Title Page
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Site
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Date and Time of Inspection
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Shift
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Inspector (Full Name)
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Location
Patrol Inspection
Environment
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Are resources available to deal with very hot or very cold conditions (drinking water, lined gloves, insulated boots)?
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Is the rain/cold weather gear that is provided comfortable, and light enough so as not to constitute a hazard?
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Are work surfaces and grip surfaces safe when wet?
Work Process
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Are repetitive motion tasks properly paced and kept to a minimum?
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Are the safety data sheets accessible to all employees?
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Are hazards signalled by signs and tags?
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Have all trucks, forklifts and other equipment been inspected and maintained?
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Are lockout or tagout procedures in place and followed?
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Is ventilation equipment working effectively?
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Is the fume and dust collection hood working effectively?
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Are the safety showers and eye wash stations in good working condition?
Warehouse and Shipping
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Are dock platforms, bumpers, stairs and steps in good condition?
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Are light fixtures in good condition?
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Are all work areas clean and free of debris?
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Are stored materials properly stacked and spaced?
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Are tools kept in their proper place?
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Are there metal containers for oily rags and similar rubbish?
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Are floors free of oil spillage or leakage?
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Is absorbent available for immediate clean-up of spills and leaks?
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Are all hazardous products stored appropriately?
Housekeeping
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Is the work area clean and orderly?
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Are floors free from protruding nails, splinters, holes and loose boards?
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Are aisles and passageways kept clear of obstructions?
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Are permanent aisles and passageways clearly marked?
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Are covers or guardrails in place around open pits, tanks and ditches?
Materials Handling and Storage
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Is stored material stable and secure?
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Are storage areas free from tipping hazards?
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Is charging of electric batteries performed only in designated areas?
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Are dock boards (bridge plates) used when loading or unloading from dock to truck or dock to rail car?
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Are necessary warning devices and signs in use for railway sidings?
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Are specifications posted for maximum loads which are approved for shelving, floors and roofs?
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Are racks and platforms loaded only within the limits of their capacity?
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Are chain hoists, ropes and slings adequate for the loads and marked accordingly?
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Do personnel use proper lifting techniques?
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Are elevators, hoists, conveyors, balers, etc., properly used with appropriate signals and directional warning signs?
Completion
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Recommendations
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Inspector (Full Name and Signature)