Information
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Conducted on
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Prepared by
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Signed
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Personnel
Mobile Equipment Tow Motor/Pallet Jacks
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Is operator trained and carrying a valid license?
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Is shift tow motor checklist filled out properly?
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Are safety cones/accordian guard used when loading and unloading pallets and racks?
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Does the operator sound horn at all corners and intersections?
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When on, is the forklift attended at all times? Is the operator within in 25 ft of sight at all times?
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Is the load no more than 6 inches above ground at all times?
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Battery charger is off when not in use
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Is there evidence of working and utilizing horn in designated areas?
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Is the operator traveling in reverse when they cannot see over the load?
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Are dock locks and wheel chocks being used for loading and unloading of trucks?
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When using pallet jack, is the person pulling it looking out for pedestrians as they move through the area
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Outside pedestrians observing safe distance of 15 feet from trucks
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Operating equipment safely and maintaining total control over load carrying?
General Safety
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Area is free of all trip/slip hazards?
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Outside pedestrians observing safe distance of 15 feet from trucks
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Exits visible at all times and never blocked
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Employees wearing PPE during purging process
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Fire extinguishers accessible to employees and never blocked
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There are no cords hanging from the ceiling causing a choke hazard or in socket not being used
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Pallets stacked neatly away from high traffic areas. No visible protruding nails
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Spills, drips, and/or leaks identified and cleaned up in a timely manner
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Pedestrians observing stop signs and designated paths
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Employees wearing PPE and GMP dress code
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Are all containers/spray bottles etc labeled according to HAZCOM procedures?
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Employees are properly entering and exiting parking lot
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Pallets are secure and not on their side leaning
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Employees using proper lifting techniques
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Employees follow caution and stop signs
Machine Safety
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Employees understand and follow LOTO procedures (if applicable)
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There is no evidence of temporary fixes like tape and cardboard
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Employee understands and can demonstrate when to use e-stop buttons
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Guarding is present in all required areas (and has not been removed)
Security
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Traffic aisles, emergency exits, and fire doors are clear at all times
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Car tags visible on each car
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Employee clearly understands who is responsible to permit non employees into the building
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Electrical cabinets have a 3 foot clearance
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All doors locked and secure
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Dumpster and gates closed at all times
First Aid Kits and Other Emergencies
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First aid kits are stocked appropriately
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Employees understand where first aid kits are located
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Employees understand where eyewash stations are located
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Eyewash station has been used and not activated
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Employees can articulate where the emergency shelters are located inside the building
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Employees can articulate what to do in the event of a building evacuation
Truck Safety
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Dock locks and wheel chocks being used for loading and unloading of trucks
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Truck checklist is filled out properly
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Outside pedestrians are observing at a safe distance of 15 feet from trucks
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Safety cones/accordian guards used when loading and unloading pallets and from racks
