Magnetic Safety Switch Inspection Checklist Form
Complete this checklist to document the inspection of magnetic safety switches. Ensure all items are reviewed and findings are recorded accurately.
Inspector Name
*
First Name
Last Name
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Switch Location / Identifier
*
Operational Status
*
Operational
Non-Operational
Requires Further Testing
Physical Condition
*
Good
Damaged
Signs of Wear
Wiring and Connections Secure
*
Yes
No
Needs Attention
Switch Alignment with Actuator
*
Aligned
Misaligned
Tamper Resistance Intact
*
Yes
No
Test Results (Functionality Test)
*
Pass
Fail
Not Tested
Additional Comments / Findings
Submit Inspection
Should be Empty: