Hazardous Material Handling Checklist Form
Please complete this checklist to ensure safe handling of hazardous materials.
Employee Full Name
First Name
Last Name
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Material Type
Please Select
Flammable Liquids
Corrosive Substances
Toxic Chemicals
Compressed Gases
Radioactive Materials
Other
Have you received proper training for handling this material?
Yes
No
Are you wearing the required personal protective equipment (PPE)?
Yes
No
Is the material properly labeled and stored?
Yes
No
Are emergency procedures known and accessible?
Yes
No
Additional comments or concerns
Supervisor Signature
Submit
Should be Empty: