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Sample Safety/Health Checklist
February 23, 2009
| DATE OF INSPECTION _______________________ | DATE OF LAST INSPECTION _______________________ |
| PREPARED BY _______________________ | REVIEWED BY _______________________ |
All NO answers require comments and a completion date for corrective action.
| CONDITION AND PROTECTION SATISFACTORY? | YES | NO | COMMENTS |
| TOOLS AND EQUIPMENT | |||
| Tools/equipment inspected regularly to ensure safe operating condition. | |||
| Unsafe/unusable equipment tagged to indicate it must not be used. | |||
| Grinders properly guarded. | |||
| Tools stored properly. | |||
| Employees properly trained in the use of tools and equipment. | |||
| Tools used only for purpose for which they were designed. | |||
| Handles are replaced when they become cracked or broken. | |||
| Air hose connections have positive locking action or securing chain. | |||
| Air hose nozzles proper type. | |||
| Tools disconnected when relieving jams, making repairs, etc. | |||
| You may add items specific to your facility here. | |||
| WORK AREA | |||
| Work areas clean and well organized. | |||
| Isles open and pallets in proper areas. | |||
| Waste, scrap and excess materials removed or placed in proper container. | |||
| Spills and leaks cleaned up when discovered | |||
| Aisleways clearly marked and uncluttered | |||
| Fire extinguishers and electrical boxes unblocked | |||
| Aisles of adequate width | |||
| Lighting sufficient for job functions (no burned out lights) | |||
| Personal property marked and rated for industrial applications | |||
| Fan guards maintained with no opening in excess of 1/4 inch | |||
| Required supplies paced in proper locations and heights to limit stretching, bending, lifting or other physical strains |
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