Title Page
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Date and Time
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Inspected By
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Location
Self-Safety Inspection Checklist
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All work areas clean, sanitary, and orderly?
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Spills promptly cleaned up or contained with non-combustible absorbent materials?
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Storage neat, stable, and orderly?
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Bathrooms, wash facilities, lunchrooms, locker rooms, maintained in a clean and sanitary condition?
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Floors, steps, ramps, and other walking surfaces free of any trip hazards and maintained in a good condition free of any spills or hazards that could cause slips or falls?
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Vehicle exhausts hose and/or collection system in good condition and used?
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Portable fire extinguishers at assigned areas, accessible, and visible?
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Portable fire extinguishers in operational condition with current inspection tag?
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Combustible materials kept clear from heating equipment and other heat producing equipment?
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Proper eye protection worn at all times in shop areas?
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Respirators maintained in a clean and operable condition. Respirators properly stored when not in use in a sealed container?
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Means of egress unobstructed and free of trip hazards?
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First aid kits readily accessible and properly stocked?
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Emergency showers/eye washes readily accessible, clean, and operational and appear to be properly maintained?
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Electrical cords free from damage, properly used, third prong used and grounded?
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Electric motors, tools, and other equipment free of accumulation of dirt, oil, waste and debris?
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Ground fault circuit interrupters operational and provided in shop and wash bay areas?
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Utility work lights in good condition and guard properly around light bulbs?
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All guards provided on equipment pulleys, gears, sprockets, pinch points, and points of operation to prevent physical contact?
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Hoses, extension cords, utility lights, tools, and other equipment not being used stored at assigned areas to help prevent trip hazards?
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Are all hand tools and equipment maintained in a good condition and free of any defects?
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Are all power tools and equipment maintained in a good condition and free of any defects?
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Are the working rests on abrasive wheel grinders within 1/8-inch of the wheel?
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Are spark shields provided on the bench grinders in place?
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Grinding wheels in good condition free of chips, cracks, grooves, defects, and does not wobble when operated?
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Are all air tools and equipment maintained in a good condition and free of any defects?
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Are lifts, hoists, and jacks clean and in good working condition?
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Lift hoses, connections, controls, lift cylinders, and other components free of any leaks or other defects?
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Lift safety locks engaged and functional?
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Vehicles positioned properly on lifts and jacks?
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Jack safety stands being used when portable jacks are used?
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Wheels chocks placed in front and back of tires when jacks are being used?
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Equipment maintained and serviced according to manufacturers guidelines.
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Are chains, slings, and hooks being inspected by the operator (daily) before use and maintain in operable condition?
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Service pits covered or guarded when not in use?
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No leaks or dripping of combustible or flammable liquids?
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Combustible and flammable liquids used, dispensed, and stored away from ignition sources?
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Flammable and combustibles properly stored in safety cabinets?
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All compressed gas cylinders secured/chained and valves capped?
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Spray room/booth, exhaust system duct work, and other equipment clean from accumulation of deposits of combustible materials?
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Are all ladders maintained in good condition, joints between steps and side rails tight, and all hardware and fittings securely attached and moveable parts operating freely without binding or undue play?
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Are ladder rungs, steps, and side rails free from oil, grease, and other foreign materials?
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Exterior area free of any slip, trip and fall hazards?
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Dumpster area clean and free of any slip hazards such as oil spills?
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Seatbelts worn all times when driving?
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Shop employees are not wearing any rings, jewelry, watches, or torn or loose clothing?
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Employees with long hair contained under a hat or hair net?
Sign Off
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Name and Signature