Information
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Element 1: Premises and Housekeeping
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Building and floors clean and in good condition
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Eating and drinking prohibitions adhered too
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Workplace tidy and clear of superfluous material
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Good stacking and storage practices
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Demarcation visible and complied with
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Lighting level sufficient - no lights out and windows clean
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Sufficient ventilation, fresh air, air movement
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Pollution of ground, air and water prevented
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Sufficient waste bins provided and frequently emptied
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Spill kits available and complete with content and signage
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Sanitation, plant hygiene and personal hygiene
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Inside plant : free of rodents and birds, free of droppings
Element 2: Mechanical, Electrical and Personal Safeguarding
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Office equipment in good condition
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Portable electrical equipment stored securely and in good standing
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Machine guard/covers in place
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Adequate signage and in good condition
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Ladders in good condition and correctly stored
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Lifting gear inspected
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Forklifts in good condition and daily checks conducted
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Workers following safe work procedures while using equipment (lifts, Forklifts...)
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Power tools and equipment used safely. Right tool for the job
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All workers following safe work practices
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Hand tools in good condition and inspected
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Safety belt/harnesses in good condition and inspected
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Compliance to PPE
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Electrical panels locked
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Lock-out system
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Portable gas cylinders correctly stored,
Element 3: Management of Fire and Other Emergency Risk
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Fire equipment available, inspected and on register
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Fire equipment signage in place and compliant
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Emergency plan displayed
Element 5: Organizational Management
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Safety, Health and Environmental policies displayed
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First aid box in place, first aider identified and first aid box inspected
Additional Comments
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Is there other concerns
Sign-off of Audit Report
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Date and Time of Audit
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Lead Auditor Signature
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Acceptor: Please rate the quality of the inspection conducted