Title Page

  • Company Name

  • Registered Address
  • Inspected by

  • Conducted on


  • Is training provided for each person newly assigned to a job?

  • Does initial training include a thorough review of hazards and incidents associated with the job?

  • Is adequate instruction in the use of personal protective equipment provided?

  • Is training for the use of emergency equipment provided?


  • Are resources available to deal with very hot or very cold conditions (drinking water, lined gloves, insulated boots)?

  • Is the rain/cold weather gear that is provided comfortable, and light enough so as not to constitute a hazard?

  • Are work surfaces and grip surfaces safe when wet?

  • Do workers know the symptoms of heat cramps/heatstroke, or frost bite/hypothermia?


  • Is the level of light adequate for safe and comfortable performance of work?

  • Does lighting produce glare on work surfaces, monitors, screens and keyboards?

  • Is emergency lighting adequate and regularly tested?

Floor and Wall Openings

  • Are ladder-ways and door openings guarded by a railing?

  • Do temporary floor openings have standard railings or someone constantly on guard?

Stairs, Ladders, and Platforms

  • Are stairs and handrails in good condition?

  • Are ladders free of defects?

  • Are ladders set up properly before use?

  • Are the elevated platforms properly secured and do they have handrails?

Elevating Devices

  • Are elevating devices used only within their capacity?

  • Are capacities posted on equipment?

  • Are they regularly inspected, tested and maintained?

  • Are operators trained?

Confined Spaces

  • Are the confined space procedures and training available and followed by all involved?

  • Are entry and exit procedures adequate?

  • Are emergency and rescue procedures in place (e.g. trained safety watchers)?


  • Is the work area clean and orderly?

  • Are floors free from protruding nails, splinters, holes and loose boards?

  • Are aisles and passageways kept clear of obstructions?

  • Are permanent aisles and passageways clearly marked?

  • Are covers or guardrails in place around open pits, tanks and ditches?


  • Is the proper code followed for operation, use, repair and maintenance?

  • Are all machines properly grounded?

  • Are portable hand tools grounded or double insulated?

  • Are junction boxes closed?

  • Are extension cords out of the aisles where they can be abused by heavy traffic?

  • Is permanent wiring used instead of extension cords?

Tools and Machinery

  • Are manufacturers' manuals kept and followed for all tools and machinery?

  • Do power tools conform to standards?

  • Are defective tools tagged and removed from service as part of a regular maintenance program?

  • Is proper training given in the safe use of tools and machinery?

Machine Guards

  • Are all machine parts adequately guarded?

  • Do machine guards meet standards?

  • Are all guards in place and operating as designed?

  • Are lockout procedures followed when performing maintenance with guards removed?

Sound Level/Noise

  • Are regular noise surveys conducted?

  • Is hearing protection available and used properly?

Temporary Work Structures

  • Are temporary work structures used only when it is not reasonably practicable to use permanent ones?

  • Are excavations properly shored, free of large objects (rocks, etc.) at the edges?

Personal Protective Equipment (PPE)

  • Is required PPE provided, maintained and used?

  • Has the PPE been chosen to protect against the hazards that are present?

  • Is the PPE reliable?

  • Are the areas requiring PPE usage properly identified by warning signs?

Materials Handling and Storage

  • Is there safe clearance for all equipment through aisles and doors?

  • Is stored material stable and secure?

  • Are storage areas free from tipping hazards?

  • Are only trained operators allowed to operate forklifts?

  • Is charging of electric batteries performed only in designated areas?

  • Are necessary warning devices and signs in use for railway sidings?

  • Are specifications posted for maximum loads which are approved for shelving, floors and roofs?

  • Are racks and platforms loaded only within the limits of their capacity?

  • Are chain hoists, ropes and slings adequate for the loads and marked accordingly?

  • Are slings inspected daily before use?

  • Are pallets and skids the correct type and inspected?

  • Do personnel use proper lifting techniques?

Hazardous Product / Chemical Storage

  • Has the safety data sheet (SDS) been reviewed before handling, moving, or storing the product?

  • Is appropriate PPE used for that product?

  • Is the storage area and products organized to keep incompatible products separated?

  • Are hazardous products stored away from heat sources?

  • Are containers checked for leaks or damage?

  • Are containers stored in drip trays where necessary?

  • Are all products labelled, and are missing or damaged labels replaced immediately?

  • Is spill cleanup material immediately available?

  • Are bonding and grounding connections immediately available for flammable products?

  • Is the ventilation for the storage area adequate for the products stored within?

Work Process

  • Are repetitive motion tasks properly paced and kept to a minimum?

  • Are the safety data sheets accessible to all employees?

  • Are hazards signalled by signs and tags?

  • Have all trucks, forklifts and other equipment been inspected and maintained?

  • Are lockout or tagout procedures in place and followed?

  • Is ventilation equipment working effectively?

  • Is the fume and dust collection hood working effectively?

  • Are the safety showers and eye wash stations in the proper locations and in good working condition?

Employee Facilities

  • Are facilities kept clean and sanitary?

  • Are facilities in good repair?

  • Are cafeteria facilities provided away from hazardous products?

  • Are hand washing facilities available, especially in washrooms and near eating areas?

Fire Emergency Procedures

  • Is there a clear fire response plan posted for each work area?

  • Do all workers know the plan?

  • Are fire extinguishers chosen for the type of fire most likely in that area?

  • Are there enough extinguishers present to do the job?

  • Are extinguisher locations conspicuously marked?

  • Are extinguishers properly mounted and easily accessible?

  • Are all extinguishers fully charged and operable?

  • Are special purpose extinguishers clearly marked?

Means of Exit

  • Are there enough exits to allow prompt escape?

  • Do employees have easy access to exits?

  • Will exit doors open in an emergency to allow egress?

  • Are exits clearly marked?

  • Are exits and exit routes equipped with emergency lighting?

  • Are exits and exit routes accessible (e.g., no items stored in the pathway or doorway)?

Medical and First Aid

  • Do all employees know how to get first aid assistance when needed?

  • Do the first-aiders know when and to which hospital or clinic an injured person should be taken?

  • Are there employees trained as first-aid practitioners on each shift worked?

  • Are first-aid kits provided as per regulations?

  • Are first-aid supplies replenished as they are used?


  • Additional Comments

  • Industrial Safety Inspector Name and Signature

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.