Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Safety Inspection Report
Inspect and assess safety conditions of the workplace (Monthly Per Yard )
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Location
*
Joe's Yard
Retail Yard
Henderson"s
Other:
Required
Name ?
*
Your answer
Did you check the safety box for paper reports?
*
Yes
No
All OSHA & Workman's Compensation notices in a visible area?
*
Yes
No
Material Safety Data Sheet readily available
*
Yes
No
Fire Extinguishers charged, signed off and accessible?
Yes
No
Clear selection
First Aid Kits Complete
*
Yes
No
Ladders Stored properly?
Yes
No
Clear selection
Clean drinking water available at all time.
Yes
No
Clear selection
Forklift daily inspection completed?
*
yes
No
Hazardous Substances properly labeled and stored?
*
Yes
No
Eye wash station?
yes
no
Clear selection
Oil rags properly stored in their respective containers?
*
Yes
No
Lids on Irrigation boxes ?
yes
No
Clear selection
All holes (gopher, irrigation etc.) filled or safely taped off and covered?
*
Yes
No
Storage & Equipment neat & orderly?
Choose
Satisfactory
Unsatisfactory
NA
Needs work
Walkways and aisles kept clear ?
Choose
Satisfactory
Unsatisfactory
NA
Needs work
Worksite Clean and orderly ?
Choose
Satisfactory
Unsatisfactory
NA
Needs work
Lighting & Ventilation ?
Choose
Satisfactory
Unsatisfactory
NA
Needs work
Notes
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report