Title Page

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Walking/Working Surfaces:

  • Work center floors clean and dry?

  • Hangar decks clear of FOD and spills?

  • Unprotected/unidentified trip hazards

  • Stairs safe (secure rails, treads)

  • Scaffolding/maintenance stands <5 ft have top & mid rails, toe boards, wheel locks


  • All disconnects and circuit breakers labeled

  • 36" clearance around circuit breaker panels (No obstructions)

  • No exposed live wires or circuits

  • Circuit breaker panels / receptacles have no holes, open slots or removed knockouts

  • All receptacles, switches and boxes have covers in place and in good condition

  • No permanent extension cords used in place of fixed wiring

  • Explosive proof lighting / machinery in use where needed

  • GFCI circuits used in wet areas

  • Plug ends do not have ground pins removed

Machinery Guarding:

  • Barrier guards on moving machinery parts, belts and pulleys

  • Point of operation and pinch points guarded and mart

  • Fan blades guarded (<1/2" opening)

  • Fixed machinery anchored to deck / workbench to prevent movement

  • Bench grinders (1/8 "to rest and 1/4"tongue adjusted from wheel)

  • Band saw blades guarded above guide rollers

  • Safety zones around shop equipment

  • Abrasive wheels in good condition with no evidence of side grinding or non-Ferrous materials being ground

  • On / off / kill switch easily accessible

Hazardous material:

  • Only approved lockers in use (three point locking mechanisms and bungs installed)

  • Hazmat lockers properly identified (flammables, oxidizers, corrosives)

  • Hazmat labeled with approved labels. No NFPA labels (diamond shaped)

  • Lockers contain only material listed on a AUL, inventory and have SDS

  • No smoking signs posted and observed

  • Are SDS readily available and accessible (no physical or administrative barriers)

  • Rooms used to store flammable properly ventilated and use explosive approve equipment and lighting

  • Are refrigerators properly labeled as to contents (either " food only" or HAZMAT "No Food)

  • Are dispensing containers (55 gallon drums) grounded to prevent static discharge

General Safety

  • Plumbed eyewash stations showers flushed weekly (verify inspection record)

  • Portable eyewash stations purged monthly (verify inspection record)

  • Safety zones painted around eyewash stations (suggest green) and kept clear

  • Firefighting equipment inspected monthly, clear of obstacles and has painted red zone

  • PPE in good condition (elastic, lenses material integrity)

  • Weight handling equipment ( WHE ) inspected and load tested

  • Space heaters have approved auto trip over protection

  • Coffee makers approved by fire marshal and on metal surface/trey

  • Industrial hygienist survey posted in workcenters

  • DOD / NAVOSH placard and policy statement posted (current CO)

  • Unstable shelving secured to prevent tripping hazard

  • Our members smoking in designated areas only

  • Are applicable warning signs posted (hearing, sight, foot )

  • Comments and/or notes:

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.