Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Physical Condition
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Building and Structures
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Floor Surfaces
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Road Surfaces
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Work Surfaces
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Stacking and Storage
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General Housekeeping
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Notices, signs and labels
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Color coding (Fire, drain, fresh water, chevron, roadmarking etc)
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Reception (Walk off mats, public seating and furniture etc.)
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Eating Facilities / Storeroom / Dressing rooms
Electrical Appliances and Equipment
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Permanent Installation (HT, LT, DB rooms/board, general condition)
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Portable appliances
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Standby Generator (Room clean, ventilated, acoustics, fuel tanks)
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Earth Leakages
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Bonding and earthing (Visual, copper strip - water pipes, gutters)
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Cable penetrations/cut-offs - wall & slab<br>Openings through buildings elements sealed
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Labeling<br>Is it adequate, still in force each switch & plug
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Infra-red monitoring results<br>Tests by third party on electrical distribution boards
Mechanical Appliances and Equipment
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Machines guards, restraints<br>All V-belt guards, moving parts, fences
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Pressure vessels, boilers<br>Annual checks and 3 year testing
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Gas cylinders and hoses<br>Signage, fire hazard
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Lockout system<br>When working on electrical equipment
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Hoisting/Lifting equipment<br>Maintenance, operator training
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Scaffolds/ladders/stairs
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Manual tools/Equipment<br>Condition and correct use
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Transport/Vehicles<br>Regular maintenance and road worthiness
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CCTV Cameras<br>Unobstructed, loose cabling
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Smoke Detection<br>Smoke detectors, systems working
Occupation Hygiene and General Safety
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Dangerous chemical and material locked.<br>Paint, thinners, cleaning material, pest control
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Ventilation<br>Adequate for occupancy type, room use
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Temperature<br>Too high or too low
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Lighting levels
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Ear and eye hazard contaminant<br>Noise, Light & dust
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Pollution of environment<br>Chemical/biological waist, refrigerant gas
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Basic hygiene (toilets etc.)<br>Cleaning, condition, functional
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First aiders<br>One for 10 - 100 employees
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First aid equipment<br>One box for 5 and more employees
PPE
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All tasks evaluated<br>Require PPE or not
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Correct type<br>Safety harness, hard hats and earmuffs
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Issue and condition<br>Working order, issue records
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Training done<br>Correct use of equipment
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Storage when not in use<br>Accessibility and cleanliness
Fire Protection and Preparedness
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Reduction/removal of fuels.<br>Storage areas, refuse room, garden refuse
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Extinguishers/Hoses in position and Numbered
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Last service date by third party<br>Not to exceed 12 months
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Appointment of fire marshals<br>Available and up to date
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Competence of fire marshals<br>Adequate training
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Fire Plan<br>Available and displayed in appropriate areas
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Hotwork permit records to date<br>Confirm use and effectiveness
Training and Preparedness
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Anyone need training Fire, first aid, etc.
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Do all know their duties<br>Fire marshals and safety representatives
Additional
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Additional concerns, findings or comments to be listed below and dated.
Signatures
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Inspectors Name and Position