Title Page

  • Reporting Person Name

  • Please select the Cell you would like to check.

  • General - Physical Environment - Work areas free of slip, trip and fall hazards (e.g., cables, debris, worn carpeting, etc.)

  • General - Physical Environment - Exit/entry doors clear of obstruction

  • General - Physical Environment - Walkways free of obstructions

  • General - Physical Environment - Demarcated zones clearly marked out

  • General - Physical Environment - All items/parts are kept within demarcated zones

  • General - Physical Environment - Defective lighting

  • General - General Storage (Not including racking) - No protruding objects

  • General - General Storage (Not including racking) - Bulkier items are placed on the lower shelves

  • General - General Storage (Not including racking) - Shelving adequate for task and in good condition

  • General - Tooling - Turnover stand with component secured with strap at the winch handle

  • General - Manual Handling - Lifting/manual handling carried out with correct ergonomic posture.

  • General - Manual Handling - Loads not obstructing vision

  • General - Manual Handling - Bend knees to lift a load from the ground

  • General - Manual Handling - Loads carried with both hands

  • General - Manual Handling - Use of buckets with handles or similar device to carry loose item

  • General - Manual Handling - Twisting of body avoided when bending forward while lifting

  • General - Manual Handling - No rushing when lifting

  • General - Manual Handling - Work instruction is available for manual handling (Point of instruction)

  • General - Personal Protective Equipment (PPE) - Display of PPE information at work areas e.g. entrance, doorway

  • General - Personal Protective Equipment (PPE) - Comply to PPE requirement inclusive of task-based PPE worn e.g. cut resistant gloves, ear plugs (refer to point of instruction)

  • Fire Safety - Fire Fighting Equipment - Fire hose reel and fire extinguishers inspected (monthly)

  • Fire Safety - Fire Fighting Equipment - All extinguishers (e.g. fire-extinguisher, intergern system) fully charged and in their designated places

  • Fire Safety - Fire Fighting Equipment - Fire hose reel and fire extinguishers unobstructed

  • Fire Safety - Fire Fighting Equipment - Fire suppression system operational e.g. no fault code

  • Fire Safety - Storage of Flammable Material - No cluttering of combustible materials (Fire risk)

  • Fire Safety - Storage of Flammable Material - Chemical waste disposed in red disposal bin

  • Fire Safety - Storage of Flammable Material - Storage of flammable material i.e. fuel farm/ fuel; pipes/ Gas farm/ gas pipes/ Liquefied petroleum storage are guarded from damage by vehicles

  • Fire Safety - Storage of Flammable Material - Fuel, gas and oxygen cylinders separated by distance, fire resistant barriers or other means while in storage

  • Fire Safety - Storage of Flammable Material - Flammable materials, combustible material stored away from ignition sources (3 meters)

  • Fire Safety - Storage of Flammable Material - Segregation of flammable and combustible materials. Separated by a distance of at least 3 meters or by a non-combustible partition with a fire resistance rating of at least one hour.

  • Fire Safety - Storage of Flammable Material - Flammable liquid container covered

  • Fire Safety - Storage of Flammable Material - Combustible scrap, debris and waste materials (i.e. oily rags) stored in covered metal receptacles

  • Fire Safety - Storage of Flammable Material - Combustible scrap, debris and waste materials disposal bin is not cluttered

  • Fire Safety - Signages - "Warning" signs posted at flammable storage area

  • Fire Safety - Signages - Flammable materials labelled with GHS label

  • Fire Safety - Signages - Flammable material storage area comes with SDS

  • Fire Safety - Emergency Escape - All door in exit path kept closed & exit routes unobstructed. (at least 1M clearance for walkway)

  • Fire Safety - Emergency Escape - Exit sign operational and illuminated

  • Fire Safety - Emergency Escape - Fire escape staircase adequately lighted

  • Chemical Processes - PPE - Chemical gloves worn while handling chemicals (Based on SDS)

  • Chemical Processes - PPE - Nitrile Gloves (Ferric Chloride, Isopropyl Alcohol, Kerosene, Sodium Hydrooxide)

  • Chemical Processes - PPE - Neoprene (Hydrochloric acid, hyfrofluoric acid, Nitric acid)

  • Chemical Processes - PPE - Butyl rubber (Acetone, MEK, Sulfuric acid)

  • Chemical Processes - PPE - Apron worn while handling chemicals (Based on SDS)

  • Chemical Processes - PPE - Safety eyewear/ face shield worn while handling chemicals

  • Chemical Processes - PPE - Respirator worn while handling chemicals (Based on SDS)

  • Chemical Processes - Storage - Flammable or toxic chemicals stored in original containers

  • Chemical Processes - Storage - Flammable or toxic chemicals stored in designated storage e.g. flammable cabinet or acid/alkaline cabinet

  • Chemical Processes - Storage - Chemical storage area is well-ventilated

  • Chemical Processes - Storage - Inventory list available at storage cabinet

  • Chemical Processes - Storage - Safety data sheets available at storage area

  • Chemical Processes - Storage - Secondary containment present

  • Chemical Processes - Storage - Containers are not leaking or damage.

  • Chemical Processes - Storage - Keep containers tightly closed when not in use.

  • Chemical Processes - Storage - Chemical is not emitting fume (Storage)

  • Chemical Processes - Storage - Area free of strong odor or fume

  • Chemical Processes - Storage - Housekeeping at chemical usage and storage area satisfactory (include waste storage)

  • Chemical Processes - Emergency Response - Prohibited from eating in areas where hazardous chemicals are present

  • Chemical Processes - Emergency Response - Eye wash and safety shower operational and unobstructed

  • Chemical Processes - Emergency Response - Spill control kit available

  • Chemical Processes - Emergency Response - Visual emergency shut-off indication of equipment using chemical

  • Chemical Processes - Disposal - Chemical waste disposed in red bin

  • Chemical Processes - Disposal - Waste disposal area not cluttered

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.