Title Page
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Company / Site
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Inspected by
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Date & Time
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Location
General Work Environment
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Are all work areas adequately illuminated?
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Are all worksites clean and orderly?
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Are all spilled materials or liquids cleaned up immediately?
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Are combustible scrap, debris, and waste stored safely and removed from the worksite promptly?
Personal Protective Equipment
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Are all protective equipment maintained in a sanitary condition and ready for use?
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Are workers provided with the appropriate PPE for their job?
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Are hard hats inspected periodically for damage to the shell and suspension system?
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Are protective goggles or face shields provided and worn where there is any danger of flying particles or corrosive materials?
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Are employees who need corrective lenses (glasses or contacts lenses) in working environments with harmful exposures, required to wear only approved safety glasses, protective goggles, or use other medically approved precautionary procedures?
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Are hard hats provided and worn where danger of falling objects exists?
Scaffold
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Wheel locks are properly used
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Frames, bracing, and guard rails are all in good condition.
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Hooks on ladders are secured
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Toe boards used; platform is secured
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"Safe to Use" or "Unsafe to Use" utilized when needed
Electrical
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Main board can be locked and is weatherproof
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Leads are safely placed
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All electrical equipment/ plant are in good condition
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There are appropriate guards on plant for electrical equipment/ plant
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There are adequate emergency lighting
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There are no faulty wiring or damaged electrical equipment
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LOTO procedures are being followed
Walkways
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Are aisles and passageways kept clear?
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Are aisles and walkways marked as appropriate?
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Are holes in the floor, sidewalk or other walking surface repaired properly, covered or otherwise made safe?
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Are wet surfaces covered with non-slip materials?
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Are aisles or walkways that pass near moving or operating machinery, welding operations or similar operations arranged so employees will not be subjected to potential hazards?
Stairs and Stairways
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Are standard stair rails or handrails on all stairways having four or more risers?
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Are steps on stairs and stairways designed or provided with a surface that renders them slip resistant?
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Where stairs or stairways exit directly into any area where vehicles may be operated, are adequate barriers and warnings provided to prevent employees stepping into the path of traffic?
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Do stairway landings have a dimension measured in the direction of travel, at least equal to width of the stairway?
Hand Tools and Equipment
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Are employees made aware of the hazards caused by faulty or improperly used hand tools?
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Are broken or fractured handles on hammers, axes and similar equipment replaced promptly?
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Are tool cutting edges kept sharp so the tool will move smoothly without binding or skipping?
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Are tools stored in dry, secure location where they won't be tampered with?
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Are damaged equipment replaced when needed?
Power Operated Tools & Equipment
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Are power tools used with the correct shield, guard or attachment recommended by the manufacturer?
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Are rotating or moving parts of equipment guarded to prevent physical contact?
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Are effective guards in place over belts, pulleys, chains, and sprockets, on equipment such as concrete mixers, air compressors, and the like?
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Is hoisting equipment available and used for lifting heavy objects, and are hoist ratings and characteristics appropriate for the task?
Completion
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Additional recommendation
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inspector's Full Name & Signature
