Title Page
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Conducted on
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Prepared by
Machinery and Equipment
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Pump guards in place and in good condition?
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Barrel Line Guarding is properly installed and in good condition
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Observed Ladders in Safe condition
Safety Equipment
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Emergency Response Manual in Warehouse Office
Eye Wash Stations
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Eye Wash Stations clean and operational
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Eyewash #1
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Eyewash #2
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Eyewash #3
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Eyewash #12
First Aid Kits
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First Aid Kits present and stocked
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Warehouse Washroom
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Last inspected
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Warehouse Lunchroom
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Last inspected
Safety Harness
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Safety Harness (Forklift Storage Room in Safety Locker)
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Clean
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in good condition
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Hung up
Fire Extinguishers
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enter all extinguishers checked (at least 4)
AED
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1. Open the AED lid
2. Wait for the AED to indicate status: Observe the change of the status indicator from green to red. -
After approximately 5 seconds, verify that the status indicator returns to green
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Expiration date of electrodes
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Audible voice prompts
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3. Close the lid and observe the change of the status indicator to red.
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After approximately 5 seconds verify that the indicator status returns to green.
Housekeeping / 5S
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All Materials Stored Neatly and Safely
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Furniture Safe and in good repair
Fire Doors
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Check all linkages on roll-up doors.
Check that all man fire doors are operative (open man doors 90 deg to the wall and let go. The Door should close completely) -
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