Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Floors & Aisles

  • Floor and aisles are free of slip & trip hazards?

  • Designated walkways are plainly marked & free of stored or staged material?

  • Are non exit doors labeled?

  • Is fire equipment accessible and not blocked?

  • Are fire exit signs properly lighted?

  • Are evacuation maps posted?

  • Storage locations are identified and the proper items are being stored there?

  • Portable equipment such as fans, heater, etc., and cords operating these devices installed to not cause a trip hazard ?

Machinery & Equipment

  • Are all safety devices in place and functioning properly (interlocks, fences, light curtains, guards, etc.)?

  • The danger zones on or around machinery properly marked & identified?

  • Have all machines been properly maintenanced according to manufacturers requirements?

  • Does the machinery have its lockout tagout procedure posted?

  • Are Work Instructions posted for all jobs?

  • Have all of the daily inspection checklists been completed for mobile equipment?

  • Is the machinery and equipment maintained in a neat & clean condition?

Material Handling & Storage

  • Are items stacked & stored in such a way to prevent them from falling over?

  • Are hazardous chemicals stored away from high traffic areas & in designated locations?

  • When lifting devices are used (slings, chains, forklift attachments) are they inspected & documented beforehand?

  • Are the handles on handcarts properly labeled with PUSH ONLY?

  • Is the weight limit on shelving posted?

Shipping Docks

  • Trailers are properly chocked?

  • Jackstands in place under front center of live load trailers?

  • Glad Hands Locks/Salvo system/Dock Locks operate properly according to SOP?

  • Docks are painted according to Dock Standard?

  • Dock cones and Lane Cones are in proper place and in good condition?

  • Dock chains or Dock gate are in place?

Maintenance Shop/Parts Room

  • Is flammable liquids cabinet orderly and door closed?

  • Is the floor area in front of electrical panels clear and assessable?

  • Are gas cylinders properly chained to the wall (if not in use)?

  • Is floor of main shop area neat and orderly?

  • Are fire extinguishers present in main shop and maintained?

  • Are guards in place on all hand tools being used?

  • Are TM's assigned specific areas to 5S after their shift?


  • Is management visible on the floor? Who and how much?

  • Are TM's provided with adequate cleaning supplies?

  • Are cleaning supplies located and identified to their proper storage location?

  • Are hand tools and equipment stored in their proper locations? Is location identified?

  • Are TM's assigned specific areas to 5S after their shift?

Employee Observation

  • Are employees wearing all required personal protective equipment properly?

  • Is employee conducting work according to standard work instructions (WIS) or Standard Operating Procedure (SOP)?

  • Do you observe any employee doing an unsafe behavior?

  • Are employees using proper tool for the job?

  • Can employees identify the key safety hazard and protective procedure for the task they are conducting?

  • Are employees utilizing safe ergonomic practices?

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.