SWO - Em

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Inspection/site/personnel information

Surrounding Area

• Is the work area orderly, no trip hazards or waste?

  Yes

  No

  N/A

• Is there adequate space, light, and ventilation for the task?

  Yes

  No

  N/A

Equipment

• Is electrical equipment tested and tagged?

  Yes

  No

  N/A

• Is the correct equipment being used for the task?

  Yes

  No

  N/A

• Equipment stored appropriately?

  Yes

  No

  N/A

• Hazardous chemicals stored safely?

  Yes

  No

  N/A

Vehicle

• Vehicle appears in safe condition; current WOF?

  Yes

  No

  N/A

PPE/signage

• Is appropriate PPE being worn?

  Yes

  No

  N/A

• Is wet floor signage in place (where needed)?

  Yes

  No

  N/A

Movement

• Body posture/movement/grip/lifting; are appropriate for the task?

  Yes

  No

  N/A