Operational Safety Checklist
Complete this checklist to ensure all operational safety standards are met before starting work or using equipment.
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Inspector's Full Name
*
First Name
Last Name
Inspection Location/Area
*
Equipment or Area Being Inspected
*
Checklist of Operational Safety Items
*
Rows
Compliant
Non-Compliant
Not Applicable
Personal protective equipment worn
1
2
3
Emergency exits accessible
4
5
6
Fire extinguishers present and functional
7
8
9
First aid kit available and stocked
10
11
12
Electrical equipment in safe condition
13
14
15
Walkways clear of obstructions
16
17
18
Hazardous materials properly stored
19
20
21
Warning signs posted and visible
22
23
24
Were any hazards identified during this inspection?
*
Yes
No
If hazards were identified, describe them here
Corrective Actions Taken or Recommended
Overall Safety Rating
*
1
2
3
4
5
Additional Comments or Observations
Inspector's Signature
*
Submit Checklist
Submit Checklist
Should be Empty: