Instruction

Safe Work Instruction

Scope

Authorizations

Prestart Requirements

Hazards

Safety Controls

Instructions

Closing Procedures

Emergency Procedures

Completion
Created by (Name and 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.