Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Access and Egress

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low.

  • Hazard Controls

  • Action Priorities

  • Person Responsible

  • Add signature

Warning Devices, Signage, Fences and Barricades

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium , 3 Low

  • Hazard Controls

  • Action Priority

  • Person Responsible

  • Add signature

House Keeping

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Person Responsible

  • Add signature

Hotworks, Screens & Flashback Arrestors

  • Hazard Present

  • Hazard Details

  • Risk Rating

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Penitrations , Covered, Secured, and Identified

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Services overhead and Underground

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Traffic and Vechicles

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

PPE

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Hazardous Substances, Dangerous Goods and Storage

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Confined Spaces

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Excavation and Trenches

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Overhead Works , Exclusion Zones, Signage and Barricades

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Ladders Fit for Purpose and Secure

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Scaffold Handover Certificate and Tag

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Electrical Testing, Tagging and Mechanical Protection

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Plant and Equipment

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Lighting , Task and Emergency

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Ammenities , Fit for Purpose.

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Add signature

Emergency Equipment, First Aid and Fire

  • Alarms Working; Evacuation Plan in Place; Emergency Signage in Place; Fire Fighting System Inspected;

  • Hazard Present

  • Hazard Details

  • Risk Rating 1 High, 2 Medium, 3 Low

  • Hazard Controls

  • Action Priority

  • Persons Responsible

  • Persons Responsible

  • Add signature

Inspected Completed by

  • Add signature

  • Select date

Follow Up Inspection Completed By

  • Add signature

  • Select date

  • Hazard Control Implemented

  • Hazard Control are Effective

  • Rate Control Effectiveness on a Scale From 1 to 10

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.