Title Page

  • Conducted on

  • Prepared by

  • Location
  • Fire evacuation assembly points are displayed in the area?

  • Please specify action taken:

  • Fire extinguishers serviced and in date?

  • Please specify actions taken:

  • Clear access to extinguishers?

  • Please specify actions taken:

  • Fire Marshall checklist is up to date and accurate?

  • Please specify actions taken:

  • Fire point signage is in place and clearly visible?

  • Please specify actions taken:

  • Emergency exits are clear and free from any obstruction?

  • Please specify actions taken:

PPE:

  • Safety footwear worn?

  • Please specify action taken:

  • Appropriate overalls, aprons correctly worn?

  • Please specify action taken:

  • Respirators and dust masks correctly worn when necessary?

  • Please specify action taken:

  • Appropriate ear protection being worn?

  • Please specify action taken:

  • Appropriate hand protection being worn?

  • Please specify actions taken:

  • Appropriate eye protection being worn?

  • Please specify actions taken:

  • Cut resistant gloves and glasses being used when using bladed tools?

  • Please specify actions taken:

  • Bladed add & removal systems being used?

  • Please specify actions taken:

First Aid:

  • First aid station is in place and stocked with in date supplies?

  • Please specify actions taken:

  • Eye wash station is in place and stocked with in date supplies?

  • Please specify actions taken:

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.