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Hydraulics Lab Safety Sign Off Sheet E1-15

Course/Section: Student Name:____________________________

Semester:_________________ Student ID # _____________________________

Faculty Name:

I have received and understood the Hydraulics Lab Orientation on proper PPE procedures, machine use and emergency
stop locations so I can safely operate in the hydraulics lab. I will abide by all safe practices that I was trained in. Those
practices include:

1. Wearing proper personal protective equipment at ALL times while past the yellow safety line, which includes
safety glasses and safety shoes or any other protective equipment the instructor has mandated.
Initialled: _____________

2. Not smoking, drinking or eating while in the lab and placing all belongings under the table at the beginning of the
lab.
Initialled: _____________

3. Knowing that the E-Stop will remove power (Electrical and Pneumatic) from the individual cell.
Initialled: _______________

4. NOT bypassing any door or emergency stop switches.

Initialled: _______________

5. Cleaning the work area before leaving the lab (including wrapping up all cables/hoses, putting chairs back under
the tables and picking up loose articles). Failure to do so will result in loss of marks and/or removal of lab
privileges.
Initialled: _____________

6. Inspecting all equipment BEFORE use to ensure all tubing/wiring is connected properly.

Initialled: _____________

7. Informing the instructor or lab technician about any equipment failureBEFORE the equipment is used.
Initialled: _____________

8. NOT removing a lock (unless I was the one who installed it). I will abide by the safety lock-out system (the
details of which are located next to the LOCK BOX that is next to the main door)
Initialled: _____________

9. Turning off all power sources (Electrical and Pneumatic) BEFORE leaving the cell.

Initialled: _____________
If there are any concerns or questions about safety issues, please report them to the instructor immediately. Failing to
follow all the safety procedures will result in my suspension from the lab for the remainder of the lab. Continuing to fail
to follow all safety procedures will result in my permanent suspension from the lab.

Signed ______________________________________

Date ______________________________________