Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location


    1. Please answer all questions below.
    2. Add Photos in "Media" and Comments in "Add note..." on each question as needed.
    3. Add a Corrective Measure in "Action" . Provide a description, assign to a member, set priority, and due date.
    4. Complete the audit by providing a digital signature.


  • Are safety glasses with side shields being worn by all employees?

  • Is PPE stored in convenient locations near the hazardous functions in an accessible manner?

  • Are safety toed shoes being worn by all employees on the shop floor?

  • Is hearing protection being worn in all required areas?

  • Are gloves being worn in potential hand injury areas?

  • Are flame resistant coats, chaps, spats and other associated being worn by welders?

  • Is long hair tied back and jewelry removed around rotating equipment?

  • Are protective sleeves being worn in areas prone to forearm, wrist and elbow lacerations?

  • Are face shields being used in conjunction with safety glasses when grinding is being performed?

  • Are source capture arms being used in the weld area?

Additional Details

  • General Comments and Recommendations


  • Completed By:

  • Signature:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.