Information

  • Plant Location

  • Conducted on

  • Prepared by

  • Personnel

Documentation / general items

  • MSDS / SDS available for all chemicals?

  • All posters / notices on bulletin board?

  • Storm water & spill plan available?

  • Spill clean up supplies available?

  • Fire extinguishers properly mounted and inspected monthly?

  • Site housekeeping in good order?

  • First aid kit properly stocked?

  • Eyewash available? Bottle sealed and in date?

  • Signage posted and readable?

  • Emergency numbers posted?

Personal protective equipment

  • Workers outside control room and equipment wearing hard hats?

  • Safety glasses and face shields available and in good condition?

  • Gloves available for handling hot materials?

  • Hearing protection available and in use where needed?

  • Arc flash gear available for use?

  • Fall protection equipment available , stored properly and in good condition?

Walking / working surfaces

  • Stairways clear and in good condition?

  • Platforms and walkways protected with guardrail systems?

  • Gates / chains across ladder and stair openings?

Mobile Equipment

  • Equipment inspected and documented?

  • Back up alarms functional?

  • Fire extinguishers an all equipment?

Mechanical Equipment & tools

  • All belts, pulleys and tail wheels fully guarded?

  • Hand tools in good condition (handles, edges, etc.)

  • Hand grinders have proper guard?

  • Compresses air hoses in good condition and connections properly secured?

  • Ladders in good condition and properly used?

Electrical

  • All panels and covers securely fastened?

  • Panels and disconnects labeled?

  • All panels and junction boxes covered?

  • 3 foot area in front of panels clear?

  • Lock out equipment readily available?

  • Extension cords in good condition (minimum of 12 gauge, no cuts or slices, ground prong in place)?

  • GFCI in use?

Chemicals / hazmat

  • Drums stored where they are safe from being struck or punctured?

  • All containers properly labeled?

  • Flammables and combustibles stored in approved safety cans?

  • Compressed gas cylinders properly secured and stored?

Additional Comments

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Signature

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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.