Information
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Document No.
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Machine Identification
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Conducted on
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Prepared by
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Location
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Personnel
Points of Operation
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Is there a guard or safety device provided for each point of operation of the machine?
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Are the guards complete? (Do the guards allow the operator's hands, arms, or other body parts to make contact with hazardous machine parts?)
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Are the guards effective? (Is there evidence that the guards have been tampered with or bypassed to make them ineffective?)
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Are the guards firmly secured and not easily removed?
Operator Controls
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Are starting / stopping controls within easy reach of the operator?
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If there is more than one operator station, are separate controls so located that operators can see the entire operation?
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Are controls, including foot controls, guarded against accidental activation?
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Are controls labeled to identify their function?
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Are controls similar in type and arrangement to other similar machines in the plant?
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Are emergency stop controls easily accessible and clearly identified?
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Is the machine wired so that it must be manually restarted if power is interrupted and then reapplied?
General Safeguarding Requirements
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Are controls that require two handed activation wired to include the following:<br>- Concurrent use of both hands?<br>- Anti-Repeat?<br>- Anti-Hold Down?
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Can the machine be locked out at each power source?
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If applicable, has a separate circuit and lockout capability been provided for auxiliary equipment (i.e. Hot melt pot) on the machine which may require power during short duration maintenance shut downs?
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If equipment is provided with a jog function, is it designed so that it cannot be used to operate the machine continuously (instead of inching)?
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If access is normally required to a danger zone of the machine, (such as for clearing jams) are interlocked barrier guards or similar system used to prevent access while the machine is in operation?
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If the machine has a thread speed mode, do safety devices (e.g. interlocks, photocells, etc) continue to function in this mode?
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Do interlocked barriers incorporate a braking system, or zero motion detection system, when coast down time is a concern?
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Are the guards designed so that they will not create hazards such as shear or pinch points or sharp edges?
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Can adjustments be made without removing or opening any guards?
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Can the machine be lubricated without opening or removing any guards?
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Is there sufficient room for maintenance and repair?
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Is there adequate lighting in general at the points of operation?
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Is there adequate supervision to ensure that employees are following safe machine operating procedures?
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Are safety procedures in place for minor intervention activities (such as jam clearing, cleaning, adjustments) and start up?
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Are employees trained on all applicable safety procedures relating to machine operation?
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Is all machinery and equipment kept clean and properly maintained?
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If special hand tools are used for placing and removing material, do they protect the operator's hands?
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Are provisions made to prevent machines from automatically starting when power is restored after a power failure or shut down?
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Is the operator dressed safely for the job? (i.e. No loose fitting clothing or jewelry)?
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Signature