Sugar Mill Inspection

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Floors, platforms, walkways areas clear of debris and obstacles?

  Yes

  No

  N/A

• Are openings or holes in floors are other walking surfaces covered, repaired or otherwise made safe?

  Yes

  No

  N/A

• Are lighting levels satisfactory for operators to utilize equipment safely?

  Yes

  No

  N/A

• Are all pulleys and belts properly guarded?

  Yes

  No

  N/A

• Are all moving the chains and gears properly guarded?

  Yes

  No

  N/A

• Is all machinery or equipment capable of movement required to be de-energized or disengaged and blocked while cleaning, servicing, adjusting or setting up?

  Yes

  No

  N/A

• Are all securing chains, ropes or slings properly maintained and adequate for the job being performed?

  Yes

  No

  N/A

• Our employees wearing required personal protective equipment?

  Yes

  No

  N/A

• Is appropriate signage in place (confined space, pinch points, LOTO)?

  Yes

  No

  N/A

• Have any usual conditions or safety concerns been identified and discussed prior to shift change?

  Yes

  No

  N/A

• Are all other areas free of hazards not identified in this inspection

  Yes

  No

  N/A

• Additional comments are areas for improvements

Corrective Actions

• Enter appropriate corrective action for "no" responses

• Photos of corrected hazards

  Media

• Signature

  Sign