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SAMPLE

PLANT NAME:_____________________
SAFETY CHECKLIST
AREA NAME:________________
Date: / / Shift: Small Gro! Name:
Che"#e$ %&: De!t': E(i!me)t
%e Safe * Follo+ GRASP a)$ Safet& Lo"#ot Pro"e$re, at all time,'
Che"# the Follo+i)- .K Remar#,
Are Peo!le Safe from Area Ha/ar$,0
1. Walking and working surfaces clean, dry and clear
2. Materials correctly stacked, blocked, and interlocked
3. Hazardous material properly labeled and stored
Are Peo!le Safe from E(i!me)t Ha/ar$,0
1. Cranes, oists!
"correct rigging, limit switces operational, no o#erloading
"emergency stops and operating controls in good condition
"ooks, cains, cables in good condition wit inspection data
"end stops secure
2. $#eread suspended e%uipment!
"secondary restraining de#ices in place
"weels run tigt to rails
"end stops secure
3. Maintenance performed as re%uired
&. Macine guarding ade%uate and in place
'. (arrier and o#eread guarding in place and free from damage
). Macine controls clearly identified and functioning correctly
*. +isconnect switces!
"in good repair
"easily accessible from working le#el
"capable of being locked out
"clearly labeled for lockout
,. -wo"and controls functioning properly
.. /mergency stop de#ices clearly identified and functioning correctly
10. /lectrical panels closed and properly identified
"no e1posed wires
"2unction bo1 and solenoid co#ers in place
Are Peo!le Safe from E)1iro)me)tal Ha/ar$,0
1. 3ir %uality safe for employees
"no symptoms of azardous e1posure
"re%uired #entilation and air %uality control de#ices functioning properly
2. 4e%uired earing protection5noise controls in place
3. 4e%uired personal protecti#e e%uipment pro#ided to
employees and used properly
&. 6igting functioning properly
Mi,"ella)eo,
7now your responsibilities!
7now and follow safe procedures for your 2ob 8rotect yourself, your family and your co"workers troug
3sk %uestions wene#er in doubt good ealt and safety abits
7now and follow all safety guidelines at your location 4eport all azards to your super#isor immediately
Wear re%uired personal protecti#e e%uipment 4eport all in2uries to your super#isor and to medical staff
FORD PRODUCTION SYSTEM
9022.00 4/:;<;$= +3-/! 0&5015.)

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