Information

  • Client / Site

  • Conducted on

  • Prepared by

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

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

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

  • Are all pulleys and belts properly guarded?

  • Are all moving the chains and gears properly guarded?

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

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

  • Our employees wearing required personal protective equipment?

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

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

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

  • Additional comments are areas for improvements

Corrective Actions

  • Enter appropriate corrective action for "no" responses

  • Photos of corrected hazards

  • Signature

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. You should independently determine whether the template is suitable for your circumstances.