Spot Check

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

  Select

• Location

  Select

• Yes

  No

  N/A

PPE

• Head Protection

  Yes

  No

  N/A

• Eye/Face Protection

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Protective Clothing

  Yes

  No

  N/A

• Arm Protection

  Yes

  No

  N/A

• Fall Protection

  Yes

  No

  N/A

• Hand Protection

  Yes

  No

  N/A

• Foot Protection

  Yes

  No

  N/A

Body Position- Ergonomics

• Lifting Safety/No Bending at the Waist

  Yes

  No

  N/A

• Posture

  Yes

  No

  N/A

• Grip

  Yes

  No

  N/A

• Pushing (not Pulling)

  Yes

  No

  N/A

• Wrists Straight

  Yes

  No

  N/A

• No Over-Exertion

  Yes

  No

  N/A

Lockout/ Guarding

• Employee has lock

  Yes

  No

  N/A

• Equipment is Locked out

  Yes

  No

  N/A

• Employee knows Hazardous Energy Sources

  Yes

  No

  N/A

• Employee Understands Lock Out Procedure

  Yes

  No

  N/A

• Guards are in Place

  Yes

  No

  N/A

• Employee is not Reaching Past Guards

  Yes

  No

  N/A

• Hand tool Used to Clear Jams if Required

  Yes

  No

  N/A

Tools and Equipment

• Vibration Present

  Yes

  No

  N/A

• Correct Tool for the Job

  Yes

  No

  N/A

• Not using damaged tools

  Yes

  No

  N/A

• Yes

  No

  N/A

Housekeeping

• Work area is Free of Slip Hazards

  Yes

  No

  N/A

• Work Area is Free of Trip Hazards

  Yes

  No

  N/A

• No Combustion Near Welding

  Yes

  No

  N/A

Mobile Equipment

• Operator Carries License

  Yes

  No

  N/A

• Safe Speed

  Yes

  No

  N/A

• No Listening devices present of Lift

  Yes

  No

  N/A

• Load Carried (Stable)

  Yes

  No

  N/A

• Aware of Surroundings/Pedestrians

  Yes

  No

  N/A

• Stops at Corners and Intersections/Sounds Horn

  Yes

  No

  N/A

• Yes

  No

  N/A

Inspections

• Crane Inspections complete

  Yes

  No

  N/A

• Press Brake Inspections Complete

  Yes

  No

  N/A

• Fork Lift Inspections complete

  Yes

  No

  N/A