Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Location

  • Conducted on

  • Prepared by

  • Personnel present/joined

  • Other information/Remarks

Training

  • Do you want to perform the element "TRAINING"?

  • Is training provided for each person newly assigned to a job?

  • Does initial training include a thorough review of hazards and accidents associated with the job?

  • Is adequate instruction in the use of personal protective equipment provided?

  • Is training for the use of emergency equipment provided?

Work Process

  • Do you want to perform the element "WORK PROCESS"?

  • Are hazards signalled by signs and tags?

  • Are the safety data sheets placed in (e)locations accessible to all employees?

  • Are lockout or tagout procedures in place and followed?

  • Is (central) ventilation equipment working effectively?

  • Are fume hoods, weighing cabinets, exhaust arms working effectively and properly used?

  • Are the safety showers and eye wash stations in the proper locations and in good working condition?

  • Are repetitive motion tasks properly paced and kept to a minimum?

  • Have all trucks, forklifts and other equipment been inspected and maintained?

  • Are work permits provided to external parties and is safety measure implementation regularly checked?

Personal Protective Equipment (PPE)

  • Do you want to perform the element "PERSONAL PROTECTIVE EQUIPMENT

  • Is required equipment indicated, provided, maintained and used?

  • Does equipment meet requirements?

  • Is it reliable?

  • Is personal protection utilized only when it is not reasonably practicable to eliminate or control the hazardous substance or process?

  • Are the areas requiring PPE usage properly identified by warning signs?

Hazardous Substances and Storage

  • Do you want to perform the element "HAZARDOUS SUBSTANCES"?

  • Do colleagues receive general instruction on how to work safely with hazardous substances?

  • Has the safety data sheet (SDS) been reviewed before handling, moving, or storing the product?

  • Are colleagues instructed on containment (safety) measures to be used in different processes/tasks with specific hazardous substances?

  • Are fumehoods, safety cabinets, isolators used in a proper way? Not cluttered, no blocked ventilation, proper maintenance.

  • Are flasks, drums, boxes properly labelled (CLP/GHS labels, content description)

  • Are incompatible chemicals stored in a proper way?

  • Are containers stored in drip trays where necessary?

  • Are containers checked for leaks or damage?

  • Is spill cleanup material immediately available?

  • Is there no long term storage of chemicals in working areas (only what is needed for the process)?

  • Are bonding and grounding connections immediately available for flammable products?

  • Is waste stored and disposed of in a in a safe manner?

  • Is hazardous waste separated in different waste types?

Explosion/Fire Safety

  • Do you want to perform the element "EXPLOSION/FIRE SAFETY"?

  • Is an assessment of explosion risks available?

  • Is equipment with explosion risk properly labelled?

  • Have zones (processes) with explosion risks been indicated?

  • Are rules related to explosion safety (e.g. ATEX equipment only) adhered to?

  • Is grounding regularly checked (preventive maintenance?)

  • Are hot work procedures in place aimed at preventing fire/explosions?

Materials Handling and Storage

  • Do you want to perform the element "MATERIAL HANDLING AND STORAGE"?

  • Is there safe clearance for all equipment through aisles and doors?

  • Is stored material stable and secure?

  • Are storage areas free from tipping hazards?

  • Are only trained operators allowed to operate forklifts?

  • Is charging of electric batteries performed only in designated areas?

  • Are dock boards (bridge plates) used when loading or unloading from dock to truck or dock to rail car?

  • Are necessary warning devices and signs in use for railway sidings?

  • Are specifications posted for maximum loads which are approved for shelving, floors and roofs?

  • Are racks and platforms loaded only within the limits of their capacity?

  • Are chain hoists, ropes and slings adequate for the loads and marked accordingly?

  • Are slings inspected daily before use?

  • Are all new, repaired, or reconditioned alloy steel chain slings proof-tested before use?

  • Are pallets and skids the correct type and inspected?

  • Do personnel use proper lifting techniques?

  • Is the size and condition of containers hazardous to workers?

  • Are elevators, hoists, conveyors, balers, etc., properly used with appropriate signals and directional warning signs?

Warehouse and Shipping

  • Do you want to perform the element "WAREHOUSE AND SHIPPING"?

  • Are dock platforms, bumpers, stairs and steps in good condition?

  • Are light fixtures in good condition?

  • Are all work areas clean and free of debris?

  • Are stored materials properly stacked and spaced?

  • Are tools kept in their proper place?

  • Are there metal containers for oily rags and for rubbish?

  • Are floors free of oil spillage or leakage?

  • Is absorbent available for immediate clean-up of spills and leaks?

  • Are all flammable and combustible products stored appropriately? Is storage requirement analysis available; are special storage units/conditions in place or are (bulk quantities) stored outside the warehouse?

Loading/Unloading Racks

  • Do you want to perform the element "LOADING/UNLOADING RACKS"?

  • Are steps, railings and retractable ramps on raised platforms in good repair?

  • Is piping and in-line equipment in good condition and free of leaks?

  • Are loading arms operating satisfactorily?

  • Do submerged filling two-stage valves operate properly?

  • Are bonding and grounding cables free of breaks or damage?

  • Are connections tight and sound?

  • Is the general condition of wiring and junction boxes, etc. in good condition (visual inspection)?

Electrical

  • Do you want to perform the element "ELECTRICAL"?

  • Do policies/practices with respect to electricity adhere to local legislation (e.g. NEN3140) during operation, use, repair and maintenance?

  • Are all machines properly grounded?

