• Your LBU

  • Location audited / observed

  • LBU audited / observed

  • Date of SOT

  • Manager in charge

  • Notes

Category A: Use of personal protective equipment PPE

  • A1: Are the areas on site where PPE is required properly marked or identified?

  • A2: Is PPE worn and properly used where required?

  • A3: Is required PPE available to all workers?

Category B: Health and Safety risks

  • B1: Are appropriate protections in place against electric power sources?

  • B2: Is there any risk of collision against cars or heavy vehicles?

  • B3: Are cars or heavy vehicles driven in a dangerous way?

  • B4: Is risk of fire present at workplace?

  • B5: Are fire fighting equipment and evacuation routes easily accessible?

  • B6: Are incorrect postures adopted at work?

  • B7: Do workers walk or work under hanging loads?

  • B8: Is there the risk to fall down from unguarded areas?

Category C: Ergonomics and working environment

  • C1: Is manual handling of loads carried out in an appropriate way?

  • C2: Is workplace free from fumes, powder, bad odours?

  • C3: Is the level of noise acceptable in the workplace?

  • C4: Are workers exposed to significant level of vibrations?

Category D: Machinery and tools

  • D1: Are machinery and tools clean?

  • D2: Are fixed guards in place for mechanical transmissions and other dangerous parts?

  • D3: Are emergency stop buttons in place on all moving machinery?

  • D4: Is there the risk of impact, cutting or crushing during work?

  • D5: Are there dangerous pieces of machinery without protection on site ? ( exposed electrical live conductors, hot parts, sharp edges etc.) <br>

  • D6: Are tools in good condition and appropriate for the required tasks?

  • D7: Are warehouse and storing equipment appropriate and marked with safe weight capacity?

Category E: Procedure

  • E1: Do suitable procedures and work instructions exist for high risk tasks?

  • E2: Are procedures known by all workers?

  • E3: Are procedures properly implemented?

  • E4: Are contractors properly supervised and managed?

  • E5: Are 'permit to work' procedures in place where necessary?

Category F: Housekeeping

  • F1: Is workplace well organized, clean and tidy?

  • F2: Are materials properly stored in warehouse or deposit areas?

  • F3: Are walkways and routes free from obstacles?

  • F4: Are chemical substances and dangerous equipment under control?


Safety issues / observations

  • Safety issues raised with observed team / manager


  • Please report observed incident, accident, near miss or hazard via the Zero Harm online reporting portal.

  • Insert signatures of auditors

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.