Daily Workshop Audit

• Site and Date

• Prepared by

• Supervisor

CONTRACTORS

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• ARE THERE CONTRACTORS WORKING ONSITE

  Off

  On

• Completing Contractor Audit

  Off

  On

• Correct PPE Worn

  Yes

  No

  N/A

• Photographs

  Media

• STOP Task Issue Correct PPE

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Add drawing

  Drawing

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Is Positive Isolation Being Used

  Yes

  No

  N/A

• Photographs

  Media

• STOP TASK

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Add drawing

  Drawing

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Are Risk Assessments being used

  YES

  NO

  N/A

• Type of Risk Assessments

  Select TAKE 5 JSEA

  • TAKE 5
  • JSEA

• Number of Take 5s

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Are all workers adequately Supervised

  YES

  NO

  N/A

• Add drawing

  Drawing

• Corrective Actions

Workshop

• Completing Workshop Audit

  Off

  On

• Correct PPE Worn

  Yes

  No

  N/A

• STOP Task Issue Correct PPE

• Photographs

  Media

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Are Risk Assessments being used

  YES

  NO

  N/A

• Type of Risk Assessments

  Select TAKE 5 JSEA

  • TAKE 5
  • JSEA

• Number of Take 5s

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Is Positive Isolation Being Used

  Yes

  No

  N/A

• Photographs

  Media

• STOP TASK

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Add drawing

  Drawing

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Signage in Order

  Yes

  No

  N/A

• Photographs

  Media

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• General Housekeeping

  Good

  Poor

• Photographs

  Media

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Parking

  Safe

  At Risk

  N/A

• Photographs

  Media

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Oil Storage Area

  Safe

  At Risk

  N/A

• Photographs

  Media

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Storage Containers

  Good

  Poor

• Photographs

  Media

• Add drawing

  Drawing

• Corrective Actions

• Due Date For Corrective Actions

  Date

• Responsible Person

  Sign

• Comments

  Off

  On

• Add drawing

  Drawing

• Comments

• Any further issues

  YES

  NO

• Add drawing

  Drawing

• Comments

• Add media

  Media

• Person(s) completing audit

Person

• Audit Complete

  Sign