Controlled Access Zone Compliance Checklist Form
Checklist for tracking compliance checks in controlled access zones. Please complete all items accurately for each access event.
Site/Location Name
*
Zone or Access Point Identifier
*
Date of Check
*
-
Month
-
Day
Year
Date
Time of Check
*
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
First Name
Last Name
Reason for Access/Check
*
Please Select
Routine Inspection
Maintenance
Incident Response
Visitor Entry
Other
Access Authorization Status
*
Authorized
Not Authorized
PPE/Required Gear Check
Hard Hat
Safety Vest
Safety Glasses
Hearing Protection
Gloves
Other
Key Card/Badge Status
*
Valid and Present
Missing/Invalid
Door/Gate/Lock Status
*
Secured
Unsecured
Submit Checklist
Should be Empty: