Name *

First Name

Last Name

Today's Date *

MM

DD

YYYY

Have all of your coworkers been through Rantoul Foods' Safety Training? *

IF NO, INDICATE WHOM NEEDS TRAINING IN NEXT QUESTION

Yes

No

Is all of your equiptment clean and ready to enter the building? *

Yes

No

Have you obtained "pink" tags from Jared Ernst? *

If no, please go get them from his office.

Yes

No

Is all of the product removed from your area of work? *

If no, please call Jared Ernst and stop all work.

Yes

No

Have all of the doors been closed and marked with tape? *

Yes

No

Has all of the equipment been LOTO? *

Yes

No

Has all of the equipment been covered with plastic? *

Yes

No

Has all boxes, vats, plastic bags, etc. been removed from the work area? *

Yes

No