Title Page
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Document No.
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Room number and room title
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Laboratory custodian
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Inspection date and time
Inspection routine checks
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Make routine checks during this inspection
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Are the occupants wearing the correct PPE
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Is the laboratory occupied
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Is a current health and safety handbook available
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Is a stocked first aid kit available
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Is the eye wash working or are eye wash bottles available
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Are all vessels appropriately labelled
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Are Operational Instructions forms displayed for all experimental work
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Are all gas cylinders properly secured and in good order
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Are all gas regulators less than retirement age and in good order
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Area the oxygen depletion and/or carbon monoxide alarms in working order
Inspection non-routine checks
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Additional inspection findings
Additional findings
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Additional inspection finding
Unresolved issues from previous inspections
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Report on unresolved issues from previous inspections
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Unresolved issues from previous inspections
Unresolved issues
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Unresolved issue from previous inspection
Inspection sign off
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Inspector signatures
Inspector
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Inspector