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
Untitled Page
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Date:
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Location:
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Inspected By:
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Category
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Hazard Rating
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Action
General Workplace conditions (Main Office)
Floors (Walking and Working Surfaces)
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Clean, orderly and sanitary condition
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Free of slip, trip or fall hazards
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Free of protrusions
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Openings covered or barricaded
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Are light fittings clean and in good condition
Aisles and Passageways
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Clear and unobstructed
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Desk areas and file cabinets not posing hazard
Exits
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Sufficient exits for prompt escape
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No locks or fastening restricting escape
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Routes and exits are clearly marked
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Exits adequately illuminated
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More than one exit from work area
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Approaches to exits unobstructed
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Flammable kept out of exits
Restrooms
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Good ventilation
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Clean orderly and sanitary
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Painted and well lighted
Safety
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Fire Extinguishers inspected
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First aid supplies and injuries monitored
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Employees Working in a safe manner
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Electrical outlets kept uncluttered
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Desk heaters kept clear
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Emergency Telephones list
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Can exit doors be effortlessly opened
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First aid and fire extinguishers signs posted
Plant and Factory
Mechanical Hazards
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Mechanical power Transmission Belts guarded
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Guard affixed to machines or secured to prevent displacement
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Emergency Stop arrangements at all machines
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Are hands tools in good repairs
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Portable power hand tools provided with circuit breakers
Electrical Hazards
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Are there broken or unsecured wires and cables
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Switch boxes and distribution board covers and in good condition
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Are all connections and electrical devices earthed
Hazardous Material and chemical Safety
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Are all hazardous substances clearly and permanently labelled
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Are all flammable liquids kept in covered and appropriate containers when not in use
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Are no smoking signs posted in areas for storage and use of flammable, combustible materials
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Are material safety data sheet available
Gas Cylinders
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Are gas cylinders stored in upright position
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Are gas cylinders secured from damage and being knocked over
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Are valve protection caps provided and kept on gas cylinders
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Do gas cylinders show obvious signs of defects like rusting
Walkways / Floors
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Are floor surfaces even and uncluttered
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Are Floor surface dry and clean
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Are walkways clearly marked and free from obstruction
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Are there unguarded / inadequately covered floor openings (e.g., stairways, floor openings.)
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Are stairways in good condition with standard railing provided for every flight
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Are working platform at higher levels provided with handrails and toe boards
Material Handling
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Are all lifting appliances marked with their safe working load
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Are wires, ropes and chains slings in good condition
Ladders
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Are ladders free from splinters, sharp and decay
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Are Rungs of ladders uniformly spaced in good conditions