1. HOUSEKEEPING CHECKLIST
Workplace Inspected By: Inspection Date:
Inspection Item Yes No N/A Action Required By Who By When Completed
Yes/No/Date
Floors
Clean and uncluttered
Free of slip, trip and fall hazards
Aisleways unobstructed
In good repair
Stairways
Clear, with effective emergency lighting
Handrails in good order
Exits
Clearly marked
Locking devices work
Doors open outwards
Is there more than one exit?
Date COMPANY NAME Reference No
Sept 07 Housekeeping Checklist 20.4
Page Authorised by Version 1.0 Revision Date
Page 1 of 6 Sept 09

2. Page 1 of 6
HOUSEKEEPING CHECKLIST
Page 2 of 6
Date COMPANY NAME Reference No
Sept 07 Housekeeping Checklist 20.4
Page Authorised by Version 1.0 Revision Date
Page 2 of 6 Sept 09

3. HOUSEKEEPING CHECKLIST
Page 3 of 6
Workplace Inspected By: Inspection Date:
Inspection Item Yes No N/A Action Required By Who By When Completed
Yes/No/Date
Waste Disposal
Materials
Rubbish checked
Shelving bins in place, used and cleared
regularly
Signs/labels legible and in place
Clear instructions posted for toxic waste
disposal
Properly stored and/or stacked
Personal Protective Equipment
Stools/ladders In good order
Walkways identifiedin good order:
Worn correctly and
Racking
Safety footwear
Hats, hair restriction
Stable and in good repair
Hearing forklift operation
Clear forprotection
Safety Aid
First glasses/goggles/face shields
Gloves kit in place and identified
First Aid
Respirators aider identified
Qualified first
Overalls/dust coats
First aid kit well stocked
Date COMPANY NAME Reference No
Sept 07 Housekeeping Checklist 20.4
Page Authorised by Version 1.0 Revision Date
Page 3 of 6 Sept 09

4. HOUSEKEEPING CHECKLIST
Page 4 of 6
Workplace Inspected By: Inspection Date:
Inspection Item Yes No N/A Action Required By Who By When Completed
Yes/No/Date
Electrics
Panels identified and accessible
Plugs, connectors and leads in good order
Lockout tags in use
Cords, plugs and equipment are maintained
and tested regularly
Fire Protection
Portable extinguishers appropriate
People are trained to use equipment
Manual call points identified, unobstructed and
in good condition
Fire warden identified
Equipment is regularly checked
Fire procedure notices in place
Date COMPANY NAME Reference No
Sept 07 Housekeeping Checklist 20.4
Page Authorised by Version 1.0 Revision Date
Page 4 of 6 Sept 09

5. HOUSEKEEPING CHECKLIST
Page 5 of 6
Workplace Inspected By: Inspection Date:
Inspection Item Yes No N/A Action Required By Who By When Completed
Yes/No/Date
Extraction
Dust/fume units operational
Vents clean and unobstructed
Dust/fume units sufficient
Adequate ventilation
Dangerous Goods
Clearly identified
Labels clear and sufficient
Safety signs (eg No Smoking, PPE) displayed
Fire equipment nearby
Material Safety Data Sheets readily available
Appropriately stored
Date COMPANY NAME Reference No
Sept 07 Housekeeping Checklist 20.4
Page Authorised by Version 1.0 Revision Date
Page 5 of 6 Sept 09

6. HOUSEKEEPING CHECKLIST
Page 6 of 6
Workplace Inspected By: Inspection Date:
Inspection Item Yes No N/A Action Required By Who By When Completed
Yes/No/Date
Vehicles
Forklifts in good order
Operator trained
Maintenance checks undertaken
Licences up to date
Compressed Gases
Shut off valves marked and accessible
Gauges in good order
Cylinders stored upright and secured
Valves and lines labelled
Stored away from heat sources
GENERAL COMMENTS:
Date COMPANY NAME Reference No
Sept 07 Housekeeping Checklist 20.4
Page Authorised by Version 1.0 Revision Date
Page 6 of 6 Sept 09