Safety Checklists

Equipment Safety Inspection Checklist

The purpose of the Inspection Checklist is to document and verify equipment safety and operation. The checklist presented is for demonstration purposes only and should be modified to meet the requirements of a business. If an inspector finds that a piece of equipment is out of compliance, the actions required to resolve the issues should be documented in the recommendations section and signed-off by the appropriate individuals. This form contains standard language commonly use in this type of form, however, this form should be modified to fit the needs of the user. Small businesses can use this form to verify equipment safety.

Inspection Checklist

Equipment: _________________________________

Date: _______________________

Equipment Location: _________________________

Checklist Yes No Action Required

Walking Surfaces

1. Are floors and aisles clear of tripping hazards? __X___ _____

2. Is there adequate drainage to collect liquid __X___ _____ discharge from the equipment?

3. Is non-slip surface coating applied around the Install non-slip coating in _____ __X___ equipment? front of stairway

4. ________________________________ _____ _____

Equipment Guarding

1. Is the equipment securely anchored? __X___ _____

2. Are the rotating parts, pulleys, belts, etc. guarded? __X___ _____

3. ________________________________ _____ _____

Equipment Shutdown

Apply yellow reflective adhesive around the

1. Is the electrical power shutdown clearly marked? _____ __X___ shutdown box and install an Emergency Stop sign

2. Is there an adequate number of properly located __X___ _____ manual reset emergency stops?

3. Have maintenance employees been trained in the equipment-specific shutdown and chemical __X___ _____ handling procedures?

4. ________________________________ _____ _____

Electrical

1. Is all conduit, cable, and wire properly attached? ___X__ _____

2. Is there evidence of fraying electrical cords? _____ __X___

3. Are switches mounted in clean, tightly closed ___X__ _____ metal boxes?

Recommendations:

To prevent the risk of falling, a non-slip coating needs to be installed in front of the equipment stairway.

The electrical power shutdown switch is not clearly marked and could prevent a rapid shutdown of the equipment in the case of an emergency.

These repairs must be complete by __/__/____, and a re-inspection will be scheduled for __/__/____.

Inspected by: Approved by:

(Signature) (Signature)

Download the checklist

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