Title Page
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Site conducted
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Conducted on
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Inspected By
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Accompanied By
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Location
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Inspection Code:
Y - Meets Standard
N - Does Not Meet Standard
N/A – Not Applicable
N/R – Not Reviewed-
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<br> First Aid kit adequate and clean<br>
Fire Protection
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Extinguishers proper type for the next potential hazard
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Extinguishers proper type for the purpose: nearest potential hazard
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Date of last inspection:
Lights
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Circuits properly fused
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Wiring outlets grounded (Check GFCI)
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Electric tools properly grounded
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Extension cords to code
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Power cords to tools in good repair
Eye Wash Stations
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Working properly.
Stock Room Storage
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Items overhead cannot fall
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Floor clean: no items blocking aisle
Sanitary
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Wash room and toilets clean and orderly
Exits
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Adequately signed
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Easily accessible
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Unlocked during work hours.
Tools
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Tools in good condition
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Required tool guards in place
Hazardous Materials
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All chemicals in proper containers
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Containers properly labeled
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MSDS Available for every material
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Equipment in place
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Equipment in good repair
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PPE Available for anticipated tasks
Sign Off
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Name and Signature