
| Company | โ |
| Company address | โ |
| Rack Safety Coordinator | โ |
| Telephone | โ |
| Site / branch | โ |
| No. of damaged racks | 0 |
| Next inspection due date | โ |
| Last Annual Rack Safety Inspection date | โ unknown |
| Inspected in last 12 months? | Unknown |
| ARSI conducted by | โ |
| Item | Rating |
|---|---|
| ๐ฉ Baseplate condition | ๐ข GREEN |
| โ Floor anchors / fixings | ๐ข GREEN |
| ๐ Shim plates in place | ๐ข GREEN |
| ๐ก๏ธ Safety protectors condition | ๐ข GREEN |
| ๐๏ธ Uprights โ visible damage | ๐ข GREEN |
| โ Beams โ visible damage | ๐ข GREEN |
| โง Bracing โ visible damage | ๐ข GREEN |
| ๐ญ General rack condition | ๐ข GREEN |
| Reviewer | Name | Signature | Date |
|---|---|---|---|
| Rack Safety Coordinator | โ | 02 Jul 2026 |