Bierschbach Equipment & Supply Safety

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Outside/Yard

• Is the fence surrounding the store/yard in good shape?

  Yes

  No

  N/A

• Is there a clear path to the fire hydrant?

  Yes

  No

  N/A

• Are the fuel barrels in good shape?

  Yes

  No

  N/A

• Are the lights/speakers in working order?

  Yes

  No

  N/A

• Is the parking lot free of debris?

  Yes

  No

  N/A

• Are the forms stacked safely?

  Yes

  No

  N/A

Warehouse

• Is the equipment and/or supplies secure on the shelves?

  Yes

  No

  N/A

• Are the exits/doorways clear?

  Yes

  No

  N/A

Is there a clear path to the electrical panel?

• Are all doors secure?

  Yes

  No

  N/A

• Is the rental equipment put away?

  Yes

  No

  N/A

• Are the aisles clear?

  Yes

  No

  N/A

Showroom/Office

• Are the doors secure?

  Yes

  No

  N/A

• Are all the lights in working order?

  Yes

  No

  N/A

• Are the aisles clear?

  Yes

  No

  N/A

• Is the equipment/supplies displayed secure?

  Yes

  No

  N/A

Shop

• Are the doors and exits clear?

  Yes

  No

  N/A

• Are the gas/diesel cans put in the cabinet?

  Yes

  No

  N/A

• Are the exhaust fans working properly?

  Yes

  No

  N/A

• Is the equipment under repair secure?

  Yes

  No

  N/A

Overview

• Are there any immediate safety concerns that need addressed at this time?

  Safe

  At Risk

  N/A

• Who will be contacted to resolve these issues?

• Add signature

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