Title Page

  • Inspection Title

  • Document No.

  • Conducted on

  • Prepared by

  • General housekeeping is good

  • Take photo of problem area

  • Comment

  • Slip, trip, fall hazards

  • Take photo of problem area

  • Comment

  • Switch/cover plates in place

  • Take photo of problem area

  • Comment

  • Adequate ventilation

  • Take photo of problem area

  • Comment

  • Ventilation clean

  • Take photo of problem area

  • Comment

  • Any burnt out bulbs

  • Take photo of problem area

  • Comment

  • Emergency lighting operating

  • Take photo of problem area

  • Comment

  • Overexertion observed

  • Take photo of problem area

  • Comment

  • Proper PPE's

  • Take photo of problem area

  • Comment

  • Fire hoses/extinguishers checked

  • Take photo of problem area

  • Comment

  • Equipment clearly marked

  • Take photo of problem area

  • Comment

  • Fire equipment clear of blockage

  • Take photo of problem area

  • Comment

  • Any unsafe practices observed

  • Take photo of problem area

  • Comment

  • Inspector 1

  • Inspector 2

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