Title Page

  • Client / Site

  • Conducted on (Date and Time)

  • Inspected by

  • Location

Work Area

  • The work area is clean, tidy and clutter-free.

  • There are no unnecessary items in the work area.

  • There are no food and drinks in the work area.


  • Floors (e.g., tiles, boards and carpets) are in good condition.

  • Floors are dry and free from accumulated dust, broken glass and leaks or spills (e.g., oil or water).

  • Floor markings are highly visible and not faded.

  • Floor openings or holes are guarded by a cover, grating or guardrail on all sides (except at entrances to stairways or ladders).

Aisles, Walkways, Stairways, and Exits

  • Aisles, walkways, stairways, and exits are unobstructed.

  • There are no objects protruding into aisles and walkways.

  • No item is placed around emergency equipment (e.g., fire extinguishers, first aid kits).

  • Lamps or light sources are clean and provide adequate illumination for working.

Storage Area

  • Storage areas are clean, tidy and organized.

  • Stacked materials are placed on a flat and firm foundation.

  • Storage racks used are adequate for the task and in good condition.

  • Heavier and bulkier items are placed on the lower shelves of a storage rack.

  • Hazardous substances (e.g., flammable materials, toxic substances) are stored in compatible containers, stored under appropriate conditions and affixed with GHS labels.

  • Physical barriers and warnings signs are installed around workplace hazards (e.g., sharp objects, protruding objects, a hot surface, a floor opening).

Tools, Machine and Equipment

  • Machine and equipment guards are in place and secure.

  • Tools are in good condition and in their designated location.

  • Warning signs are in good condition and can be clearly seen from afar.

  • Cords, cables, and hoses are bundled up when not in use.

Waste Disposal

  • Proper waste bins for general waste, recyclable waste, hazardous waste, and so on are provided at work areas to facilitate responsible disposal.

  • Combustible waste is properly disposed of. For example, oily rags are disposed of in closed metal waste bins.

  • Waste (including hazardous waste) is collected regularly so that there is no unnecessary accumulation of waste.

  • A predetermined disposal area has been designated for situations where waste materials (e.g., bulky waste, toxic waste) need to be accumulated till the next waste collection date.


  • Full Name and Signature of the Inspector

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.