Loading Dock Safety Inspection Checklist
Complete this checklist to ensure loading dock safety compliance and document inspection results.
Inspector Name
*
First Name
Last Name
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of Inspection
*
Hour Minutes
AM
PM
AM/PM Option
Dock Location/Number
*
Dock Surface Condition (Free from damage, cracks, or debris?)
*
Pass
Fail
N/A
Dock Leveler/Plate Condition (Operational and undamaged?)
*
Pass
Fail
N/A
Dock Bumpers (Secure and in good condition?)
*
Pass
Fail
N/A
Dock Lights (Functioning and properly positioned?)
*
Pass
Fail
N/A
Vehicle Restraint Devices (Working and used correctly?)
*
Pass
Fail
N/A
Emergency Equipment (Fire extinguisher, first aid kit present and accessible?)
*
Pass
Fail
N/A
Comments or Observations
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: