Machinery Safety Checklist Example
Example document for Machinery Safety Checklist. Use this as a reference when creating your own.
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Document: Machinery Safety Checklist
Example Document
Last updated 7/30/2026
Machinery Safety Checklist
Business Name: Jones Earthworks Pty Ltd Job/Site Location: 45 Smith Road, Logan Date of Inspection: 14/10/2023 Make/Model: Kubota U35-4 Machine ID/Registration: EXC-009
1. Pre-Start Visual Inspection
Condition: Pass
- General condition of machine clean and free of mud/oil build up
- No visible cracks on the chassis or structural components
- Tyres or tracks in good condition with adequate tread
- All safety decals and warning stickers are legible and in place
- No fluid leaks (oil, hydraulic, coolant) visible under the machine
- ROPS (Roll Over Protection Structure) and FOPS (Falling Object Protection Structure) secure and undamaged
2. Operational Safety Features
Condition: Fail
- Emergency stop buttons tested and functional
- All guards (belt, pulley, gear) are securely fitted and in place - Bolt missing on track guard
- Seatbelt / operator restraint system is functional
- Mirrors and lights (head, tail, warning beacons) are clean and working
- Horn and reversing alarm operational
- Brakes tested and effective (service and parking brakes)
- Steering functions correctly without excessive play
3. Controls and Instrumentation
Condition: Pass
- All control levers and pedals return to neutral position
- Dashboard warning lights illuminate on start up
- Hour meter matches maintenance log records
- Hydraulics operate smoothly without unusual noises or drift
- Electrical wiring is secure and insulation is intact
4. Documentation and Logs
Condition: Pass
- Operator manual available on site
- Current maintenance logbook is present and up to date
- Risk assessment for this specific machinery is available
- Plant registration documents are current (if applicable)
5. Comments and Defects
Details of any defects found: Rear track guard on left side has a missing mounting bolt. Guard is loose and could detach during operation.
Action Taken:
- Machine locked out and tagged out (LOTO)
- Supervisor notified immediately
- Defect recorded for repair
- Machine deemed safe to operate with caution
6. Sign Off
I confirm that I have inspected the above machinery and recorded the findings accurately.
Name of Inspector: Mark Smith Signature: M. Smith Date: 14/10/2023
Supervisor Review: Name: Sarah Jones Signature: S. Jones Date: 14/10/2023
Notes
In this example the inspector found a minor defect with a missing bolt. They correctly identified the risk and chose to lock out the machine (LOTO) rather than use it with caution. This strict adherence to safety protocol prevents the guard from falling off and potentially injuring someone or damaging the machine. The supervisor countersigned to confirm they are aware of the issue.
About this Example
Part of the Machinery Safety Checklist document collection
Document Type
Machinery Safety Checklist
A practical tool used to inspect machinery and plant equipment to ensure it meets Australian Work Health and Safety standards and is safe for use.