Respondent Information

  • Date | Tarikh

  • Area Audited | Lokasi Audit

  • Building | Bangunan

  • Name of Auditor | Nama Juruaudit

  • Name of Auditee | Nama Pekerja yang Diaudit

  • Employee No. | No. Pekerja

Notes / Observations / Evidences / Statements <br>Note: Take photo as evidence.

6.1.2 Environmental Aspect

  • Established and determined for all activities and services (HSE/EASI/0xx) | Dibuat dan dikenalpasti untuk semua aktiviti dan servis (HSE/EASI/0xx)

  • Are the changes including planned or new development and new or modified activities? | Adakah perubahan tersebut termasuk pembangunan yang dirancang atau baru serta aktiviti baru atau yang diubahsuai?

  • Is there any significant impact (R3 & R4) determined in EASI and transfer to risk and opportunity list? | Adakah sebarang impak yang signifikan (R3 & R4) telah ditentukan dalam EASI dan dipindahkan ke senarai risiko dan peluang?

  • Is the EASI include normal, abnormal or emergency situations | Adakah EASI merangkumi situasi normal, tidak normal atau kecemasan?

6.1.3 Compliance obligation (Air, water, land & noise)

  • Are general waste and scheduled waste separated? | Adakah sampah biasa dan buangan terjadual diasingkan?

  • Scheduled wastes generated were segregate and dispose according to scheduled waste code. | Buangan terjadual yang dihasilkan diasingkan dan dilupuskan mengikut kod sisa terjadual.

  • What is type of scheduled waste generated at your workplace? | Apakah buangan terjadual yang dihasilkan di tempat kerja anda?

  • Scheduled waste is labeled with a toxic sticker and information that needs to be recorded on the sticker such as the scheduled waste code and first-generation date. | Buangan terjadual dilabel dengan pelekat toksik serta maklumat yang perlu direkodkan pada pelekat seperti kod sisa terjadual dan tarikh pengeluaran pertama.

  • Is the use of chemicals properly maintained and controlled according to the chemical management procedures? i.e. updated SDS, proper chemical labeling and updated chemical list, etc. | Adakah penggunaan bahan kimia diselenggara dan dikawal dengan secukupnya mengikut prosedur pengurusan bahan kimia? cth, SDS yang dikemas kini, pelabelan bahan kimia yang betul dan senarai bahan kimia yang dikemas kini, dll.

  • If NO, state the issue. | Jika TIDAK, nyatakan isu tersebut.

  • Is that any machine release pollutant to atmosphere (eg: Autoclave, oven, spray booth, etc.) | Adakah terdapat sebarang mesin yang melepaskan bahan pencemar ke atmosfera (contoh: Autoclave, oven, spray booth, dll.)

  • Does the chimney on the above machine have a written declaration from the Department of Environment? | Adakah cerobong pada mesin di atas mempunyai pengisytiharan bertulis daripada Jabatan Alam Sekitar?

  • Is there any water usage in the process or machine? | Adakah terdapat penggunaan air pada proses atau mesin?

  • Is the water discharged into the environment and could it harm the environment? | Adakah air tersebut dibuang ke persekitaran dan boleh membahayakan alam sekitar?

  • Can your work process disturb the environment and the surrounding community? | Adakah proses kerja anda boleh mengganggu alam sekitar dan penduduk di sekeliling?

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

6.2 Environmental Objective

  • Are the employees aware of environmental objectives such as energy and waste reduction activities? | Adakah pekerja tahu objektif alam sekitar seperti aktiviti pengurangan tenaga dan sampah?

  • Do the employees participate in achieving the objective? | Adakah pekerja mengambil bahagian dalam mencapai objektif tersebut?

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

Notes / Observations / Evidences / Statements <br>Note: Take photo as evidence.

7.2 Competency

  • Are the employees handling scheduled waste and chemicals trained and have a valid license? | Adakah pekerja yang menguruskan buangan terjadual dan bahan kimia dilatih dan mempunyai lesen yang sah?

  • If YES, state name, last training and license validity.| Jika YA, nyatakan nama, latihan terakhir, dan tempoh sah lesen.

  • Are the employees operating the forklift trained and have a valid license? | Adakah pekerja yang membawa forklift dilatih dan mempunyai lesen yang sah?

  • If YES, state name, last training and license validity. | Jika YA, nyatakan nama, latihan terakhir, dan tempoh sah lesen.

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

7.3 Awareness

  • Are employees provided with environmental awareness in terms of environmental policy, legal compliance obligations, environmental aspects and impacts, environmental performance, and the consequences of non-compliance? | Adakah pekerja diberi kesedaran alam sekitar dari segi polisi alam sekitar, kewajipan pematuhan undang-undang, aspek dan impak alam sekitar, prestasi alam sekitar dan kesan sekiranya tidak patuh?

  • Are any environmental awareness briefings conducted? | Adakah terdapat sebarang taklimat kesedaran alam sekitar dijalankan?

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

7.4 Communication

  • What communication media (internal / external) are used to convey environmental information? | Apakah media komunikasi (dalaman / luaran) yang digunakan untuk menyampaikan maklumat berkaitan alam sekitar?

