Title Page

  • Prepared by

Untitled Page

Info:

  • Walked With:

  • Date:

  • Time (Started):

  • Time (Finished):

Personal Protective Equipment (Warehouse)

  • Hard hats worn and maintained as required

  • Hearing protection worn as required

  • Gasketed safety glasses worn properly

  • Proper foot protection worn for job performed

  • Face shields or goggles worn as required

  • Cut level '3' resistant gloves being worn as required

Housekeeping

  • Emergency Exits are free of obstructions

  • Walkways and passageways free of trip hazards

  • Equipment property stored

  • Scrap material free of protruding nails or other puncture hazards

  • Trash receptacles are in good order and not overflowing

  • Materials are stored properly

Fall Protection

  • Guardrails in "crows nest" are in good order

  • Fall Protection equipment maintained, inspected and stored properly

  • Perimeter guarding present (if required) Guardrails must be able to support 250 lbs

Scaffolds and Ladders

  • Scaffold frames are free of rust and other visible defects (bends, cracks, breaks)

  • Wood scaffold planks are free of visible defects (dry-rotting, splits, knots, wormholes)

  • Scaffold planks show weight capacity

  • Scaffold bolt on ladders are free of visible defects (rust, bends, breaks, cracks)

  • Ladders are free of visible defects (bends, breaks, cracks, dried/fraying rope)

  • Ladders have stickers showing weight capacity

Tools and Equipment

  • Tools are maintained in a safe condition, damaged tools red tagged

  • Powder Actuated gun used properly, stored correctly

  • Proper tools used for the job performed

  • GFCI used with extension cords and corded tools

  • GFCI tested and found to be functioning properly

  • GFCI used with office heaters

Fork Lifts and Shop Vehicles

  • Fork Lift operators have current user lift card issued by the company on person

  • Fork Lift is inspected before use

  • Controlled Access Zone is established during loading/unloading operations

  • Drivers of shop vehicles are properly licensed and insured

  • Shop vehicles are inspected before use

Fire Protection

  • All combustible products away from spark producing equipment

  • Fire extinguishers properly located and inspected

  • Pins in place on fire extinguishers and secured with breakaway tie

ACKNOWLEDGMENT

**SIGNATURES REQUIRED**

  • Foreman:

  • Safety Inspector:

NOTES

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