Industrial Inspection Checklist
Complete this checklist to ensure proper operation and maintenance of the tilt discharge station.
Inspector Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Station Location
*
Safety Equipment Checked
*
Emergency Stop Button
Guarding and Shields
Warning Signs
All Safety Devices Operational
Discharge Valve Status
*
Open
Closed
Malfunctioning
Discharge Chute Condition
*
Lubrication and Maintenance
*
Lubricated Recentl
No Leaks
Calibration Checked
Other
Operational Noise and Vibration
Electrical Connections Status
*
Secure
Loose
Damaged
Requires Repair
Additional Observations or Issues
Submit
Should be Empty: