Title Page

  • Plant

  • Prepared by

  • Date

  • Location

    1. Answer "Yes", "No", "Not 100%", "N/A" on the questions below.
    2. Add photos and notes by clicking on the paperclip icon
    3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date
    4. Complete audit by providing digital signature
    5. Share your report by exporting as PDF, Word, Excel or Web Link


  • Administrative

• Safety Manual

  • Is the manual complete and updated?

  • Is LO/TO section certified by EHS Manager?

  • Does manual have correlating training documents for:

  • - BBP?

  • -HAZCOM?

  • -LO/TO?

  • -CPR trained First responders/Hep B?

  • -Powered industrial truck training?

  • -Arc flash suit and training?

  • -Are line roll operators certified in writing?

  • -Respiratory program or signed Append. D for Masks?

  • -Heat stress?

  • Does the facility have a safety matrix?

  • Is the matrix utilized effectively?

  • Does the facility have communication centers?

  • Are the centers effective?

  • Has a PPE hazard assessment been conducted in the last year?

  • Does the team have a safety plan to cover goals, incentives theme and banner?

• Hazard Assessment/Recognition Program

  • Does the facility have a hazard assessment inspection program?

  • Are hazards being tracked by department?

  • Are CARs and root cause analysis being completed on hazards?

• OSHA Recordkeeping

  • Are OSHA logs being maintained properly to include the previous five years?

  • Are CARs being conducted on recordable injuries?

  • Is root cause analysis effective?

  • Is the first aid log being properly maintained?

• Safety Committee

  • Is the Safety Committee meeting monthly and are minutes being kept properly?

• Respirable Crystalline Silica

  • Does the facility have a written exposure control plan?

  • Has the facility completed a exposure assessment with air sampling?

  • Are there signs posted in regulated areas?

• Hearing Conservation

  • Are hearing tests conducted annually?

  • Are STS being handled appropriately?

• Facility Safety

  • Are thermographic scans being conducted every two years?

  • Are hoist inspections being conducted annually?

  • Are hoist inspections being conducted daily/monthly?

  • Is the property checklist completed by EHS Manager monthly?

  • Is the plant close up checklist completed daily?

  • Is the AED being maintained properly?

  • Are corrective actions complete from Fortier audits?

  • Are sprinkler drain tests done quarterly an documented?

  • Is sprinkler and alarm system evaluated by third party annually?

  • Are required posting present? (Right to know, Safety Policy, Enviro. Policy, OSHA 300A,Hearing Cons., W/C, Bomb threat)

  • Physical Walk

• Are the following programs in place and effective:

  • Fall Protection?

  • Suspended Loads?

  • Powered Industrial Trucks?

  • Line Roll?

  • Cut resistant gloves?

  • Electrical cords and boxes?

  • Electrical safety inside home?

  • Housekeeping?

  • Fire extinguishers?

  • Floor jacks (Koni or scissor lifts)?

  • Dust control?

  • Flammable storage?

  • Step access to house and tables?

  • Material Handling?

  • Eye Wash stations?

  • No blocked exits or panel boxes?

  • Hitch lock?

  • Machine guarding?


  • Compliance

  • Does team have a storm water plan with up to date training?

  • Are samples up to date?

  • Does the plant have an air permit and in compliance?

  • Are material usages being sent to Strata monthly?

  • Are the usages tracked by physical means (not purchasing)?

ISO Program

  • Does the HBF have an ISO Coordinator?

  • Is the manual being properly maintained?

  • 6.1.2c Aspects reviewed annually and updated every 3 years?

  • Planning - 6.2.2b Correctly filled out and tracking progress?

  • Objective Tracking - Does 6.2.1, 6.2.2a & 9.1.1 all have matching overall objectives?

  • Are all meetings being conducted IAW the program?

  • Have CARs been conducted for all noted deficiencies?

  • Is root cause analysis effective?

  • Is required training conducted? 7.2 a&b

  • Does the team have an effective ISO communication board?

  • Is the ISO program effective and moving towards completing listed goals & objectives?


  • Auditor's Name and Signature

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.