Jennifer Provost

670-FRM-0057 H&S Verification - Rev:2

Consult annex 670-REF-0004 for additional information

Use this Template

Print as PDF

Use this Template

Go digital today!

Convert your paper checklists into digital forms

Scan this QR code to use this paper checklist on your smartphone or tablet or visit https://safetyculture.com/

Title Page

Document No.
Conducted on
Prepared by
Sector audited

General cleanliness

Demonstrate the cleanliness of the area with photos

Observations

Housekeeping
H&S posting
PPE
Machine safety & LOTO
Safety measures
Mobile equipment
Other Observations

Links

H&S inspection checklist - 670-INS-0004
http://dms.gbl/corpo_docs/dms_docs//200-PDF_Versions/670-INS-0004_en.pdf
Evacuation plan - Hawkesbury
http://dms.gbl/corpo_docs/dms_docs/002-Master_Data/670-DRW-0011_all.docx

Jennifer Provost

670-FRM-0057 H&S Verification - Rev:2

Consult annex 670-REF-0004 for additional information

Use this Template

Print as PDF

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.