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JIFFY LUBE MONTHLY HSSE CHECKLIST Date: Store Number: 1478 Performed By: Peter Gaines Questions: Yes No N/A Questions: Yes No N/A STORAGE CONTAINERS/AREAS Are safety messages being signed by all employees, posted on the communications board and filed in the HSSE Recordkee in Manual? Are all storage containers(including product tanks, Is there access to MSDS information?(MSDS should drums and portable chemical containers)properly be loaded on computer hard-drive and a chemical labeled with the standard labels provided by HSSE? inventory icon should be on desktop) Is the required secondary containment(concrete Are employees aware of access to MSDS? berms,etc.)intact and undamaged? Is the lower bay free from any cracks the wall and Are Near-Miss incidents being reported and floor? documented when they occur? Are all drainage valves for outside AST Have all new employees completed the New-Hire containment locked or plugged when not draining? Induction Checklist? Are attic storage areas free of obstructions SPILL PREVENTION,CONTROL AND blocking vents? COUNTERMEASRE(SPCC)PLAN Are attic areas and emergency exits(including Does the store have an SPCC Plan on-site and is stairwells)free of flammable materials? dated within the last five ears? Are emergency exits free of obstructions? Have all new employees been trained on the SPCC Ian? Are all outside storage container areas secured? Is the SPCC Plan up-to-date?(Must use Management of Change Form to ensure operational changes (changes to piping,storage tanks,secondary containment)are communicated Are JLI Do-It-Yourself(DIY) used oil collection MISCELLANEOUS drop-off logs being completed? Is all food or beverages stored and consumed in areas free of any hazardous material? Is DIY used oil kept separate in a labeled Are hood props available and used when necessary? container from customer-generated oil? Is the compressor clean of dust or lint? Is the area around the dumpster clean? Are the footprints for guiding cars in and out properly located for each bay? Out of path of vehicle Are all containers of waste kept closed at all times Are bay doors in good condition(no cracked glass, except when waste is being added or removed? rollers on track,doors can open and close easily)? Have all empty drums or containers in the Are drains/gutters in good condition?(Not crushed or dum ster storage area been removed/picked up? clogged, and facing away from foundation) A/C SERVICE Is the lower bay ventilation system in good working order? switch identified,screen clean,timer working) Are all technicians who perform the service JLI Is there a store planogram that includes specific certified? locations of tools,mops,and ancillary equipment? Is their training certificate available? Is the first aid kit present,easily accessible and adequately stocked? Are A/C machines registered with the JLI A/C Has the monthly bulk storage inspection list been registration program and is decal present?(Decal completed? should be located on top right rear panel of unit Have the weekly hazardous waste and oil container and will be purple in color) ins ection los been completed MA only) TOOLS Has the daily inspection checklist been conducted(CA only) Are six-point configurations available for the most Is there any ice build-up present around the store? commonly used wrenches? Have all filter wrenches been inspected and worn Does the store have a Hazardous Materials Business or damaged equipment re laced? Plan and is it up to date? CA only) Are tools kept clean after use? Have all corrective actions from last month been addressed? COMMUNICATION REQUIRED POSTERS/MANUALS Do new employees/contractors know where the Are required postings(OSHA,Worker Compensation, staging area is located for evacuation? Federal and State All-In-One, Env. Policy)available for all employees to review? Is the Fire/Evacuation Diagram Posted in a Is the address of the clinic posted for employees to prominent location and up-to-date? view? Are lockout/tagout locks and tags available? Are all applicable permits such as hazardous materials, boiler permits(for compressors),tank registrations,etc. poste d as required by local agencies? Do employees know lock/out to /outprocedures? Does store have copy of current HSSE manuals: Are employees aware of their rights under Toxic HSSE Recordkeeping Manual Substance Control Act(TSCA)? JLI Policy&Procedures(1991) Are safety meetings being conducted weekly? Injury and Illness(2006) All Jiffy Lube Monthly HSSE Checklist deficiencies must be corrected. I have reviewed each item of this checklist,and to the best of my knowledge,the answers provided accurately describe the conditions of this location. Signature: DATE