Information
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Conducted on
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Prepared by
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Location
Housekeeping
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Aisles/Walkways kept clear?
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Work area kept organized?
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Housekeeping: spills, cords or other trips, trash/clutter, lighting, or Flammables
Personal Protective Equipment
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All appropriate equipment or gear worn correctly?
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PPE kept in good condition?
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Personal protective equipment: hand, body, eyes/face, head, foot, respiratory, fall protection, hearing protection, or FR clothing/gear
Working Position
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Body position
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Location in working environment
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Working Position: poor posture, over stretched, above shoulder, below knees, twisting, caught in between, struck by, working at heights greater than 4', floor or wall opening, unprotected work edge, or false ceiling or floor.
Tools and Equipment
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Appropriate tools or equipment being used?
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Tools or equipment being used correctly?
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Tools or equipment in good condition?
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Tools and equipment: ladders, power or hand tools
Safe behaviors observed-actions taken to encourage safe behavior
Unsafe behaviors observed-action taken to correct and prevent recurrence
Line of fire. Is the worker in the line of fire?
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Grinding or drilling operations creating flying objects or particles - goggles/face-shield. Heavy equipment movement in the area - operator aware of pedestrian? Around rigging operations - hand in pinch point not under equipment? Working in front of live electrical panel - NFPA70E PPE
Safety procedures
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Lock-out/Tag-out, Arc Flash, Hot Work Permit, Confined Space
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Inspection Conducted By
