Title Page

  • Company

  • Work Area

  • Date

  • Supervisor/Lead

  • Location

  • Team Member Conducting Audit:

  • Contractor Being Observed:

  • Location:

  • Area Being Observed:

  • Summery of job Task:

Section to Identify that all PPE, Equipment, and conditions are safe:

  • Are eye and or face protection being used?

  • Is appropriate respiratory protection used?

  • Is appropriate hand protection being used?

  • Is appropriate foot protection being used?

  • Is appropriate Hearing protection being used?

  • Are all Employees wearing FRC's?

  • Is fall protection being used?

  • Are H2S monitors or 4 gas monitors being used?

  • Are JSEA's/SOP's available for reference?

  • Are safety meeting/tailgate meetings being held?

  • Is training documentation available?

  • Are required permits available? (LOTO, Hotwork, Hazardous Work Permit, Etc.)

  • Is good housekeeping in place?

  • Have any spills been identified?

  • Are there any slip trip and falls?

  • Are machine guards in place?

  • Are cords/hoses in good condition?

  • are slings/chains/ropes in good condition?

  • Is there an emergency management plan in place?

  • Are lifting devices in good condition?

  • Have tools been inspected and are being used properly?

  • Are fire extinguishers available and inspected?

  • Are bonding cables and grounding equipment in place?

  • Are workers aware of Stop Work Authority?

  • Is a Hazard Communication system in place along with SDS for chemicals on location?

Positive Observations

  • Observation Issues

  • Observation No. 2

  • Observation No. 3

  • Additional comments:

  • Additional Pictures

  • Contractor Signature

  • Observer 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.