&equipmentcordsrunsoastopreventdamage
tothecordinsulation?

2. Areallextensioncords&equipmentcordsplacedinsuchamanneras
tominimizetheriskoftrippingoverthecord?

3. Doextensioncordsremaininuseforlessthan30days?
4. Areallextensioncordspurchasedorinuseofthethreewiretypewitha
minimumwiresizeof14AWG?(16AWGisnotacceptable.)

5. Doallpowerstripspurchasedorinuseshallhaveacord6feetorlessin
length,a15ampcircuitbreaker/fuse,andasurgeprotector?

6. Ispluggingextensioncordsorpowerstripsintooneanothersoasto
increasetheirlengthorcapacityprohibited?

7. Isthepurchaseoruseofcubetapsprohibited?
8. Istheuseofadaptersthateliminatetheequipmentground(3prongto
2prongadapters)prohibited?

9. Doallelectricalpanelshaveaclearareaatleast36inchesby36inches,
centeredonthepanel,infront?

10. Are the faceplates on switches and receptacles present and do they
completelycovertheswitch/receptaclewiring?

11. ArereceptaclesintheemployeebathroomsprotectedbyaGFCI?
12. Doallemployeesknowhowtocontactmaintenancefortheirlocation?
13. HaveallemployeestakenBasicElectricalSafetyforOfficeEmployees?
II.AdditionalQuestionsforMAINTENANCE/CONSTRUCTIONDepartments: YES NO N/A
1. Do employees inspect their power tools, extension cords, and portable
GFCIs(worninsulation,bent/missingpins,etc.)beforeuse?

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2. Are all employees involved in maintenance, remodeling, or repair of
buildings,structures,orequipmentorsimilarconstructionlikeactivities
provided groundfault circuit interrupter (GFCI) protection while using
equipment powered from 125 volt, singlephase, 15, 20, or 30 ampere
receptacles?

3. Doextensioncordspurchasedformaintenanceorconstructionuse
havegroundfaultcircuitinterrupter(GFCI)protectionintegratedinto
thedesign?

4. Do15&20ampreceptaclesonrooftopsandinoutdoorareashave
GFCIprotection?

5. HaveallemployeestakenBasicElectricalSafetyforMaintenance
Employees?

6. Haveemployeeswhoworkonhighvoltagesystemsorwhoareatriskof
exposuretoarcflashbeentrainedonworkpracticesanddotheyhave
appropriateelectricalsafetyequipment&PPEfortheirwork?


III.AdditionalQuestionsforHIGHVOLTAGE/ELECTRICALShops:
1. Areinsulatingequipment(gloves,mats,etc.)inspectedfordamage
beforeeachdaysuseandafteranyincidentthatcouldbesuspectedof
havingcauseddamage?

2. Areinsulatingglovesairtestedbeforeeachdaysuseandafterany
incidentthatcouldbesuspectedofhavingcauseddamage?

3. Areinsulatingequipmentstoredinsuchalocationandinsuchamanner
astoprotectitfromlight,temperatureextremes,excessivehumidity,
ozone,andotherinjurioussubstancesandconditions?

4. Haverubberinsulatingglovesbeenelectricallytestedwithinthepast6
months?

5. Haverubberinsulatingsleevesbeenelectricallytestedwithinthepast
12months?

6. Haverubberinsulatingblanketsbeenelectricallytestedwithinthepast
12months?