執行安全衛生自動檢查計劃
個別實驗實習場所一般性作業環境自動檢查表
作業場所位置(實驗室編號):
作業場所名稱:
檢查日期: 每個星期一檢查
檢查項目 |
檢查重點 |
檢查結果 |
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一般安全 |
室內走道維持80公分 |
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走廊通道無堆積雜物 |
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× |
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× |
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電氣設備是否接地 |
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電線無磨損 |
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× |
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電器插座須立於地面或桌面(防止液體流入造成短路) |
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× |
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室內需有適當之照明 |
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未以延長線作為永久配線(延長線所能負荷的電力未知,恐有意外發生) |
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無障礙物橫越通道(防止絆倒) |
× |
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消防安全 |
滅火器壓力正常(作業場所出入口10公尺內) |
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- |
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- |
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- |
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- |
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滅火器短時間即可取得 |
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- |
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- |
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- |
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- |
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貯放位置明顯標示 |
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- |
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- |
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- |
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檢查項目 |
檢查重點 |
檢查結果 |
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消防安全 |
灑水頭外觀正常(蓋板無掉落、無灑水障礙) |
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牆壁或天花板完整(防止火災時煙霧擴散) |
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公共安全 |
備有緊急照明燈 |
× |
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逃生出入口無障礙物阻擋 |
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作業場所內備有緊急逃生圖 |
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緊急應變 |
作業場所內備有緊急聯絡電話表 |
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× |
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作業場所內備有緊急事故應變程序表 |
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急救箱內藥品正常 |
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人員管理 |
有新進人員 |
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全體人員皆配合安全衛生相關事項 |
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其他 |
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建議改善事項:沒有設置滅火器
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正常:P 異常:× 無該項目:-
檢查人員: 場所責負人: 單位主管:
*****************************************************************************************************************************
提出改善計畫&預算
項目 |
原因 |
改善計畫 |
個數 |
價錢 |
預算 |
滅火器 |
無配置滅火器 |
購買滅火器 |
3 |
550 |
1650 |
無障礙物通道 |
有雜物 |
確實清除 |
-- |
-- |
-- |
走廊通道 |
有堆積箱子 |
確實搬走 |
-- |
-- |
-- |
連絡電話表 |
無確實填寫 |
確實填寫 |
-- |
-- |
-- |