Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

  • Adequate and functioning lighting provided in all work areas

  • VRC/Elevator(s) functioning properly

  • Work areas free of tripping hazards (cords/wires, free-standing electrical fixtures, etc.)

  • Warning signs and/or mats provided when floors are wet

  • Furniture (e.g. desks, chairs, filing cabinets) in good and safe condition?

  • Overhead storage utilized properly, so as not to create unsafe work environments

  • Basic First Aid supplies adequate

  • Staff lounge and eating areas clean and sanitary

  • Manual Handling aides are available and used

  • Minimum 18' clearance below sprinkler heads

  • Areas surrounding the electrical panel(s) free of flammable, hazardous, combustible material

  • All employee lounge areas free of any visual evidence of a fire hazard or violation (Please document any specific concerns in the "Comment" section below)

Signature

  • Any other comments?

  • When completed please provide signature here:

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