BASE TEMPLATE

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

PREVIOUS INSPECTION

• Has the past inspection been reviewed

  Yes

  No

  N/A

• Has action to improve safety been set in place since past inspection?

  Yes

  No

  N/A

PERSONAL PROTECTION

• Only trained individuals use machinery?

  Yes

  No

  N/A

• People who use the lab are aware of danger and how to avoid it?

  Yes

  No

  N/A

• Appropriate safety equipment is worn (PPE )?

  Yes

  No

  N/A

• Lockout/Tagout procedures are complete and current?

  Yes

  No

  N/A

• Lab users are familiar with standard operating procedures of the facility?

  Yes

  No

  N/A

• Users are aware of emergency lab evacuation procedures?

  Yes

  No

  N/A

• People who work alone are aware of safety procedures?

  Yes

  No

  N/A

ROOM SAFETY

• Alarm system and controls are operational?

  Yes

  No

  N/A

• Is the area well lit?

  Yes

  No

  N/A

• Is there appropriate ventilation?

  Yes

  No

  N/A

• Shelves and objects stored at height are properly secured?

  Yes

  No

  N/A

• Ceiling tiles and light fixtures are are in good condition?

  Yes

  No

  N/A

• Exits are clear of obstruction & are clearly marked?

  Yes

  No

  N/A

• UNB safety handbook is available?

  Yes

  No

  N/A

• Safety labels are visible and can be clearly understood?

  Yes

  No

  N/A

• All floors are flush and level?

  Yes

  No

  N/A

• Necessary disposal bins are available?

  Yes

  No

  N/A

• Is an eye wash station available?

  Yes

  No

  N/A

• Appropriate cleanup supplies are available and used?

  Yes

  No

  N/A

• Room, counters and tables are clutter free?

  Yes

  No

  N/A

• All apparatus is stored in an orderly fashion?

  Yes

  No

  N/A

• Are first aid supplies available?

  Yes

  No

  N/A

• Fire extinguisher and other fire safety equipment are properly marked, visible, up to date, and correct for flammables present?

  Yes

  No

  N/A

• Gas lines are clearly marked?

  Yes

  No

  N/A

• Is the room capacity known and followed?

  Yes

  No

  N/A

• Gas lines remained closed when not in use and are in good condition?

  Yes

  No

  N/A

• Are safety switches visible and in good working order?

  Yes

  No

  N/A

• Electrical wires are organised and kept off floor?

  Yes

  No

  N/A

• Is electrical equipment marked, grounded, and guarded?

  Yes

  No

  N/A

• Is there a phone available?

  Yes

  No

  N/A

• Other concerns?

Validation

• INSPECTOR'S SIGNATURE:

  Sign

• DATE:

  Date