Title Page
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Site conducted
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Conducted on
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Prepared by
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Cubic Farms HQ
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All workers wearing CSA approved shoes?
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Lockout devices available for shipper/receivers?
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Trailer locked out or trailer stand in place while loading/unloading?
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Glad locks are applied when loading/unloading is be done?
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No entry of personnel when loading/unloading is carried out?
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Blind spots and corners have warning signs?
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The work area is free of tripping hazards such as tools left on the ground, garbage etc.
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Cleaning tools of production area are present?
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Floors are not wet or slippery?
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Doors clear and free of obstruction?
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Emergency lights functioning and present where required (exits, in-alignment with building codes/regs
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Fire extinguishers present, marked with signage and clear of obstruction
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Adequate lighting fully functional?
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Wires and cables, connections etc. free of damage
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Electrical panels clear of obstruction (3 feet rule) allowing for easy access
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Workers do not demonstrate impairment, mentally, physically or emotionally
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Was supervisor reachable in the area?
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Work alone plan is in place?
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MSDS sheets readily available
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Chemicals stored properly and secured with authorized access only
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Vehicle pre-use inspections completed by a competent operator
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Pre-use inspections booklet available and in good condition
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Vehicles in good working order
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Horns used to warn traffic areas, blind spots, doors, exits etc.
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Has there been any recent changes to the processes? i.e. equipment moved or relocated?
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Any contractors in the area performing work? Are they working safely?
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Any additional training required for new employees? i.e. forklift, lock-out etc.
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Any related comments, infractions, non-compliance items can be documented here: