Safety Spot Inspection

Organization, unit, activity, or work area being inspected:

Spot Inspection Date & Time
Inspector Name/Office Symbol

Description of the areas, equipment or processes/procedures reviewed as well as observations (positive findings, hazards, or unsafe work practices):

Add media
Causes of deficiencies and hazards:


Recommendations for corrective action:

Name and phone number of person responsible for implementing corrective action:

Notes, corrective action taken, 332 Work Order number, Request RAC/Safety Office:

Follow-up date (30 days):
Date closed:
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.