Equipment

Equipment
Name of Equipment
Manufacturer

Equipment safe to use

Equipment requires attention

Equipment requires Immobilization

Safety Surface Damaged

Equipment requires Painting

Comments

Signature

Inspectors Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.