Title Page
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Conducted on
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Shift
Page 1 - Mayekawa Debone
Mayekawa Debone
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Guards in place?
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Comment:
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LOTO devices on person?
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Comment:
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Emergency cable operational?
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Comment:
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Signage
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Comment:
Additional Comments:
Page 2 - OSSIDS
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Training completed? (LOTO and Operator)
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Comment:
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LOTO devices on person?
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Comment:
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Following safe procedures?
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Comment:
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Signage?
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Comment:
Additional Comments:
Page 3 - Salvage Saw
SALVAGE SAW
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Training Completed?
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Comment:
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Salvage Saw DSCS Completed?
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Comment:
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Foot Pedal Operational?
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Comment
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Following safe procedures?
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Comment:
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Signage?
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Comment:
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Chain Gloves, PPE?
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Comment:
Additional Comments:
Page 4 - Cage Dump
CAGE DUMP
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Training Completed?
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Comment:
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Lights Operational?
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Comment:
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Control Panel Door?
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Comment:
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Warning Sign on Control Cover?
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Comment:
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Following safe procedures?
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Comment:
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Signage?
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Comment:
Additional Comments:
Page 5 - Receiving Forklift Pedestrian
RECEIVING FORKLIFT PEDESTRIAN
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Training Completed?
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Comment:
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Safety barriers in place and closed?
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Comment:
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Workers stop when entering barriers?
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Comment:
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Cages are latched by operators?
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Comment:
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Cages latched on outside by only jockeys?
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Comment:
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High visibility vests?
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Comment:
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Hockey Helmets in use?
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Comment:
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No unauthorized workers in forklift area?
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Comment:
Additional Comments:
Page 6 - Misc. Safety Checks
Misc. Safety Checks
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PPE Glove Checks?
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Comment:
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Ear Plug Checks?
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Comment:
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Slip & Trip Hazard Checks?
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Comment:
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Machine Guarding Checks
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Comment:
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Safety Glasses with High Pressure Hoses?
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Comment:
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Proper Hose use for employee wash down?
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Comment:
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Proper hose storage for floor cleaning.
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Comment:
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Housekeeping/Walkways/Drain covers
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Comment:
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Safety Showers / Eyewashes
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Comment:
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LOTO spot checks
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Comment:
Additional Comments:
Signature Page
Coordinator Signature
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