Hip Thrust Machine Checklist
Complete this checklist to ensure the Hip Thrust Machine is safe and ready for use.
Inspector Name
*
First Name
Last Name
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Machine Location or ID
*
Is the machine frame free from visible damage?
*
Yes
No
Needs Attention
Are all moving parts operating smoothly?
*
Yes
No
Needs Lubrication
Is the padding clean and free of tears?
*
Yes
No
Needs Cleaning/Repair
Are safety pins and locks functioning properly?
*
Yes
No
Needs Repair
Are all bolts and fasteners securely tightened?
*
Yes
No
Needs Tightening
Is the area around the machine clear and safe?
*
Yes
No
Additional Comments or Issues Found
Inspector Signature
*
Submit Checklist
Submit Checklist
Should be Empty: