Facility Dust Hazard Assessment Checklist Form
Use this checklist to assess and document dust hazards within your facility. All items are focused on identifying and mitigating dust-related risks.
1. Are visible dust accumulations present on surfaces?
*
Yes
No
2. Housekeeping procedures for dust removal are in place and followed regularly.
*
Yes
No
Partially
3. Are ignition sources (sparks, open flames, hot surfaces) controlled in dust-prone areas?
*
Yes
No
Not Applicable
4. Select all areas where dust accumulates excessively.
Floors
Overhead beams/rafters
Equipment surfaces
Ductwork/vents
Other
5. Rate the effectiveness of dust ventilation/extraction systems.
1
2
3
4
5
6. Are dust control measures (enclosures, barriers, suppression) implemented?
*
Yes
No
Partially
7. Are warning signs and safety instructions posted in dust hazard areas?
Yes
No
8. Select the types of personal protective equipment (PPE) used for dust protection.
Respirators/masks
Protective eyewear
Coveralls
Gloves
Other
9. Overall risk level for dust hazards in this area:
*
Low
Moderate
High
10. Additional comments or observations
Submit Assessment
Should be Empty: