Drive entry and access pathways are clear and easily maneuvered?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Buckets are lidded and properly stored?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Items in storage are properly labeled and off the ground?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Proper storage of materials overhead?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Walkways are clear of clutter?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
No aerosol cans present?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Proper trash cans with lids?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
No spills or debris evident?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Equipment guards are in place and effective?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Hand tools are properly stored?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Hand tools are in good repair?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Proper PPE is readily available and being utilized by employees?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Area is free of combustibles?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Ladders / stools are in good condition and inspected?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Ensure there are no leaky sources anywhere?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Is garbage management in place and effective?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Overall housekeeping is effective?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Eyewash stations are in good condition and inspected?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Breakers, controls and switches are properly labeled?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Are there any missing knock-outs?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Electrical current checks are current?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
All power cords are in good condition?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
All power cords are in good condition?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Adequate lighting with guards?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
GFCI protection on outlets?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Steps and handrails are in place and securely mounted?
Environmental
Health (dust, noise)
Improve Safety
Positive Recognition
Housekeeping
Completion Date:
Auditor(s) Signature
Sign
Revision 1.0 iCloud posted document is the controlled copy. 06/18/13
link copied
Jeff Boothe
FMSO Wash Rack
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.