Inspection Checklist Operations


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									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. ________________________________                        _____    _____

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?

© Copyright 2011 Docstoc Inc.                                                                2

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

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 12/05/2011, and a re-inspection will be scheduled for

Inspected by:                                      Approved by:
(Signature)                                        (Signature)

© Copyright 2011 Docstoc Inc.                                                            3

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