Title Page
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Building/Warehouse
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Prepared by
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Location
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Conducted on
Loading Dock and Surrounding Area
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Is the dock and surrounding area well lit?
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Are the floors free of debris and moisture?
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Are dock equipment being maintained?
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Is dock equipment sufficient for cargo?
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Are fire extinguishers and first aid kits easily accessible and well marked?
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Are all fire exits clearly marked and accessible?
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Are dock doors closed and barricaded when not in use?
Daily Operations
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Are trailers being chocked during loading/unloading?
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Are vehicles turned off during loading/unloading?
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Are workers properly trained in safety and first-aid measures?
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Are material Safety Data Sheets nearby (if necessary)
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Are spills cleaned immediately?
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Are damaged equipment reported and properly tagged as "not safe for use"?
Sign off
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Inspector's full name and signature