Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • X=not applicable
    0=non compliance
    1=insufficient
    2=acceptable
    3=excellent

  • Equipment is not operated until after an inspection is completed. (each shift)

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  • The inspection form is current (not completed ahead of time and completed for each shift's use).

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  • All blanks on the top of the inspection form are filled out.

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  • Inspector to check all inspection items as acceptable or not (or n/a) and noting any problems in the "comments" section.

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  • The operator inspecting the equipment their name is on inspection paper

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  • If problem exist, the operator is to have the supervisor determine what corrective actions, if any, need to be taken and get their signature in the appropriate column before operating the equipment.

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  • If a condition is found during this inspection that adversely affects the safety of the equipment operation, the equipment is not to be used until the unsafe condition has been corrected. Note: all items on the safety inspection form are safety items.

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The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.