Title Page

  • Site conducted

  • Conducted on

  • Inspected By

  • Accompanied By

  • Location
  • 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

  • Extinguishers proper type for the next potential hazard

  • Extinguishers proper type for the purpose: nearest potential hazard

  • Date of last inspection:

Lights

  • Circuits properly fused

  • Wiring outlets grounded (Check GFCI)

  • Electric tools properly grounded

  • Extension cords to code

  • Power cords to tools in good repair

Eye Wash Stations

  • Working properly.

Stock Room Storage

  • Items overhead cannot fall

  • Floor clean: no items blocking aisle

Sanitary

  • Wash room and toilets clean and orderly

  • Exits
  • Adequately signed

  • Easily accessible

  • Unlocked during work hours.

Tools

  • Tools in good condition

  • Required tool guards in place

Hazardous Materials

  • All chemicals in proper containers

  • Containers properly labeled

  • MSDS Available for every material

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  • Equipment in place

  • Equipment in good repair

  • PPE Available for anticipated tasks

Sign Off

  • Name and Signature

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