Title Page

  • Conducted on

  • Prepared by

  • Exit Route: Map is posted and route is unobstructed

  • Rinse Aid and Titration Solutions: Rinse Aid and titration solution levels are appropriate and titration solution has not expired.

  • Unused tools, parts, or equipment: Area is free of unused tools, equipment or parts - and free of those used by other departments.

  • Beneath Washer: Area is free of un-needed SORT items and is clean.

  • Paperwork: SPC Binder is present, organized, and contents are current

  • Slip/Trip Hazards: Area is free of trip/slip hazards

  • Safety Item Accessibility: Exits, fire extinguishers, eyewash stations, spill kits, e-stops, etc are accessible.

  • Cabinets/ Furniture: All are clean, in good appearance and being used for intended purpose.

  • Computers/Printers/ Scanners & Related Wiring: Equipment is clean and appears to be operating properly. Cables/wires are well organized and secure.

  • Waste removal: Standard Garbage bins are in proximity are not overflowing and are clean.

  • Lighting: Lighting appears sufficient for area. All bulbs are working and clean.

  • Electrical Panels: Nothing is stored on top of panels, they are secured and in good condition, and there is 3' clearance.

  • Floor: Floor, including pedestrian aisle, appears clean and recently swept/mopped.

  • Painted Surfaces: Painted surfaces are in good condition - in particular, yellow painted surfaces that are prone to damage.

  • Walls & Columns: Walls, including mesh and tarp walls, are clean.

  • Movable items: Movable items have homes defined by shadowboxing/signage and items are located to standard.

  • End of Shift 5S Expectations are posted: 5S Expectations (Form 4766) is available for every employee.

  • Common Areas: Area under conveyor before and after the QR wall (Colour Line 2 conveyor) is clean.

  • Washer/DI Trenches: Trenches are visibly clean.

  • Process Filters: Filters are properly dispositioned with none on floor.

  • Please enter Auditor's Signature

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.