Site Shutdown Closure Checklist Form
Document and verify all required shutdown closure tasks for your site. Ensure all steps are completed and approved before final closure.
Site Name and Location
*
Shutdown Date
*
-
Month
-
Day
Year
Date
Responsible Party (Name and Role)
*
Closure Status
*
Closed
Partially Closed
Open
Key Shutdown Tasks Completed
*
Machinery and equipment secured
Hazardous materials removed
Site cleaned and cleared
Perimeter locked
Other
Outstanding Issues (if any)
Safety and Security Verification
*
Verified - All secure
Verified - Minor issues
Not verified
Utility and Equipment Status
*
All utilities shut off and equipment de-energized
Partial shutdown
Not shut down
Final Inspection Outcome
*
Pass
Fail
Pending
Closure Approval / Sign-Off (Name and Role)
*
Submit Checklist
Should be Empty: