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Appendix F


Sample Pullout/Restraint Inspection Checklist

Each pull-out or restraint device in use must be visually inspected and checked for proper adjustment at the start of each operator shift, following a new die set-up, and when operators are changed. Necessary maintenance, repair, or both shall be performed and completed before the press is operated.

MACHINE NO.__________________________      DEPARTMENT____________________________
OPERATOR ID_________________
DATE____________________  TIME__________________  SHIFT CHANGE___________________
DIE CHANGE___________________________  OPERATOR CHANGE________________________

A SEPARATE PULLOUT/RESTRAINT DEVICE MUST BE PROVIDED FOR EACH OPERATOR IF MORE THAN ONE OPERATOR IS USED ON A PRESS. EACH OPERATOR'S DEVICE MUST BE INSPECTED.

OK NOT OK PART INSPECTED IF NOT OK, CONDITION DATE OF CORRECTION
___ _____ All parts, nuts, bolts etc. secure _______________________________________ _______________
___ _____ Attachments connected to and being operated only by the press slide or upper die _______________________________________ _______________
___ _____ Attachments adjusted to prevent each operator from reaching into the point of operation or to withdraw the operator's hands from the point of operation before the die closes _______________________________________ _______________
___ _____ Horizontal support secure _______________________________________ _______________
___ _____ Vertical support secure _______________________________________ _______________
___ _____ Cables must not be bent, frayed or twisted _______________________________________ _______________
___ _____ Brackets secure and in good condition _______________________________________ _______________
___ _____ Visual inspection of total system _______________________________________ _______________

Signature_____________________________________________________________________________
                                                     (Name and Job Title)
PULL-OUTS APPROVED FOR OPERATION___________________________________________________
RED TAGGED___________________________________________________________________________
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