Observation

Protective Equipment

Wears eye protection? (goggles, safety glasses)

Wears face protection? (face shield over goggles and glasses)

Wears cut and moisture-resistant gloves?

Wears hearing protection when required?

Does not wear loose clothing or jewelry?

Wears class 2 high visibility clothing when on road calls or working outside of shop?

Wears hard hat when required?

6" high work boots are being worn?

Fire prevention

Keeps fire exits and paths clear?

Completes and follows hot work permits?

Combustibles removed ,or protects it with fire resistant barriers?

Cordons off area before wielding or cutting?

Slips, Trips and Falls

Uses stairway handrails?

Keeps walk area clear?

Reports any spills immediately?

Walks does not run?

Watches where stepping?

Ergonomics

Gets close to equipment to minimize reaching?

Avoids twisting back motions or excessive back bending?

Lifting technique? ( bends at the knees and lifts)

Unsafe acts not covered above? ( please write in notes column)

Unloads vehicle safely?

Follows rule prohibiting scavenging?

Turns off truck to avoid leaving it idle?

Lift truck/Heavy equipment

Only operates if trained by a SWACO trainer?

Wears seatbelt as required by SWACO policy?

Checks both ways and to rear before operating any motorized equipment?

Sounds horn when backing and at all blind spots?

Does not lift more than truck can safely carry?

Lock-Out / Tag-Out

Follows equipment specific lockout procedures?

Applies locks and or tags as required? (SWACO SOP)

Supervisor/Safety comments and signatures.
Mechanics/Employee comments and signatures.

Mechanics comments:

Mechanics signature:

Supervisor/Safety comments:

Supervisor/Safety signature

Corrective action required? ( Explain any action and date when to be completed by)

Add any Pictures Relevant to Observation
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.