  • Are portable hand tools grounded or double insulated?

  • Are junction boxes closed?

  • Are extension cords out of the aisles where they can be damager by (heavy) traffic?

  • Is permanent wiring used instead of extension cords?

Machine Guards

  • Do you want to perform the element "MACHINE GUARDS"?

  • Are all dangerous machine parts adequately guarded?

  • Do machine guards meet standards?

  • Are lockout procedures followed when performing maintenance with guards removed?

Lighting

  • Do you want to perform the element "LIGHTING"?

  • Is the level of light adequate for safe and comfortable performance of work?

  • Does lighting produce glare on work surfaces, monitors, screens and keyboards?

  • Is emergency lighting adequate and regularly tested?

Tools and Machinery

  • Do you want to perform the element "TOOLS AND MACHINERY"?

  • Are manufacturers' manuals kept for all tools and machinery?

  • Do power tools conform to standards?

  • Are tools properly designed for use by employees?

  • Are defective tools tagged and removed from service as part of a regular maintenance program?

  • Are tools and machinery used so as to avoid electrical hazards?

  • Is proper training given in the safe use of tools and machinery?

Temporary Work Structures

  • Do you want to perform the element "TEMPORARY WORK STRUCTURES"?

  • Are temporary work structures used only when it is not reasonably practicable to use permanent ones?

  • Are excavations properly shored, free of large objects (rocks, etc.) at the edges?

Floor and Wall Openings

  • Do you want to perform the element "FLOOR AND WALL OPENINGS"?

  • Are ladder-ways and door openings guarded by a railing?

  • Do temporary floor openings have standard railings or someone constantly on guard?

Confined Spaces

  • Do you want to perform the element "CONFINED SPACES"?

  • Are the confined space procedures and training available and followed by all involved?

  • Are entry and exit procedures adequate?

  • Are emergency and rescue procedures in place (e.g. trained safety watchers)?

  • Are measuring devices (e.g.O2, CO2, CO) available and has personnel been instructed on their use?

Stairs, Ladders and Platforms

  • Do you want to perform the element "STAIRS, LADDERS AND PLATFORMS"?

  • Are stairs and handrails in good condition?

  • Are ladders free of defects?

  • Are ladders set up properly before use?

  • Are the elevated platforms properly secured and do they have handrails?

  • Are stairs and ladders used in a safe manner (e.g. handrail use, mobile phone use...)

Elevating Devices

  • Do you want to perform the element "ELEVATING DEVICES"?

  • Are elevating devices used only within capacity?

  • Are capacities posted on equipment?

  • Are they regularly inspected, tested and maintained?

  • Are controls of the dead man" type?"

  • Are operators trained?

Sound level/noise

  • Do you want to perform the element " Sound Level/Noise "?

  • Are regular noise surveys conducted?

  • Is hearing protection available and used properly?

Housekeeping

  • Do you want to perform the element "HOUSEKEEPING"?

  • Is the work area clean and orderly?

  • Are floors free from protruding nails, splinters, holes and loose boards?

  • Are aisles and passageways kept clear of obstructions?

  • Are permanent aisles and passageways clearly marked?

  • Are covers or guardrails in place around open pits, tanks and ditches?

Employee Facilities

  • Do you want to perform the element "EMPLOYEE FACILITIES"?

  • Are facilities kept clean and sanitary?

  • Are facilities in good repair?

  • Are cafeteria facilities provided away from toxic chemicals?

  • Are hand washing facilities available?

  • Are measures preventing carry-over of chemicals from workplace to employee facilities in place?

Means of Exit

  • Do you want to perform the element "MEANS OF EXIT"?

  • Are there enough exits to allow prompt escape?

  • Do employees have easy access to exits?

  • Are exits unlocked to allow egress?

  • Are exits clearly marked?

  • Are exits and exit routes equipped with emergency lighting?

Fire Emergency Procedures

  • Do you want to perform the element "FIRE EMERGENCY PROCEDURES"?

  • Is there a clear fire response plan posted for each work area?

  • Do all workers know the plan?

  • Are drills held regularly?

  • Are fire extinguishers chosen for the type of fire most likely in that area?

  • Are there enough extinguishers present to do the job?

  • Are extinguisher locations conspicuously marked?

  • Are extinguishers properly mounted and easily accessible?

  • Are all extinguishers fully charged and operable and properly maintained?

  • Are special purpose extinguishers clearly marked?

Medical and First Aid

  • Do you want to perform the element "MEDICAL AND FIRST AID"?

  • Do all employees know how to get first aid assistance when needed?

  • Do the first-aiders know when and to which hospital or clinic an injured person should be taken?

  • Are there employees trained as first-aid practitioners on each shift worked?

  • Are first-aid supplies replenished as they are used?

  • Are first-aid kits provided and clearly visible?

Environment

  • Do you want to perform the element "ENVIRONMENT"?

  • Are resources available to deal with very hot or very cold conditions (drinking water, lined gloves, insulated boots)?

  • Is the rain/cold weather gear that is provided comfortable, and light enough so as not to constitute a hazard?

  • Are work surfaces and grip surfaces safe when wet?

  • Do workers know the symptoms of heat cramps/heatstroke, or frost bite/hypothermia?

General items/comments

  • Any further comments or recommendations arising from this inspection?

  • Add any additional relevant photos?

  • Have all required corrective actions been added as Actions to this inspection?

  • Please add any corrective actions to the appropriate questions above before completing this report

Signature

  • Inspection completed by:

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