Title Page

  • Name of Location

  • Conducted on

  • Prepared by

  • Location
  • Completed with

General Environment

  • Entrances and walkways are free of obstructions and trip hazards

  • Floor surfaces are flat, even and dry

  • Floor coverings (e.g., carpet, vinyl etc.) are in good condition

  • Stairs, steps and handrails are in good condition

  • Lighting - all areas are adequately lit

  • Ventilation feels adequate (e.g, not stuffy)

  • Indoor temperature are within reasonable limits

  • Furniture is in good condition (offices and work spaces)

  • Storage areas are clean, tidy and uncluttered

  • Toilet and kitchen facilities are accessible and clean

Safety Information

  • Key contact details are displayed and current

  • Statement of Commitment to Safety is displayed

  • Incident response poster is displayed

  • Emergency response poster is displayed

  • iCare -3 Steps to Recovery poster is displayed

  • Site rules are clearly displayed to customers

Emergency Procedures

  • Egress paths are clear of obstructions

  • Fire/exit doors are operational (e.g, open/close freely, not chocked open)

  • Exist signage is illuminated (if installed)

  • Fire stairs are well lit

  • Fire extinguishers, hose reels and blankets are tested 6 monthly

  • Emergency evacuation signage is displayed and in-date (less then 5 years)

  • Current emergency contacts are displayed on posters

  • Fire Indicator panel is free from faults (if installed)

  • Occupant Warning System (OWS) or EWIS system is free from faults (if installed)

First Aid

  • First aid kit is available and stocked with in-date consumables

  • If present, AED is operating with in-date batteries and pads

  • Workers have access to trained first aid

Electrical safety

  • Power outlets (GPOs) and switches are operational and in good condition

  • Power boards are used in preference to double adaptors, and not overloaded

  • Power boards and leads are in good condition

  • Portable plug-in electrical equipment has been tested and tagged (within 12 months)

Personal Protective Equipment (PPE)

  • Workers wear gloves when sorting

  • Workers wear high-visibility clothing when in operational areas

  • Workers wear gloves when unloading collection bins

  • Workers use hearing protection when in operating areas

Pedestrian/ Traffic interaction

  • Traffic flow and parking areas are clearly marked

  • Pedestrian walkways are clearly marked

  • Pedestrian walkways and work areas are separated from mobile plant operating areas (e.g., bollards, signage etc.)

  • Speed limits are clearly marked

Plant and equipment

  • Plant and equipment is checked prior to use

  • Damaged equipment is removed from use immediately - danger tags (out of service) attached pending repair or disposal

  • Plant and equipment is routinely maintained by the supplier or competent person

  • Machine guarding is in place

  • Emergency stops are installed and operational

  • Pre-start checks are carried out and recorded (trucks, forklifts, baling machines, singulators, tail lifts etc.)

Hazardous substances

  • Chemicals are clearly labelled

  • A register is kept of any chemicals stored in quantities greater than household use

  • Safety Data Sheets (SDSs) are available for the chemicals used on site

  • Flammable liquids including hand sanitiser and LPG (forklift gas bottles) are separate from ignition sources

Completion

  • Other issues discussed or observed

  • Overall comments/notes

  • Signature of Inspector

Media section

  • Add media

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.