Title Page
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Company Name
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Registered Address
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Inspected by
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Conducted on
Training
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Is training provided for each person newly assigned to a job?
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Does initial training include a thorough review of hazards and incidents associated with the job?
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Is adequate instruction in the use of personal protective equipment provided?
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Is training for the use of emergency equipment provided?
Environment
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Are resources available to deal with very hot or very cold conditions (drinking water, lined gloves, insulated boots)?
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Is the rain/cold weather gear that is provided comfortable, and light enough so as not to constitute a hazard?
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Are work surfaces and grip surfaces safe when wet?
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Do workers know the symptoms of heat cramps/heatstroke, or frost bite/hypothermia?
Lighting
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Is the level of light adequate for safe and comfortable performance of work?
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Does lighting produce glare on work surfaces, monitors, screens and keyboards?
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Is emergency lighting adequate and regularly tested?
Floor and Wall Openings
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Are ladder-ways and door openings guarded by a railing?
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Do temporary floor openings have standard railings or someone constantly on guard?
Stairs, Ladders, and Platforms
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Are stairs and handrails in good condition?
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Are ladders free of defects?
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Are ladders set up properly before use?
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Are the elevated platforms properly secured and do they have handrails?
Elevating Devices
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Are elevating devices used only within their capacity?
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Are capacities posted on equipment?
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Are they regularly inspected, tested and maintained?
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Are operators trained?
Confined Spaces
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Are the confined space procedures and training available and followed by all involved?
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Are entry and exit procedures adequate?
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Are emergency and rescue procedures in place (e.g. trained safety watchers)?
Housekeeping
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Is the work area clean and orderly?
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Are floors free from protruding nails, splinters, holes and loose boards?
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Are aisles and passageways kept clear of obstructions?
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Are permanent aisles and passageways clearly marked?
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Are covers or guardrails in place around open pits, tanks and ditches?
Electrical
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Is the proper code followed for operation, use, repair and maintenance?
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Are all machines properly grounded?
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Are portable hand tools grounded or double insulated?
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Are junction boxes closed?
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Are extension cords out of the aisles where they can be abused by heavy traffic?
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Is permanent wiring used instead of extension cords?
Tools and Machinery
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Are manufacturers' manuals kept and followed for all tools and machinery?
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Do power tools conform to standards?
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Are defective tools tagged and removed from service as part of a regular maintenance program?
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Is proper training given in the safe use of tools and machinery?
Machine Guards
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Are all machine parts adequately guarded?
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Do machine guards meet standards?
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Are all guards in place and operating as designed?
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Are lockout procedures followed when performing maintenance with guards removed?
Sound Level/Noise
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Are regular noise surveys conducted?
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Is hearing protection available and used properly?
Temporary Work Structures
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Are temporary work structures used only when it is not reasonably practicable to use permanent ones?
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Are excavations properly shored, free of large objects (rocks, etc.) at the edges?
Personal Protective Equipment (PPE)
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Is required PPE provided, maintained and used?
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Has the PPE been chosen to protect against the hazards that are present?
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Is the PPE reliable?
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Are the areas requiring PPE usage properly identified by warning signs?
Materials Handling and Storage
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Is there safe clearance for all equipment through aisles and doors?
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Is stored material stable and secure?
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Are storage areas free from tipping hazards?
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Are only trained operators allowed to operate forklifts?
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Is charging of electric batteries performed only in designated areas?
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Are necessary warning devices and signs in use for railway sidings?
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Are specifications posted for maximum loads which are approved for shelving, floors and roofs?
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Are racks and platforms loaded only within the limits of their capacity?
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Are chain hoists, ropes and slings adequate for the loads and marked accordingly?
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Are slings inspected daily before use?
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Are pallets and skids the correct type and inspected?
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Do personnel use proper lifting techniques?
Hazardous Product / Chemical Storage
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Has the safety data sheet (SDS) been reviewed before handling, moving, or storing the product?
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Is appropriate PPE used for that product?
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Is the storage area and products organized to keep incompatible products separated?
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Are hazardous products stored away from heat sources?
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Are containers checked for leaks or damage?
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Are containers stored in drip trays where necessary?
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Are all products labelled, and are missing or damaged labels replaced immediately?
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Is spill cleanup material immediately available?
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Are bonding and grounding connections immediately available for flammable products?
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Is the ventilation for the storage area adequate for the products stored within?
Work Process
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Are repetitive motion tasks properly paced and kept to a minimum?
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Are the safety data sheets accessible to all employees?
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Are hazards signalled by signs and tags?
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Have all trucks, forklifts and other equipment been inspected and maintained?
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Are lockout or tagout procedures in place and followed?
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Is ventilation equipment working effectively?
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Is the fume and dust collection hood working effectively?
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Are the safety showers and eye wash stations in the proper locations and in good working condition?
Employee Facilities
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Are facilities kept clean and sanitary?
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Are facilities in good repair?
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Are cafeteria facilities provided away from hazardous products?
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Are hand washing facilities available, especially in washrooms and near eating areas?
Fire Emergency Procedures
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Is there a clear fire response plan posted for each work area?
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Do all workers know the plan?
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Are fire extinguishers chosen for the type of fire most likely in that area?
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Are there enough extinguishers present to do the job?
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Are extinguisher locations conspicuously marked?
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Are extinguishers properly mounted and easily accessible?
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Are all extinguishers fully charged and operable?
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Are special purpose extinguishers clearly marked?
Means of Exit
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Are there enough exits to allow prompt escape?
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Do employees have easy access to exits?
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Will exit doors open in an emergency to allow egress?
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Are exits clearly marked?
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Are exits and exit routes equipped with emergency lighting?
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Are exits and exit routes accessible (e.g., no items stored in the pathway or doorway)?
Medical and First Aid
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Do all employees know how to get first aid assistance when needed?
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Do the first-aiders know when and to which hospital or clinic an injured person should be taken?
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Are there employees trained as first-aid practitioners on each shift worked?
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Are first-aid kits provided as per regulations?
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Are first-aid supplies replenished as they are used?
Completion
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Additional Comments
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Industrial Safety Inspector Name and Signature