Title Page

  • Conducted on

  • Prepared by

  • Location

Roller Maintenance

  • Does removing, replacing, one person? or transporting the roller require more than one person?

  • Does the weight of the roller exceed 50 lb?

  • Is the roller difficult to bring close to the body because of its size, bulk, shape?

  • Do employees have to stand on or walk across the conveyor belt to remove or replace the roller?

  • To remove the roller, must employees stand on an area more than 4 above ground level?

  • Is the footing unsafe? For example, are the floors slippery, inclined, or uneven?

  • Does removing or replacing the roller require fast movements to avoid being pinned or struck by the roller?

  • Does removing or replacing the roller require stressful body postures, such as bending to the floor, twisting, reaching overhead, or bending to the side?

  • Is the employee in a kneeling or squatting posture to remove or replace the roller?

  • Does the employee lie down to remove or replace the roller?

  • Are pry bars used to remove or replace the roller?

  • Is a cutting via torch required to remove or replace the roller?

  • Are tools (excluding pry bars and hammers) used to remove or replace rollers?

  • Do employees wear gloves when removing or replacing rollers?

  • Should employees wear gloves when removing or replacing rollers?

Completion

  • Name and Signature

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