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									                                           SAFETY CHECKLIST
Staff Name :
Date :

Key:
1 = minimal risk    Equipment still works, needs to be monitored.
2 = medium risk     Equipment can be used, but needs to be fixed.
3 = high risk       Equipment out of order, not safe to use.


CARDIO EQUIPMENT
                                           RATING                   PROBLEM
                                            1,2,3
1      Stairmaster Free Runner
2      Stairmaster Stepper
3      Stairmaster Stepper
4      Stairmaster Stepper
5      Stairmaster Stepper
6      Stairmaster Stepper
7      Stairmaster Stepper
8      Stairmaster Free Runner
9      Stairmaster Club Stride
10     Stairmaster Club Stride
11     Stairmaster Club Stride
12     Stairmaster Club Stride
13     Stairmaster Club Stride
14     Stairmaster Treadmill
15     Stairmaster Treadmill
16     Stairmaster Treadmill
17     Stairmaster Treadmill
18     Stairmaster Treadmill
19     Stairmaster Treadmill
20     Stairmaster Treadmill
21     Stairmaster Upright Bike
22     Stairmaster Upright Bike
23     Stairmaster Upright Bike
24     Stairmaster Upright Bike
25     Stairmaster Upright Bike
26     Stairmaster Upright Bike
27     Stairmaster Recumbent Bike
28     Stairmaster Recumbent Bike
29     Stairmaster Recumbent Bike
30     Stairmaster Recumbent Bike


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31   Stairmaster Recumbent Bike
32   Stairmaster Recumbent Bike


Free Weights
                                               RATING             PROBLEM
                                                1,2,3
1    Lat pull down/seated row
2    Lat pull down/seated row
3    Lat pull down/seated row
4    Preacher Curl (Machine)

5    Back extension
6    Abdominal bench
7    Free weight preacher curl
8    A Frame weight tree
9    Barbell rack (10kg -35kg)
10   Barbell Rack (20lb - 105lb)
11   Dumbbell Rack (3-5kg, 30 - 40kg)
12   Dumbbell Rack (7.5-20kg)
13   Dumbbell Rack (1-3kg, 20 -
     27.5kg)
14   Dumbbell Rack (42.5-50kg)

Section 1
                                               RATING             PROBLEM
                                                1,2,3
1    Supported Row
2    Rear Deltoid / Pec
3    Chest Press (seated)
4    Tricep Pushdown

5    Pull Over machine
6    Biceps Nautilus
7    Triceps Nautilus
8    Pec Dec
9    Shoulder Press Machine
10   Deltoid lateral raise
11   Free Floating Pulley
12   Dip Unit
13   Cable Cross Over
14   Multi Hip
15   A Frame weight tree
16   Chest Press (supine)
17   Assitted Chins / Dips
18   Free Floating Pulley
     BENCHES

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1    Flat bench (Silver frame blue upholstery)
2    Flat bench (White frame black upholste)
3    Flat bench (Black frame blue upholstery)
4    Flat bench (Silver frame blue upholstery)
5    Flat bench (White frame black uphols)
6    Fixed 45 bench(blk frame blur uphols)
7    Fixed 90 seat (white frame blue uphols)
8    Adjustable bench (white frame blk up)
9    Adjustable Bench(white frame blue up)
10   Adjustable Bench(white frame blue up)
11   Adjustable Bench(white frame blue up)
12   Adjustable Bench(white frame blue up)
13   Adjustable Bench(white frame blue up)




Section 2
                                                 RATING           PROBLEM
                                                  1,2,3
1    Leg Press
2    Calf Raise (seated)
3    Calf Raise (standing)
4    Glut. Raise
5    Ham Curl
6    Ham Curl
7    Smith Machine
8    Smith Machine
9    Power Board
10   A Frame weight trees
11   A Frame weight trees
12   Bent over row
13   A Frame weight trees
14   Decline bench press
15   Decline bench press
16   A Frame weight trees
17   Leg Extension (Cal Gym)
18   Incline bench press
19   Flat bench press
20   Flat bench press
21   Free weight shoulder press
22   A frame weight tree
23   Hack Squat


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24   Squat Rack with Chin up Bar
25   Power Rack
26   Leg Extension
27   45 Leg Press
28   Ab Curl



CIRCUIT ROOM EQUIPMENT
                                 RATING                           PROBLEM
                                  1,2,3
     Kayak
     Kayak
     Cardio Climber
     Cardio Climber
     Cardio Climber
     Arm Grinder
     Arm Grinder
     Punching Bags – long
     Treadmill
     Treadmill
     Treadmill
     Treadmill
1    Concept Rower
2    Concept Rower
3    Concept Rower
4    Concept Rower
5    Concept rower
6    Concept Rower
     Swiss Balls
     Stretching mats
     Medicine Balls
     Wobble board
     Calf Stretch Box
     4 boxes 1 – Grey
     3 - Red
     Reeok Steps
     A Frame weight tree
     Running board x 2
     Skipping ropes
     Stretching stick
     Leg raise




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Front of Cardio platform
                                 RATING                           PROBLEM
                                  1,2,3
     Stretching Mats
     Swiss balls - small
     Swiss Balls – med
     Swiss Balls – large
     Paper Towels
     Spray bottles
     Hanging Fans
     Fans section 1
     TV
     Scales

Other equipment
                                 RATING                           PROBLEM
                                  1,2,3
     Clock weight room
     Clock circuit room
     Tuner radio
     Mirrors
     Paper Towels
     Spray bottles
     Fans
     Scales
     Torch
     First aid kit




If any equipment is faulty please fill in EQUIPMENT REPLACEMENT FORM.




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