Title Page
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Conducted on
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Prepared by
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Location
Personal Protective Equipment - PPE
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Face shield, apron and gloves used when topping off batteries
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Safety footwear worn by all employees including visitors
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Gloves used when handling pallets
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Gloves used when using a retractable blade knife
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Safety glasses worn at the foaming station
Ergonomics
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Are SKU locations where product is >50lbs marked for 2 person lift?
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Are employees adhering to the two-person lift guidelines for required product?
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Are employees handling TV's and large cartons safely? (Team lift, Sliding rather than lifting, using pivot points, using handles, etc)
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Are employees stacking at a safe height, reducing the risk of shoulder injury?
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Are employees bending at the knees when reaching down?
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Did you coach any individuals who were practicing unsafe lifting techniques? (Mark NA if none were observed)
