Title Page

  • Site conducted

  • Site conducted

  • Facility Area

  • Conducted on

  • Prepared by

Inspection Area


  • No evidence of food or drink, tobacco in any area other than designated areas. Only office/breakroom for food/drinks

  • There is no standing piles of product or other debris on floors/equipment throughout the department

  • All hoses and other stored items are picked up off the floor and covered (if needed) and stored away properly

  • All trash cans/dumpsters/carts are emptied frequently to prevent odors and insect activity

  • There is no standing water in the area, which prevents any odor, insect or microbial activity

  • Walls, ceilings, piping, etc. are clean and free of debris or mold

  • All chemicals/lubricants are labeled and stored properly in (locked) cabinets

  • No evidence of oil or grease leaking into product zones

  • All employees are using/or have proper PPE on in the area

Tools/Secondary Storage:

  • Noncontact product and product contact tools/parts are clean, color coded(if applicable) and properly stored

  • Secondary storage containers (buckets included) are clean and labeled for what they are being used for

  • Storage cabinets/ lockers are clean, orderly and not cluttered with items that do not belong; locked when required

  • All lids, access points are capped/closed/secure/locked as needed

  • Maintenance/Contractors have cleaned up tools, nuts, washers, bolts, welding leads, etc. after working on equipment

Pest Control:

  • Exterior of building is free from debris, trash and foliage

  • Doors are kept closed when not in use and windows are screened (if open) to prevent pests from entering the plant

  • Vents have proper guarding to prevent pests from entering the building

  • Traps are checked and documented based on service agreement frequency (ensures sufficient tracking of pests)

  • There is no clutter in the area that could potentially become a pest harborage area

  • No evidence of pest activity (droppings, feathers, etc.). Includes insect trails/webbing on equipment, walls, or ceilings

Building Structure:

  • The lighting is in good repair and adequate throughout the department

  • The stairs, walls, floors, overheads and other structures in the department are in good repair. (NO leaks or NO damage present)

  • The department is free of peeling paint in all areas

  • All doors and windows are in good repair/screened and are able to close

  • No Yellow tape on spouting/equipment longer than 45 days. Temporary repair is initialed and dated

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.