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Playground General Hazards

2. PLAYGROUND / PARK GENERAL HAZARDS INSPECTION FORM

4. Location*

   1. Aycock
   2. Lions
   3. Oak
   4. Centennial
   5. Market

8. Playground Location

   Describe location of playground at the facility.

9. Surface

10. Age of Intended Users

12. Location of piece

    Describe location of broken piece in detail.

14. Height

18. Are there any sharp points, corners, edges on any component of playground equipment?*

    1. yes
    2. no

    If yes please explain in other comments.

19. Are the wood parts smooth and free of splinters?*

    1. yes
    2. no

    If no please explain in comments.

20. Are all corners (metal and wood) rounded. A minimum curvature of 1/4 inch for corners and edges of suspended assemblies required.*

    1. yes
    2. no

    If no please explain in comments.

22. Do the exit end and sides along slide bed need special attention?*

    1. yes
    2. no

    If yes please explain in comments.

23. Are exposed open ends of all tubing capped or plugged? *

    1. yes
    2. no

    If no please explain in comments.

25. Comments (Explain in detail)

27. Actions Taken

31. Are there any protrusions or projections allowed that are capable of entangling a child's clothing or causing a laceration?*

    1. yes
    2. no

    If yes please explain in comments.

32. Was special attention given to the top of slides to minimize clothing entanglement?*

    1. yes
    2. no

    If no please explain in comments.

33. Were all protrusions tested in accordance with test procedures? (No protrusion should extend beyond the face of the gauge. Inaccessible protrusions exempted)*

    1. yes
    2. no

    If no please explain in comments.

35. Do the bolt ends protrude more than two threads beyond face of the nut? (If so they must be free of burrs and sharp edges)*

    1. yes
    2. no

    If yes please explain in comments.

36. Does any projection increase in size or diameter from initial surface to outer end even though it fits within gauges? Note: A projection that extends upward from a horizontal plane is an entanglement hazard*

    1. yes
    2. no

    If yes please explain in comments.

38. Comments (Explain in detail)

40. Actions Taken

44. Are there any groups of components that form openings that can entrap a child’s head or torso?*

    1. yes
    2. no

    If yes please explain in comments.

45. Is the distance between any interior surface less than 3 1/2 inches or greater than 9 inches? (applies to all openings if it penetrates four inches regardless of their height above the ground, except where the ground serves as the openings lower boundary; Non-rigid openings considered accessible if torso probe penetrates to a depth of four inches with a force of 50 pounds)*

    1. yes
    2. no

    If no please explain in comments.

47. Comments (Explain in detail)

49. Actions Taken

53. Are all angles of a vertex formed by adjacent components no less than 55 degrees, unless the lower leg is horizontal or projects downwards? (Exception can be made if a rigid shield is attached to the vertex between adjacent components and the shield is sized to prevent a 9 inch diameter probe from simultaneously touching components on either side of the vertex)*

    1. yes
    2. no

    If no please explain in comments.

54. Do all accessible completely bounded openings meet requirements for angles?*

    1. yes
    2. no

    If no please explain in comments.

55. Was the ASTM test used for partially bounded openings?*

    1. yes
    2. no

57. Comments (please explain in detail)

59. Actions Taken

63. Are there any accessible pinch, crush or shearing points on the playground equipment? (Consider the likelihood of body part entrapment)*

    1. yes
    2. no

    If yes please explain in comments.

64. Do any openings entrap a 5/8 inch diameter rod? (Opening less than one inch acceptable if probe cannot touch any pinch, crush, or shear point; Exemptions: chain and it's method of attatchment: attatchment area of coil springs to to body and base of rocking equiptment)*

    1. yes
    2. no

    If yes please explain in comments.

66. Comments (Explain in detail)

68. Actions Taken

72. Are all anchoring devices such as footings and horizontal bars at the bottom of flexible climbers, installed below playing surface? *

    1. yes
    2. no

    If no please explain in comments.

73. Was special attention given to environmental obstacles such as rocks, roots and other protrusions in the ground? *

    1. yes
    2. no

74. Are there any support posts for balance beams that pose a tripping hazard?*

    1. yes
    2. no

    If yes please explain in comments.

76. Are retaining walls highly visible with an obvious change of elevation using bright colors?*

    1. yes
    2. no

    If no please explain in comments.

78. Comments (Please explain in detail)

80. Actions Taken

84. Cables, wires, ropes or similar flexible components suspended between play units or from the ground to play unit within 45 degrees of horizontal to be located outside of high traffic areas.

    1. yes
    2. no

    If no please explain in comments.

85. Are suspended members brightly colored to contrast with surrounding equipment? (Suspended members located 7 feet or more above the playground surface are exempt)*

    1. yes
    2. no

    If no please explain in comments.

86. Are all non-rigid components a minimum of one inch at the widest cross section? *

    1. yes
    2. no

    If no please explain in comments.

88. Are all ropes, cables, and chains fixed at both ends unless they are 7 inches or less in length?*

    1. yes
    2. no

    If no please explain in comments.

89. Are there any elements looped on itself creating an inside perimeter greater than 5 inches? (Exeptions:multiple suspended components at two or more locations can be located below 7 feet when they comply with all other requirements and cannot be looped or stretched to contact another suspended element.)*

    1. yes
    2. no

    If yes please explain in comments.

91. Comments (Please explain in detail)

93. Actions Taken

97. Inspection Completed by:*

98. Date:*

99. Time:*

101. Follow Up Inspection

     If a follow up inspection is required, please list date, time and inspector's name here.

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103. 1. Receive an email copy of this form.
104. Email address

     This field is not part of the form submission.

105. Submit

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