Title Page

  • Client / Site

  • Conducted on (Date and Time)

  • Inspected by

  • Location

S1 – Sort – SEIRI

  • No irrelevant reference materials, documents, drawings, etc.

  • No excess pieces of equipment, documents, etc.

  • Storage area is defined to store unneeded items and out-dated documents.

  • Standards for eliminating unnecessary items exist and are being followed.

S2 – Set in order – SEITON

  • Desks and cabinets are free of accumulations of papers and other objects.

  • All tools and equipment are stored in a fixed place.

  • Tools and equipment are well organized for ease of take and return.

  • Labeling of cabinets, shelves and files allows immediate identification.

  • Documents are filed in accordance with the Record Retention Guidelines.

  • Displays are tidy, free of clutter, labeled and up-to-date.

  • Safety equipment easily accessible and in good condition.

S3 – Shining – SEISO

  • The floor is kept clean and no signs of damage.

  • Walls and ceilings are in good condition and free from dirt and dust.

  • Racks and cabinets are kept clean and in good condition.

  • Equipment and tools are kept clean and in good condition.

  • Desks, tables and other furniture are kept clean

  • Lighting is enough and the angle and intensity of illumination are appropriate.

  • Good movement of air exists through the room.

  • Trash containers are emptied on a regular basis.

S4 – Standardize – SEIKETSU

  • Visual controls and display boards are used and regularly updated.

  • Procedures for maintaining the first three S's are being displayed.

  • 5S checklists, schedules and routines are defined and being used.

  • Everyone knows his responsibilities, when and how.

  • Regular audits are taking place using checklists and measures.

S5 – Sustain – SHITSUKE

  • 5S seems to be the way of life rather than just a routine.

  • Success stories are being displayed (i.e. before and after pictures).

  • Rewards and recognition is part of the 5S system.


  • Recommendation

  • Full Name and Signature of the Inspector

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