Information

  • Audit Title

  • Completed By

  • Location
  • barrier name/number

  • make/model of operator

  • operator serial number

  • photo of barrier

  • condition of barrier

  • comments

  • access control

  • Tap to enter information
  • other

  • are there photocells?

  • Tap to enter information
  • make & model

  • comments

loop detectors

  • entrance loop

  • safety loop

  • exit loop

  • comments

safety edges

  • edge to barrier

  • comments

acccessories

  • visual warning lamps

  • audible warnings

  • ariel system

  • warnings/ariel comments

safety signs

  • no entry

  • stop

  • sign comments

operator limits

  • opening

  • closing

  • pressure

  • comments

  • opening time

  • pause time

  • closing time

  • time comments

  • manual override

  • override comments

  • barrier balancing

  • balancing comments

stops

  • opening stops

  • closing stops

  • comments

misc.

  • skirt condition

  • skirt comments

  • pogo stick condition

  • pogo stick comments

  • catch post condition

  • catch post condition

  • emergency stop switch

  • emergency stop switch comments

  • RCD supply safety

  • RCD comments

  • electrical enclosure condition

  • enclosure comments

  • general electrical connections condition

  • connections comments

  • oil levels

  • oil level comments

  • condition of arm

  • arm fixings

  • arm comments

  • photo of arm

  • condition of cabinet fixings

  • foundation fixings

  • fixings comments

  • condition of motor fixings

  • motor fixings comments

  • bearings/shaft condition

  • bearings/shaft comments

  • safety enslosure condition

  • safety enclosure comments

  • extra comments

  • pictures

  • drawing (optional)

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.