Title Page

  • Name of person conducting bucket walk, provide first name and surname

  • Shift

  • Conducted on

  • What department do you work in?

  • Where did you conduct your bucket walk?

  • Which specific area?

  • Which specific area?

  • Which specific area?

  • Which specific area?

  • Which specific area?

  • What specific area?

  • Which specific area?

Description of items found.

  • Did you find anything?

  • Select the category that best describes what you found

  • Describe what and where

  • Take photo of items found

  • What did you do with the items?

  • Were you able to identify where item came from?

  • Describe where

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.