Title Page

  • Document No.

  • Room number and room title

  • Laboratory custodian

  • Inspection date and time

Inspection routine checks

  • Make routine checks during this inspection

  • Are the occupants wearing the correct PPE

  • Is the laboratory occupied

  • Is a current health and safety handbook available

  • Is a stocked first aid kit available

  • Is the eye wash working or are eye wash bottles available

  • Are all vessels appropriately labelled

  • Are Operational Instructions forms displayed for all experimental work

  • Are all gas cylinders properly secured and in good order

  • Are all gas regulators less than retirement age and in good order

  • Area the oxygen depletion and/or carbon monoxide alarms in working order

Inspection non-routine checks

  • Additional inspection findings

  • Additional findings
  • Additional inspection finding

Unresolved issues from previous inspections

  • Report on unresolved issues from previous inspections

  • Unresolved issues from previous inspections

  • Unresolved issues
  • Unresolved issue from previous inspection

Inspection sign off

  • Inspector signatures

  • Inspector
  • Inspector

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.