Great Lakes Safety Survey

• Merchandiser Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Account Name

Preparation

• Does the merchandiser stretch before he begins each stop?

  Yes

  No

Lifting

• Does the merchandiser avoid bending at the waist?

  Yes

  No

• Does the merchandiser consistently maintain the natural curve of his/ her back?

  Yes

  No

• Does the merchandiser keep from twisting at the waist by moving his/ her feet in the direction of travel?

  Yes

  No

• Does the merchandiser hold product close to his/her body?

  Yes

  No

Equipment

• Does the merchandiser wear company issued safety shoes?

  Yes

  No

• Does the merchandiser always wear gloves when engaged in material handling processes?

  Yes

  No

• When using a blade, does the merchandiser always keep the blade pointed away from his/her body and cut to the side?

  Yes

  No

• Does the merchandiser always avoid using damaged or faulty equipment (hand trucks, 6-wheeled carts, pallet jacks).

  Yes

  No

• Does the merchandiser maintain a clean work area with regard to equipment, dunnage, spills?

  Yes

  No

• If the merchandiser is using a ladder or mobile staircase, does he/she alway use three points of contact?

  Yes

  No

  N/A