Form No.

: IMS-QK-HSE-3-0057-37
Rev.00

Monthly Hand Tools Inspection Checklist

PROJECT:

Contract No.:

Company:

Job No.:

For the Month of

Date of Inspection:

Inspected By:

Additional Comments:

Name and Signature:

Note: This checklist is referenced in procedure number:

IMS-QK-HSE-3-0057

Remarks
Joints ( Rust, Oiled )

Insulations ( No Cracks, Pinholes,

Worn-out )

Sharp Edges ( Kept Sharp, with

Cover, Guards )

Jaws ( Cracks, Rust, No Thread

Loose )

Serial No. /
Identification No.

Head ( Mushroom, Loose, Rust )

User Name

Body ( Rust, Cracks, Loose )

Item
No.

Handle ( Cracks, Splinters, Rust )

Inspection item