Title Page

  • Date and Time

  • Inspected By

  • Location

Self-Safety Inspection Checklist

  • All work areas clean and orderly, including the paint spray booth?

  • Spills promptly cleaned up or contained with non-combustible absorbent materials?

  • Storage neat, stable, and orderly?

  • Bathroom maintained in a clean condition?

  • Floors free of any trip hazards and free of any spills that could cause slips or falls?

  • Portable fire extinguishers accessible, and visible?

  • Respirators maintained in a clean and operable condition. Respirators properly stored when not in use in a sealed container?

  • First aid kits readily accessible and properly stocked?

  • Electrical cords free from damage, properly used, third prong used and grounded?

  • Hoses, extension cords, utility lights, tools, etc not being used stored at assigned areas to help prevent trip hazards?

  • Are all hand and power tools/equipment maintained in a good condition and free of any defects?

  • Are spark shields provided on the bench grinders in place?

  • Grinding wheels in good condition free of chips, cracks, grooves, defects, and does not wobble when operated?

  • Are all air tools and equipment maintained in a good condition and free of any defects?

  • Are lifts, hoists, and jacks clean and in good working condition?

  • Lift safety locks engaged and functional?

  • Are chains, slings, and hooks being inspected by the operator (daily) before use and maintain in operable condition?

  • No leaks or dripping of combustible or flammable liquids?

  • Combustible and flammable liquids used, dispensed, and stored away from ignition sources?

  • All compressed gas cylinders secured/chained and valves capped?

  • Spray room/booth and other equipment clean from accumulation of deposits of combustible materials?

  • Are ladder rungs, steps, and side rails free from oil, grease, and other foreign materials?

  • Exterior area free of any slip, trip and fall hazards?

  • Dumpster area clean to prevent pests?

Sign Off

  • Name and Signature

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