Title Page

  • Conducted on

  • Prepared by

  • Location

Prior to beginning work

  • Was a documented inspection completed on the forklift or skid steer?

Housekeeping

  • Are walkways and aisle-ways kept clear of debris and tripping hazards?

  • Do walkways have adequate lighting when working at night or before daylight?

  • Is trash, wood, metal, plastic, or other items laying around the area?

  • Are areas accessed by heavy equipment/trucks/forklifts cleaned and graded so no tripping hazards are present?

  • Are roadways kept smooth and accessible for delivery drivers?

  • Are trash receptacles readily available in work and break areas?

  • Are trash dumpsters emptied on a regular basis?

Material Storage

  • Are materials stacked in a safe manner to prevent tipping or falling over?

  • Are materials secured to a pallet for safety and ease of loading and unloading?

  • Are loose materials stored separately from other materials to reduce the risk of a tripping hazard?

Report Information

  • Weather conditions

  • Signature

  • Date and Time of Assessment

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.