• Date:

  • Time Started:

  • Checks performed by:

1. Safety Related Housekeeping

  • 1.1 Are aisle ways clear of obstructions?

  • 1.2 Are there any trip hazards?

  • 1.3 Are floors appropriately clean and dry?

2. Electrical

  • 2.1 Are electrical cords in good condition?

  • 2.2 Are extension cords used properly?

  • 2.3 Are electrical panel doors closed and in good repair?

  • 2.4. Are E-stops available and in good repair?

3. Fire Protection

  • 3.1 Are fire exits clearly marked?

  • 3.2 Are fire exits unobstructed?

  • 3.3 Are fire extinguishers available, marked and inspections up to date?

4. Material Handling and Storage

  • 4.1 Are hand trucks in good working condition and have required pre-shift
    inspections been completed?

  • 4.2 Are combo lifts in good condition?

  • 4.3 Are there ergonomic risks? If so, explain.

5. Hazard Identification

  • 5.1 Are hazardous equipment areas properly labeled?

  • 5.2 Is equipment labeled and is label in good repair?

  • 5.3 Are hazardous materials and containers properly labeled and stored?

6. Machine Guarding

  • 6.1 Are moving parts properly guarded?

  • 6.2 Is proper PPE used (earplugs, cut-resistant gloves)?

  • 6.3 Are eyewash stations available and clean?

7. Hand and Portable Power Tools

  • 7.1 Are the correct tools provided, in good repair and being used?

  • 7.2 Are the tools properly guarded?

  • 7.3 Are the tools stored properly?

8. Ladders

  • 8.1 Are ladders chained and properly stored when not in use?

  • 8.2 Are ladders used properly?

  • 8.3 Are ladders in good condition with no welded repairs?

9. Lockout/Tagout.

  • 9.1. Are machines being locked out if necessary?

  • 9.2. If machines are being locked out, is it correctly? Please list machine and employee involved.

10. Departmental Monitoring

  • 10.1 Have required checklists been completed?

  • 10.2 Have unacceptable conditions been reported to the appropriate personnel?

  • 10.3 Have reported results been resolved within an acceptable timeframe?

  • Time Completed:

  • Please sign

  • Additional comments; Suggestions or Questions.

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.