Laboratory Safety Protocol Inspection Form
Complete this form to assess compliance with laboratory safety protocols and identify areas for improvement.
Inspector Full Name
*
First Name
Last Name
Inspector Email Address
*
example@example.com
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Laboratory Name or ID
*
Laboratory Location
*
Type of Laboratory
*
Please Select
Chemical Laboratory
Biological Laboratory
Physical Laboratory
Engineering Laboratory
Other
Safety Protocol Compliance Checklist
*
Rows
Compliant
Non-Compliant
Not Applicable
Personal Protective Equipment (PPE) usage
1
2
3
Proper chemical storage and labeling
4
5
6
Emergency exits accessible and marked
7
8
9
Fire extinguishers present and inspected
10
11
12
First aid kit available and stocked
13
14
15
Chemical spill kit accessible
16
17
18
Fume hoods operational
19
20
21
Electrical equipment in good condition
22
23
24
Overall Laboratory Safety Rating
*
1
2
3
4
5
Describe any deficiencies or non-compliance observed
Recommended corrective actions
Additional Comments or Observations
Inspector Signature (confirming accuracy of inspection)
*
Submit Inspection
Submit Inspection
Should be Empty: