Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Cubic Farms HQ
  • All workers wearing CSA approved shoes?

  • Lockout devices available for shipper/receivers?

  • Trailer locked out or trailer stand in place while loading/unloading?

  • Glad locks are applied when loading/unloading is be done?

  • No entry of personnel when loading/unloading is carried out?

  • Blind spots and corners have warning signs?

  • The work area is free of tripping hazards such as tools left on the ground, garbage etc.

  • Cleaning tools of production area are present?

  • Floors are not wet or slippery?

  • Doors clear and free of obstruction?

  • Emergency lights functioning and present where required (exits, in-alignment with building codes/regs

  • Fire extinguishers present, marked with signage and clear of obstruction

  • Adequate lighting fully functional?

  • Wires and cables, connections etc. free of damage

  • Electrical panels clear of obstruction (3 feet rule) allowing for easy access

  • Workers do not demonstrate impairment, mentally, physically or emotionally

  • Was supervisor reachable in the area?

  • Work alone plan is in place?

  • MSDS sheets readily available

  • Chemicals stored properly and secured with authorized access only

  • Vehicle pre-use inspections completed by a competent operator

  • Pre-use inspections booklet available and in good condition

  • Vehicles in good working order

  • Horns used to warn traffic areas, blind spots, doors, exits etc.

  • Has there been any recent changes to the processes? i.e. equipment moved or relocated?

  • Any contractors in the area performing work? Are they working safely?

  • Any additional training required for new employees? i.e. forklift, lock-out etc.

  • Any related comments, infractions, non-compliance items can be documented here:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.