Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

AGGREGATE GROUND HOPPER

  • Pull cord E-stop

  • Conveyor and rollers

  • Lighting

  • Housekeeping

SILOS

  • Shuttle belt

  • Pull cord E-stop

  • Rollers

  • Lighting

  • Housekeeping

AGGREGATE WEIGHT BELTS

  • Rollers

  • Pull cord E-stop

  • Gear boxes

  • Housekeeping

MIXER FEED BELTS

  • Covers

  • Rollers

  • Pull cord E-stop

  • Gear box

  • Housekeeping

MIXER/MIXER DECK

  • Disconnect

  • E-stop

  • Electrical boxes

  • Hydraulic tanks

  • Lighting

  • Housekeeping

MATERIAL HOPPER AND VIBRATORS

  • Aggregate conveyor

  • Belt

  • Rollers

  • Pull cords

  • Gear box

  • Housekeeping

BLOCK MACHINE

  • Shafts and bushings

  • Electrical boxes

  • E-stop disconnect

  • Green block conveyor

  • Guarding

  • Air leaks

  • Housekeeping

LOADER/UNLOADER/RACK SHIFT

  • Electrical box

  • E-stop

  • Rack shift rollers

  • Hydraulics

  • Housekeeping

CAR AND CRAWLER

  • Safety kick bars

  • E-stops

  • Electrical

  • Hydraulics

  • Housekeeping

KILN

  • Lighting

  • Housekeeping

DEPALLETER

  • E-stops

  • Hydraulic leaks

  • Wear plates

  • Housekeeping

BTO

  • Turnover

  • Hydraulics

  • E-stop

  • Electrical boxes

  • Housekeeping

DRY BLOCK CONVEYOR

  • Rubber band spools

  • Shafts

  • Hydraulic motor

  • Hydraulic leaks

  • Housekeeping

CUBER

  • In-feed

  • Clamps

  • Pattern maker

  • Chains/Bars/Guards

  • E-stop

  • Electrical

  • Housekeeping

OVERHEAD SIDE FEED

  • Rollers

  • Hydraulic motors

  • Hydraulic leaks

  • Rubber pads

  • Chains

  • Housekeeping

TIER PUSHER

  • Electrical

  • E-stop

  • Hydraulic leaks

  • Housekeeping

CARRIAGE

  • Electrical

  • E-stop

  • Hydraulic leaks

  • Housekeeping

WRAPPER

  • Electrical

  • E-stop

  • Leaks

  • Housekeeping

ELECTRICAL ROOM

  • Electrical cabinets closed?

  • Is the A/C working properly?

  • Are the EXIT signs working properly?

  • Is the fire extinguisher operational and up-to-date?

  • Housekeeping

BREAK ROOM/CONFERENCE ROOM

  • Is the break room clean?

  • Is the conference room clean?

  • Are the bathrooms clean?

  • Are the safety cabinets up-to-date?

  • Are the EXIT signs working properly?

  • Is the fire extinguisher operational and up-to-date?

  • Housekeeping

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.