Title Page

  • Conducted on:

  • Inspected Plant:

  • Employees Performing Inspection:

Feeders

Belts (condition, splice)

  • Is there a visual risk/problem?

  • Problems

  • Date Repaired

Pans

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Bins

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Conveyors

Scrapers

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Screen

Cloth

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Frames

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Dryer

Shell

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Hot & Cold Chutes

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Tires

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Flights

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Mixing Zone

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Breach

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Baghouse

Shell

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Exhauster & Fugitive Fans

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Ductwork

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Cyclone/Knockout Box

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Screws

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Silos

Batchers (cyl., valves, bearings)

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Silos & Gates

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Transfer Slatt

Chain, Slatts & Sprockets

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

Main Slatt

Chain, Slatts/Buckets & Sprockets

  • Is there a visual risk/problem?

  • Problems:

  • Date Repaired

  • Employee Name:

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.