Manufacturing / Industrial • Inspections

Completion of Repair/Maintenance

This checklist is to ensure that everything is back as it should upon completion of the machine's Repair or Maintenance. This ensures that machine is safe to use again.

S.R. Smith, LLC

02/28/2025

Completion of Repair/Maintenance

This checklist is to ensure that everything is back as it should upon completion of the machine's Repair or Maintenance. This ensures that machine is safe to use again.

Return the system to normal operation. Tested.

Yes
No
N / A

Verify lubrication and remove any excess oil or grease.

Yes
No
N / A

Ensure all connections are closed and tight.

Yes
No
N / A

Notify Production of completion.

Yes
No
N / A

All tools are cleaned and sanitized, if applicable.

Yes
No
N / A

Re-Install any guards removed and ensure safety devices are in place and operable.

Yes
No
N / A

LOTO Needed?

Yes
No
N / A

if the answer is "oneOf [Yes]"

LO/TO & ELECTRICAL

Authorized electrical safety training is documented

Yes
No
N / A

Energy Isolation Procedure Reviewed

Yes
No
N / A

Shock protection boundaries set

Yes
No
N / A

Arc flash protection boundaries set

Yes
No
N / A

Appropriate PPE established

Yes
No
N / A

Energy sources locked out:

Yes
No
N / A

Barriers in place to prevent unauthorized access

Yes
No
N / A

Stored energy depleted:

Yes
No
N / A

Zero energy confirmed:

Yes
No
N / A

Hot Work Permit Filled?

Yes
No
N / A

if the answer is "oneOf [Yes]"

HOT WORK (cutting, welding, torch, grinding or other process that generates heat or sparks)

Standby Fire Equipment in place

Yes
No
N / A

Combustibles and flammables removed from area (35 ft away):

Yes
No
N / A

Fire watch trained and in place, plus 30 minutes after work is complete

Yes
No
N / A

Surface free from oil, grease and dust

Yes
No
N / A

Regulators, hoses, gauge, torch, cylinders and other equipment in good condition

Yes
No
N / A

Tanks, piping, ducts, dust collectors and other containers are free of combustibles

Yes
No
N / A

Wall and floor openings are covered

Yes
No
N / A

Sprinklers are in service

Yes
No
N / A

Welding & cutting shields in place

Yes
No
N / A

Trained & competent personnel to perform work

Yes
No
N / A

Area is barricaded and signs posted

Yes
No
N / A

Appropriate PPE is assigned and donned

Yes
No
N / A

Area cleaned up

Yes
No
N / A

Work Completed on (Date):

Name of Supervisor Notified that work is complete:

Completion Remarks: Describe the Repair.

Please Sign

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Source: S.R. Smith, LLC (Community Member)