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Facility: Safeway, Inc <br /> Date: Tracy Distribution Center <br /> Time: <br /> Inspected by: <br /> Inspection ✓ Comments-must note the date any deficiency is corrected <br /> 3. Is new employee training provided for those exposed <br /> to noise? <br /> 4. Have noise exposure assessments been conducted <br /> for all areas of the facility? <br /> 5.Are hearing protection areas clearly identified? <br /> 6.Are baseline audiograms provided to all affected <br /> employees? <br /> 7.Are annual audiograms provided to employees <br /> exposed above 85 dBA? <br /> i : IiO'rotectictc <br /> 1. Is there a written program and procedures for fall <br /> protection? <br /> 2. Do affected employees receive proper, documented <br /> training,with refresher training as needed? <br /> 3. Is fall protection equipment certified, readily available <br /> and regularly inspected, maintained,and used? <br /> 4. Are tasks in which employees are 4 feet or more <br /> above unguarded working surfaces identified,evaluated <br /> and controlled? <br /> 5.Are fall protection devices used, particularly when <br /> retrieving broken pallets from racks? <br /> 6. If operators tie off to the equipment(e.g.,forklift <br /> boom), has the equipment been rated for the anticipate <br /> load? <br /> Page 4 of 8 <br /> - Safeway - Privileged Document 4/13/2011 <br />