Workplace Vibration Inspection Form
Complete this form to document the inspection of vibration conditions, equipment, and worker exposure in the workplace.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Work Area/Location
*
Equipment Inspected
*
Type of Vibration Source
*
Please Select
Hand-held power tool
Stationary machinery
Vehicle-mounted equipment
Other
Measured Vibration Level (m/s²)
*
Duration of Exposure (minutes)
*
Number of Workers Exposed
*
Findings/Observations
*
Recommended Corrective Actions
Submit Inspection
Should be Empty: