Title Page

  • Site conducted

  • Document No.

  • Site

  • Location

  • Please State

  • Conducted on

  • Prepared by

General

  • Floor are in a safe condition (slip, trip, fall)

  • All lights are working and lighting is adequate

  • Power points and cords are in safe condition

  • Area is free of evidence of pests

  • First aid kit are present, obvious and stocked

  • Spill kit are accessible and stocked

  • Are there any walk way obstruction?

House keeping

  • House keeping

  • Trash, debris, and equipment not left laying around?

  • Equipment free of excessive dust, oil and/or soot?

  • Floor surfaces covered in oil/dust covering the painted surface?

  • General tripping hazards due to housekeeping, equipment layout, and/or workstation design?

Coil Storage

  • Are Coils stored correctly

Lifting equipment

  • Is Lifting equipment being used in the area

  • Has lifting equipment been checked and recorded

  • Is the equipment out of service?

  • Has the equipment been used today

  • Was the equipment being used at the time?

Work Place Transport

  • Are Fork lift trucks being used in the area

  • Has FLT been checked and recorded

  • Is the FLT out of service?

  • Has the FLT been used today

  • Was the FLT being used at the time?

  • Are FLT's being operated safey

Fire Safety

  • Fire hoses, extinguishers are certified

  • Fire hose, extinguisher signage are clean and obvious

  • Fire exits are clearly marked and unobstructed

Machine Safety

  • Has the machine had its daily safety checks completed and signed

  • Is the equipment in safe condition

CoSHH

  • Are chemicals/ acids / oils stored safely in line with CoSHH

Procedures

  • Are procedures being carried out correctly in the area, machine operation, working at Height, confined space, etc

TOILETS / WASHROOM / LOCKER ROOM

  • Does the zone have a toilet

  • Floors are in a safe condition (slip, trip, fall)

  • Areas are clean and tidy

  • Doors and windows open, close and lock

  • All lights are working and lighting is adequate

  • Power points and cords are in safe condition

  • Area is free of evidence of pests

  • Toilets are clean and working

  • Taps, basins, sinks, showers are clean and working

  • Soap and paper / air towels are available

  • Adequate facilities are per head of staff

  • Are there other hazards in this area?

Observations

    OBSERVATION
  • SAFETY CATEGORY

  • OTHER SAFETY CATEGORY

  • PHOTO OF THE ISSUE

  • SITE

  • LOCATION

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • AREA

  • AREA

  • LOCATION

  • PROCESS / EQUIPMENT

  • PROCESS / EQUIPMENT

  • TASK / EQUIPMENT

  • AREA / TASK

  • DESCRIPTION OF ISSUE

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.