Title Page

  • Conducted on

  • Prepared by

Feed hopper

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

Wash Screen main CV

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

20mm stock CV

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

10mm Stock CV

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

Reject hopper feed CV

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

Crusher Feed CV

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

0/4 washed sand stock CV

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

Screen one main wash deck

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Add media

Screen deck 2 sand screen

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

Motors / pumps

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ drives been prevented

  • Pic

Thickner guards and shaft shields

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

0/2 Washed sand CV

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

Concern point or issue

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic

Concern point or issue

  • Is All guarding present

  • Is all guards secured, weld or bolt

  • Has access to drums/ rollers been prevented

  • Pic of safety concerns

  • Add drawing

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.