Title Page

  • Department

  • Conducted on

  • Prepared by

Electrical Safety Observations

  • Panels Clear of Obstructions

  • Panels Blocked

  • Electrical doors closed

  • Electrical Equipment Free of Damage

  • Electrical Equipment Damaged

  • Voltage Labels on Electrical Boxes

  • Voltage Labels on Electrical Boxes MISSING

  • Arc Flash Labels on Electrical Boxes

  • Arc Flash Labels on Electrical Boxes MISSING

  • Exit Lights Good Working Order

  • Exit Lights Not Working

  • Emergency Lights Clean

  • Emergency Light not Clean

General Safety

  • Forklift and other Mobile Equipment Inspections Completed

  • Forklift and other Mobile Equipment Inspections NOT Completed

  • Fire Equipment Accessible

  • Fire Equipment NOT Accessible

  • Chemicals Properly Labeled

  • Chemicals MISSING Labels

  • Employees Wearing Safety Glasses

  • Employees NOT Wearing Safety Glasses

  • Employees Wearing Hearing Protection

  • Employees NOT Wearing Hearing Protection

  • Employees Wearing Proper Gloves/Hand Protection

  • Employees NOT Wearing Proper Gloves/Hand Protection

  • Employees wearing Reflective Shirts or Vest

  • Employees NOT wearing Reflective Shirts or Vest

  • Tools in Good Condition

  • Tools Broken or Improperly Modified

Housekeeping

  • Aisles are clear of Obstacles

  • Aisles are BLOCKED

  • Gas Cylinders Properly Stored

  • Gas Cylinders are NOT Properly Stored

  • All Drinking Container Tops are Properly Closed

  • Open Top Drinks or Food in Found in the Work Areas

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.