Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Guard inadequate

    Too small/does not cover moving parts
  • Too small/does not cover moving parts

  • Access port too large
  • Access port too large

  • Too accessible
  • Too accessible

  • Removed/not secured
  • Removed/not secured

  • Guard creates new hazard
  • Guard creates new hazard

Enclosure guard/gate

    Not secure closed and/or locked
  • Not secure closed and/or locked

Guarding by location

    No signage identifying hazard
  • No signage identifying hazard

  • No signage prohibiting access
  • No signage prohibiting access

  • Energy control procedures/written work practices not in place
  • Energy control procedures/written work practices not in place

  • Lock removed/unlocked
  • Lock removed/unlocked

Guarding by distance

    Guard less than 60 inches from moving parts
  • Guard less than 60 inches from moving parts

  • Mesh/holes too large
  • Mesh/holes too large

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.