Title Page

  • Site conducted

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Location

  • Is safety team Members Present

  • IS MBUSI Rep Present

  • Are all employees wearing the proper PPE?

  • Were PPE issues addressed

  • Are all employees wearing PPE properly?

  • Is the area clear of any trip hazards?

  • Are floor mats taped down to avoid tripping?

  • Are totes stacked in the station in a manner to prevent falling?

  • Is safety netting secure above workers?

  • Can the worker perform standardized work without entering mobile traffic aisles on foot?

  • Are racks all in good condition ( No bends, loose/missing bolts, damaged ) ?

  • Is this a new rack issue?

  • Are guard rails in place to protect all work areas?

  • Is the area free of head strike hazards?

  • Is all wiring in good condition and not in a pinch/cut position?

  • Were damaged wires removed from the work area?

  • Can the worker perform standardized work without ergonomic strain?

  • Are all stands, tables, and racks bolted down?

  • Please list Column & location

  • Does the presentation of all parts prevent them from falling against or on a worker?

  • Is the area clear of all pinch points?

  • Are all dolly trains in good working condition and undamaged?

  • Is the area clear of sharp objects?

  • Are all chemicals clearly marked with a safety identification label?

  • Are all dolly tongues left in an upright position when not in use?

  • The work area is free of knives, box cutters or other unapproved cutting instruments?

  • Can work be performed without a risk of striking another worker with a tool or part?

  • Workers are aware of their emergency gathering place in case of fire?

  • Are workers able to show you where to find this information?

  • Workers are aware of their emergency gathering place in case of tornado?

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.