Title Page
Contact info, inspection start date, policy and procedures.
-
Area or Yard
-
Select all areas that were inspected
-
Date Inspection Started On
-
Inspection started by
-
Were other participants part of the inspection?
Policies, Level 2 procedures and hazard assessments.
Policies
-
All H&S Policies are reviewed and up to date
Hazard Assessments and Level 2 Procedures
-
All Hazard Accessments are completed and up to date.
-
All Level 2 Safe Work Procedures are completed and up to date.
Building and Yard Inspection
-
The items below are what should be looked at during a workplace inspection. If it passes select pass. If it there is an issue select fail and complete the failed sections. If not applicable then select N/A. Additional issues can be added at the end of each section.
1. Bulletin boards and signs
-
Required postings
-
Select all locations that apply.
-
Safety signs
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
2. Building
-
Physical condition
-
Select all locations that apply.
-
Fixtures
-
Select all locations that apply.
-
Guardrails
-
Select all locations that apply.
-
Employee facilities
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
3. Floors and other work surfaces
-
Slip and trip hazards
-
Select all locations that apply.
-
Housekeeping
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
4. Stairways and aisles
-
Slip and trip hazards
-
Select all locations that apply.
-
Lighting
-
Select all locations that apply.
-
Handrails and/or handholds
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
5. Emergency and equipment
-
Emergency evacuation plan
-
Select all locations that apply.
-
Exit location, marking and accessibility
-
Select all locations that apply.
-
Exit and emergency lighting
-
Select all locations that apply.
-
Fire control equipment
-
Select all locations that apply.
-
Emergency showers and eyewash
-
Select all locations that apply.
-
First aid facilities
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
6. Security
-
Entry and exit security
-
Select all locations that apply.
-
Security of restricted areas
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
7. Furniture
-
Chairs
-
Select all locations that apply.
-
Desks, cabinets
-
Select all locations that apply.
-
Other furniture
-
Select all locations that apply.
-
Workstation ergonomics
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
8. Machinery and tools
-
Machine guarding
-
Select all locations that apply.
-
Noise control
-
Select all locations that apply.
-
Lockout procedures
-
Select all locations that apply.
-
Equipment maintenance
-
Select all locations that apply.
-
Condition of tools
-
Select all locations that apply.
-
Warning signs
-
Select all locations that apply.
-
Machine workstation ergonomics
-
Select all locations that apply.
-
Spacing around machinery
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
9. Material handling and storage
-
Material stacking and storage
-
Select all locations that apply.
-
Ergonomics
-
Select all locations that apply.
-
Size and condition of containers
-
Select all locations that apply.
-
Storage shelf/ rack capacity
-
Select all locations that apply.
-
Stepladders or stools
-
Select all locations that apply.
-
Trip hazards and obstructions
-
Select all locations that apply.
-
Material handling equipment
-
Select all locations that apply.
-
Forklifts and lifting device
-
Select all locations that apply.
-
Lifting device capacity posting
-
Select all locations that apply.
-
Battery charging
-
Select all locations that apply.
-
Dock boards and bridge plates
-
Select all locations that apply.
-
Chain hoists, ropes and slings
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
10. Dangerous substances
-
Hazardous products labeling
-
Select all locations that apply.
-
Safety data sheets
-
Select all locations that apply.
-
Chemicals storage
-
Select all locations that apply.
-
Liquid fuels dispensing and handling
-
Select all locations that apply.
-
Hazardous waste identification and storage
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
11. Electrical
-
Fuse / breaker panels
-
Select all locations that apply.
-
Junction boxes
-
Select all locations that apply.
-
Machinery grounding
-
Select all locations that apply.
-
Portable electric hand tools
-
Select all locations that apply.
-
GFCI protection
-
Select all locations that apply.
-
Extension cords
-
Select all locations that apply.
-
Lockout procedures
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
12. Personal protective equipment
-
Condition
-
Select all locations that apply.
-
Use and care
-
Select all locations that apply.
-
Warning signs
-
Select all locations that apply.
13. Vehicles
-
Maintenance
-
Select all locations that apply.
-
First aid kit
-
Select all locations that apply.
-
Emergency equipment
-
Select all locations that apply.
-
Dangerous goods transportation
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
14. Environmental
-
Lighting
-
Select all locations that apply.
-
Ventilation
-
Select all locations that apply.
-
Indoor air quality
-
Select all locations that apply.
-
Additional Issues
-
Select all locations that apply.
Completion and signatures
Completion and Signatures
-
Completion Date and Time
-
Name of person who completed the inspection.
-
Signature or initial of person who completed the inspection.