  • Is the information provided sufficient and effective? | Adakah maklumat yang disampaikan mencukupi dan berkesan?

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

7.5 Documented Information

  • Are the document and record formats used for the EASI list, monthly chemical spill kit inspection form, HSE policy, and periodic maintenance records up to date? | Adakah format dokumen dan rekod yang digunakan untuk senarai EASI, borang pemeriksaan bulanan kit tumpahan bahan kimia, HSE Polisi, rekod penyelenggaraan berkala adalah terkini?

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

Notes / Observations / Evidences / Statements <br>Note: Take photo as evidence.

8.1 Operational planning and control

  • Is the procedure for operation planning and control was established and maintain? i.e scheduled waste management, chemical management, machine maintenance, etc. | Adakah prosedur perancangan dan kawalan operasi telah ditetapkan dan dikekalkan? cth, pengurusan buangan terjadual, pengurusan bahan kimia, penyelenggaraan mesin dll.

  • How is the implementation of the 5S system at the workplace? | Bagaimanakah perlaksanaan sistem 5S di tempat kerja?

  • If there are any positive finding, please specify. | Sekiranya terdapat sebarang penemuan positif, sila nyatakan.

Waste Management

  • Are general waste and scheduled waste separated? | Adakah buangan biasa dan buangan terjadual diasingkan?

  • What types of scheduled waste are typically generated in your area of work? | Apakah jenis buangan terjadual yang lazimnya dihasilkan di kawasan kerja anda?

  • Are the scheduled wastes generated, separated, labeled, and disposed of according to the scheduled waste disposal procedures? | Adakah buangan terjadual yang dihasilkan, diasingkan, dilabel, dan dilupuskan mengikut prosedur buangan terjadual?

  • If NO, state the issue. | Jika TIDAK, nyatakan isu tersebut.

  • Is there any sustainability or life cycle perspective activity at your workplace?<br>For example: recycling, reducing raw material usage, using more sustainable products, etc. | Adakah terdapat aktiviti kelestarian atau perspektif kitar hayat di tempat kerja anda? Cth, kitar semula, mengurangkan penggunaan bahan mentah, menggunakan produk yang lebih lestari, dll.

  • If YES, state the example. | Jika YA, nyatakan contoh.

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

Chemical Management

  • Is there any evidence of chemical leakage or spillage in the temporary storage? | Adakah terdapat kesan kebocoran atau tumpahan bahan kimia di stor sementara?

  • If YES, state the issue. | Jika YA, nyatakan isu tersebut.

  • Is the use of chemicals properly maintained and controlled according to the chemical management procedures? i.e. updated SDS, proper chemical labeling and updated chemical list, etc. | Adakah penggunaan bahan kimia diselenggara dan dikawal dengan secukupnya mengikut prosedur pengurusan bahan kimia? Cth, SDS yang dikemas kini, pelabelan bahan kimia yang betul dan senarai bahan kimia yang dikemas kini, dll.

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

Air Pollution Control

  • Is that any machine release pollutant to atmosphere? E.g. Autoclave, Oven, Spray Booth, etc.) | Adakah terdapat sebarang mesin yang melepaskan bahan pencemar ke atmosfera? Cth, Autoclave, Oven, Spray Booth, dll.)

  • If YES, state type of machine | Jika YA, nyatakan jenis mesin

  • Is autonomous maintenance and preventive maintenance carried out on the machine? | Adakah penyelenggaraan autonomi dan penyelenggaraan pencegahan dijalankan pada mesin tersebut?

  • If YES, state latest autonomous maintenance and preventive maintenance records.| Jika YA, nyatakan rekod penyelenggaraan autonomi dan penyelenggaraan pencegahan yang terkini.

  • Is there any activity to reduce the release of pollutants into the environment? | Adakah terdapat aktivti untuk mengurangkan pelepasan bahan pencemar ke alam sekitar?

  • If YES, state the example. | Jika YA, nyatakan contoh.

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

8.2 Emergency Preparedness and Response

  • Has your workplace ever conducted a fire drill or chemical spill training? | Adakah tempat kerja anda pernah menjalankan latihan kebakaran atau latihan tumpahan bahan kimia?

  • Has there ever been a chemical spill or leakage, or a fire at your workplace? | Adakah tumpahan atau kebocoran bahan kimia atau kebakaran pernah berlaku di tempat kerja anda?

  • If YES, state the issue. | Jika YA, nyatakan isu tersebut.

  • Is the fire extinguisher available and in a good condition. | Adakah alat pemadam api tersedia dan dalam keadaan baik?

  • If YES, please specify the type of fire extinguisher and its expired date. | Jika YA, sila nyatakan jenis alat pemadam api dan tarikh luputnya.

  • Is the chemical spill kit available and does it contain all the necessary items? | Adakah kit tumpahan bahan kimia tersedia dan mengandungi semua barang yang diperlukan?

  • Is the monthly inspection was conducted and updated in a form provided? | Adakah pemeriksaan bulanan telah dijalankan dan dikemas kini dalam borang yang disediakan?

  • If YES, please provide the date of the last inspection. | Jika YA, sila nyatakan tarikh pemeriksaan terakhir.

  • If there are any issues, please specify. | Jika terdapat sebarang isu, sila nyatakan.

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.