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Title Page

Client / Site

Conducted on (Date and Time) 

Inspected by

Location 

Aisles

Are aisles marked?

Yes No N/A

Are the width of aisles maintained?

Yes No N/A

Are aisles in good condition?

Yes No N/A
 Are work areas clean?

Yes No N/A

Is housekeeping maintained?

Yes No N/A

Are mats, grating, etc., used where drainage is needed?

Yes No N/A

Are floors kept smooth, clean, and freed of obstruction and slippery substances?

Yes No N/A

Stairs

Are stair railings of standard height? (30”-34” above the surface)

Yes No N/A

Does every stairway have 4 or more treads have a handrail?

Yes No N/A

Are risers uniform in height and conform to proper height?

Yes No N/A

Are standard railings provided on the open side of exposed stairs?

Yes No N/A
 Are railings secured in place?

Yes No N/A

Ladders

Are any fixed ladders being used that require cages or walls?

Yes No N/A

Are ladders used without safety feet?

Yes No N/A

Are ladders free from sharp edges and splinters?

Yes No N/A

Are step ladders in use under 20’ in length?

Yes No N/A

Is scaffolding capable of carrying the intended load safely?

Yes No N/A

Air Emissions

Is carbon monoxide present due to forklifts, heaters, or idling vehicles?

Yes No N/A

Are signs posted warning of its presence?

Yes No N/A
Exits

Are building exits adequate?

Yes No N/A

Are exits properly marked?

Yes No N/A

Any emergency power supply?

Yes No N/A

Does lighting in hallways and exit signs conform to government standards? (20 and 5-
foot candles respectively)

Yes No N/A

Are exits blocked?

Yes No N/A

Work Environment

Are all work areas properly illuminated?

Yes No N/A

Are noise levels within acceptable limits?

Yes No N/A
 Are exhaust stacks and air intakes so located that contaminated air will not be
recirculated within the building?

Yes No N/A

Material Handling

Is there a safe clearance for equipment through aisles and doorways?

Yes No N/A

Are aisleways designated, permanently marked, and kept clear to allow unhindered
passage?

Yes No N/A

Are motorized vehicles and mechanical equipment inspected daily or prior to use?

Yes No N/A

Are vehicles shut off and brakes set prior to loading or unloading?

Yes No N/A

Are containers stored stacked, blocked, and limited in height so they are stable and
secure?

Yes No N/A

Are door boards (bridge plates) used when loading or unloading operations are taking
place between vehicles and docks?

Yes No N/A
 Are trucks and trailers secured from movement during loading and unloading
operations?

Yes No N/A

Fire Protection

Are all fire extinguishers accessible, and their locations clearly designed?

Yes No N/A

Are all fire extinguishers inspected and recharged regularly, and noted on the inspection
tag?

Yes No N/A

Is the emergency number properly displayed?

Yes No N/A

Is there a sufficient quantity of metal containers with self-closing lids for the disposal of
combustible waste, rags, and other flammable material?

Yes No N/A

Is the clearance between automatic sprinkler heads and material 18” for the stack of
material 15 feet or less, and 36” clearance for stacks of material 15 feet or more?

Yes No N/A

Protective Equipment

Are hard hats provided and worn where a danger of falling objects exists?

Yes No N/A
 Are hard hats inspected periodically for damage to the shell and suspension system?

Yes No N/A

Is appropriate foot protection required where there is the risk of foot injuries?

Yes No N/A

Completion

Recommendations

Full Name and Signature of the Inspector 

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solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
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independently determine whether the template is suitable for your circumstances.