Title Page
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Site conducted
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Conducted on
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Prepared by
Safety
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Machines and the area are in safe operating condition.
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All guarding & safety gating are on the machines.
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All electrical panel doors are closed.
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No exposed bare electrical wiring.
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No hydraulic oil or water on the floor.
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No empty pallets or gaylord boxes sitting on the floor are propped up on anything.
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All employee are wearing the proper PPE items.
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All hallways, walk-ways, & door-ways are free from debris such as pallets, trash, resin or color pellets etc...
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The Safety Check sheet on the forklift / pallet jack is up to date.
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Employee on the forklifts in this area are wearing the Safety Belt.
5S
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The floor is swept and mopped within the department.
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All trash cans are emptied.
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All brooms, mops, and dust pans are in their proper places.
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No trash on floor/tables.
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Department is organized/properly labeled
Miscellaneous Observations
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Additional Observations (if so document in notes below)
