KRAFT HEINZ JAX MACHINE SCAN

• Date & Time

  Date

• Shift

  1st

  2nd

  3rd

• Prepared by

Items to observe

• Any unguarded gears, sprockets, pulleys, or flywheels?

  Yes

  No

  N/A

• Describe observation

• Photograph of unguarded gears, sprockets, pulleys, or flywheels

  Media

• Any exposed belts or chain drives?

  Yes

  No

  N/A

• Return ladders to proper storage areas and secure them.

• Attach pictures here

  Media

• Describe observation

• Photograph of exposed belts or chain drives?

  Media

• Describe observation

• Any exposed set screws, keyways, collars, etc.?

  Yes

  No

  N/A

• Describe observation

• Photograph of set screws, keyways, collars, etc.

  Media

• Any bodily exposure to other dangerous moving parts?

  Yes

  No

  N/A

• Describe observation

• Photograph of bodily exposure to other dangerous moving parts

  Media

• Any part of employee observed inside machine without equipment locked out?

  Yes

  No

  N/A

• Describe observation

• Photograph of employee observed inside machine without equipment locked out

  Media