Title Page
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Prepared by
Untitled Page
Info:
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Walked With:
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Date:
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Time (Started):
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Time (Finished):
Personal Protective Equipment (Warehouse)
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Hard hats worn and maintained as required
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Hearing protection worn as required
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Gasketed safety glasses worn properly
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Proper foot protection worn for job performed
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Face shields or goggles worn as required
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Cut level '3' resistant gloves being worn as required
Housekeeping
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Emergency Exits are free of obstructions
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Walkways and passageways free of trip hazards
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Equipment property stored
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Scrap material free of protruding nails or other puncture hazards
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Trash receptacles are in good order and not overflowing
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Materials are stored properly
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Overhead doors are tested and safeguards are working properly
Fall Protection
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Guardrails in "crows nest" are in good order
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Fall Protection equipment maintained, inspected and stored properly
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Perimeter guarding present (if required) Guardrails must be able to support 250 lbs
Scaffolds and Ladders
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Scaffold frames are free of rust and other visible defects (bends, cracks, breaks)
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Wood scaffold planks are free of visible defects (dry-rotting, splits, knots, wormholes)
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Scaffold planks show weight capacity
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Scaffold bolt on ladders are free of visible defects (rust, bends, breaks, cracks)
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Broken scaffold frames/parts are tagged and discarded
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Ladders are free of visible defects (bends, breaks, cracks, dried/fraying rope)
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Ladders have stickers showing weight capacity
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Broken/damaged ladders are tagged and removed from service
Tools and Equipment
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Tools are maintained in a safe condition, damaged tools red tagged
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Powder Actuated gun used properly, stored correctly
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Proper tools used for the job performed
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GFCI used with extension cords and corded tools
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GFCI tested and found to be functioning properly
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GFCI used with office heaters
Fork Lifts and Shop Vehicles
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Fork Lift operators have current user lift card issued by the company on person
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Fork Lift is inspected before use
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Controlled Access Zone is established during loading/unloading operations
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Drivers of shop vehicles are properly licensed and insured
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Shop vehicles are inspected before use
Exterior
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Doors are locked and keypads are working properly
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Alarm system is tested and working properly
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Sidewalk in the front of the building is free of broken concrete/trip hazards
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Exterior lights are found to be in good working order
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Employee parking lot is free of broken asphalt/trip hazards
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Automatic gate and sensors are tested and found to be in good working order
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Smokers poles are emptied regularly
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Sidewalks and parking lot are shoveled, plowed and salted to prevent slips and falls
Fire Protection
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All combustible products away from spark producing equipment
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Fire extinguishers properly located and inspected
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Pins in place on fire extinguishers and secured with breakaway tie
ACKNOWLEDGMENT
**SIGNATURES REQUIRED**
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Reviewed By:
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Safety Inspector:
NOTES
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