page 1 - Item
Floor Condition
Drain Covers
Trip Hazards
Housekeeping
Raised Platform
Hand/Mid/Toe Rails
Ergo Stands
Approval Footwear
Icing
Dust
Page 2 - Electrical
Panel Clearance
NFPA 70E/Labeling
Exposed Panel Blanks
Controls Labeled
Breaker Marked & Legible
Temporary Wiring
Extension Cords
Ground plug/Double Insulated
Conduit Condition
GFCI
Panels Closed
Panels Dry
Adequate Lighting
Grounding
Page 3 - Tools/Equipment
Adequate Machine Guarding
Safety Shutoffs
Ladders
Hand Tools
Power Tools and Cords
Cylinders Stored Properly
Grinders Complaint
Page 4 - Chemical
Proper Labeling
Proper PPE/Training
Proper Container
Tanks Properly Marked
Flammable Storage
Page 5 - PPE
Eye Protection
Head Protection
Foot Protection
Check 5 Boot Treads
Gloves (Whizard/Chain)
Faceshield/Grinding
Hearing Protection
Respirators
Page 6 - PIE
Pallet Jacks
Battery Room
Forklifts
Lifts
Jockey Trucks
Tractors/Lawn Mowers
Battery Room (hoist/chargers)
Wheel Chocks
Page 7 - Emergency
Eyewash/Shower
Fire Extinguisher Inspected
Fire Extinguisher Accessible
Exits Market
Exits Clear
Emergency Lighting
Combustibles (Egress)
Page 8 - Ammonia
Valve Tagging
NH3 Smells
Piping Conditions
Page 9 - Other
Cage Dumping Alarm/Light
Tote Dumper Chains
Wrapping Machine Chains
Ice House Alarm
Miscellaneous/Comments
Any Additional Comments?
Signature Page
