Title Page

  • Conducted on

  • Prepared by

  • Location
  • Verify cigarette butt cans are being used and ground is free of butts.

  • Fire hydrant on east side of building and at employee parking lot entrance free of any obstructions?

  • Check around all exits to verify they are free from material, garbage and debris.

  • Are there any areas of standing water?

  • Are all drains open and free of any obstructions? There are 5 drains on the north and 2 drains on the south.

  • Are silos free of rust?

  • Are silos clean with no material on the ground?

  • Are any material pellets on the ground near the silos or anywhere else?

  • Are silo access ladder doors locked?

  • Is there evidence of paint, oil or material pellets at any PIT and Man doors?

  • If items are being stored outside are they organized and in a manner that will prevent personal harm?

  • Is there any exposed wiring anywhere on or outside the building?

  • Is the used oil area (dugout) clean and organized? All containers labeled and sealed?

  • Are there any areas showing signs of erosion?

  • Is there material or debris outside the vacuum pump room?

General Concerns / Noteworthy Items

  • Comments:

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.