DC Plant Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Guarding Audit

• Audit

Issue

• Description of plant

• Observation or Hazard Type

  Select Gaurding Emergency Stop Pedestrian access Overhead or potential energy Labelling or signage Housekeeping Other

  • Gaurding
  • Emergency Stop
  • Pedestrian access
  • Overhead or potential energy
  • Labelling or signage
  • Housekeeping
  • Other

• Photograph

  Media

• Notes

• Size of opening in guarding

  Select 4 mm or less 5 to 6 mm 7 to 8 mm 8 to 10 mm 11 to 12 mm 12 to 20 mm 21 to 30 mm 31 to 40 mm 40 to 120 mm Larger than 120 mm

  • 4 mm or less
  • 5 to 6 mm
  • 7 to 8 mm
  • 8 to 10 mm
  • 11 to 12 mm
  • 12 to 20 mm
  • 21 to 30 mm
  • 31 to 40 mm
  • 40 to 120 mm
  • Larger than 120 mm

• Opening shape

  Slot

  Square

  Round

• Distance to hazard

• Sketch

  Drawing

Access Audit

Location

• Description of plant or area

• Hazard type

  Select Handrail Step consistency Nosing material Trip Missing toe board or gap in walkway Head clearence Housekeeping Other

  • Handrail
  • Step consistency
  • Nosing material
  • Trip
  • Missing toe board or gap in walkway
  • Head clearence
  • Housekeeping
  • Other

• Photograph of hazard

  Media

• Notes

• Slope of path, stairs or ladder

• Sketch

  Drawing

• Riser / Going Dimension

Step

• Riser / Going

• Yes

  No

  N/A