Title Page

  • Site conducted

  • Conducted on

  • Prepared by

Overview

  • As you are walking through the plant, please look out of the following: obvious safety concerns, spills, improper lifting techniques, extension cords, missing signage, ect.

Front Lobby

  • Begin at the front lobby entry

Fire Extinguisher #8

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

GFCI outlet in Office Bathroom

  • Plug tester into an outlet. Does it read passed?

  • Are there any other safety concerns in this area?

Manufacturing Area

  • Walk the manufacturing floor clockwise, starting at the Gyro Station

Emergency Signage by Office/Plant Door

  • Is the emergency exit light illuminated?

  • Do the emergency flood lights function while holding the test switch?

Spill Kit Barrel (Located in Mixing Area)

  • -Is the Spill Kit closed, sealed and free of obstruction?

Eyewash Pull Station - Office/Plant Door

  • Is eyewash tank full?

  • Was the water replaced less than 3 months ago?

Fire Extinguisher # 4

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

Emergency Signage - East Plant Door

  • Is the emergency exit sign illuminated?

  • Do the emergency flood lights function while holding the test switch?

Eyewash Bottle - Myers & 3-Roll Wall

  • Is the bottled eye wash present and more than 60 days from expiration?

Circuit Panels - Behind Myers Mixer

  • Is the panel clear of obstructions 36" in front of it?

Emergency Signage - South Plant Door

  • Is the emergency exit sign illuminated?

  • Do the emergency flood lights function while holding the test switch?

Fire Extinguisher # 3

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

Circuit Panels - Left of Manufacturing Office

  • Is the panel clear of obstructions 36" in front of it?

Mill Rescue Cabinet - 60" 2-Roll Mill

  • Is the cabinet sealed?

Eyewash Bottle - 60" 2-Roll Mill Wall

  • Is the bottled eye wash present and more than 60 days from expiration?

Circuit Panel - 60" 2-Roll Mill Wall

  • Is the panel clear of obstructions 36" in front of it?

Fire Extinguisher # 2

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

Emergency Signage - West Plant Door

  • Is the emergency exit sign illuminated?

  • Do the emergency flood lights function while holding the test switch?

Eyewash Bottle - Red Ross Mixer Wall

  • Is the bottled eye wash present and more than 60 days from expiration?

Fire Extinguisher # 1

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

Fire Extinguisher # 7 (on mezzanine in between showers)

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

Fire Extinguisher #5

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

  • Are there any other safety concerns in this area? Safety checklists for machinery?

Laboratory

Eyewash Bottle - Wall near Phone

  • Is the bottled eye wash present and more than 60 days from expiration?

Mill Rescue Cabinet - Wall with Window

  • Is the cabinet sealed?

  • Are there any other safety concerns in this area?

Laboratory Closet

Main Electrical Panels

  • Is the panel clear of obstructions 36" in front of it?

  • Is the electrical room clean and clear of obstructions to the panels?

  • Are there any other safety concerns in this area?

Kitchen / Breakroom

Fire Extinguisher # 6

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?<br>

GFCI Outlets

  • Plug tester into an outlet. Does it read passed?

First Aid Cabinet

  • Is the First Aid Cabinet stocked and are items non-expired?

Bloodborne Pathogen Kit

  • Is the kit present and sealed?

Sharps Container

  • Is the sharps container present and not full?

  • Are there any other safety concerns in this area?

Manufacturing Area Bathroom

GFCI Outlets

  • Plug tester into an outlet. Does it read passed?

  • Are there any other safety concerns in this area?

Forklifts

Forklift #2

  • Inspect the daily safety inspection sheet - Has it been completed and any issues noted?

Fire Extinguisher on Forklift #2

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?

Forklift #6

  • Inspect the daily safety inspection sheet - Has it been completed and any issues noted?

Fire Extinguisher on Forklift #6

  • Is the inspection date more than 12 months ago?

  • Record month/year and initials on the inspection tag.

  • Is the extinguisher charge gauge in the green?

  • Is the tamper seal intact?

  • Are there any other safety concerns in this area?

Conclusion

  • Did you notice any obvious safety concerns, spills, improper lifting techniques, extension cords, missing signage, ect?

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.