Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Enter inspectors name here

  • I. Accident Reporting

  • First Aid Logs are in use and accurate?

  • If answer was "no" what is the correction date

  • Near misses are reported and on file

  • If answer was "no" what is the correction date

  • Accidents are being reported promptly - no lag time

  • If answer was "no" what is the correction date

  • Property damage is reported promptly and accurately

  • If answer was "no" what is the correction date

  • II. Sprains and Strains

  • Good body mechanics during lifting tasks

  • If answer was "no" what is the correction date

  • Forces to lift, push, carry < 50#

  • If answer was "no" what is the correction date

  • Awkward postures are avoided when possible

  • If answer was "no" what is the correction date

  • III. Material Handling

  • Round stock is racked, banded or chocked

  • If answer was "no" what is the correction date

  • Material is stored flat not Leaning i.e. Pallets

  • If answer was "no" what is the correction date

  • Stacks of material are sturdy without fall hazard

  • If answer was "no" what is the correction date

  • Arms length noted while moving material stacks

  • If answer was "no" what is the correction date

  • Slings are several inches from end of beams

  • If answer was "no" what is the correction date

  • IV. Cranes and Rigging

  • Push buttons labeled

  • If answer was "no" what is the correction date

  • No exposed wires

  • If answer was "no" what is the correction date

  • Safety latches working

  • If answer was "no" what is the correction date

  • Crane hooks inspected, wire rope unfrayed

  • If answer was "no" what is the correction date

  • Cranes in use without shock loading

  • If answer was "no" what is the correction date

  • Material lifted/moved is within load capacity

  • If answer was "no" what is the correction date

  • Crane hooks insulated during welding

  • If answer was "no" what is the correction date

  • Slings, hooks, grabs in safe condition

  • If answer was "no" what is the correction date

  • Hands and body positions are safe during C & R work

  • If answer was "no" what is the correction date

  • Plate clamps are being used correctly

  • If answer was "no" what is the correction date

  • V. Building and Fire Codes

  • Extinguishers, aisles, and exits are clear / unblocked?

  • If answer was "no" what is the correction date

  • Access to circuits, fuse and electrical panels are clear?

  • If answer was "no" what is the correction date

  • Fire extinguishers ready and inspected in past year?

  • If answer was "no" what is the correction date

  • Painting is done 25' away from hot work?

  • If answer was "no" what is the correction date

  • Hot work permit visible in coatings?

  • If answer was "no" what is the correction date

  • VI. Electrical

  • Electrical repair performed by authorized personnel?

  • If answer was "no" what is the correction date

  • No visible or exposed wires?

  • If answer was "no" what is the correction date

  • Extension cords not in use as permanent wiring?

  • If answer was "no" what is the correction date

  • Lock and Tag hardware visible during machine maint.?

  • If answer was "no" what is the correction date

  • Machine & EE flooring is dry during operations?

  • If answer was "no" what is the correction date

  • Are ground prongs intact?

  • If answer was "no" what is the correction date

  • Paint pumps and containers are grounded / bonded?

  • If answer was "no" what is the correction date

  • VII. Chemical Safety

  • Clothing and PPE prevent skin and eye exposure?

  • If answer was "no" what is the correction date

  • Clothing is free from wet chemical saturation?

  • If answer was "no" what is the correction date

  • Safety Data Sheets available and accessible?

  • If answer was "no" what is the correction date

  • Drums and containers contents are labeled?

  • If answer was "no" what is the correction date

  • Labels have been supplied?

  • If answer was "no" what is the correction date

  • Are areas free from fluid spills, hoses, trip hazards?

  • If answer was "no" what is the correction date

  • VIII. PPE / Respirators

  • Respirator barrier and face are free from facial hair?

  • If answer was "no" what is the correction date

  • Employee # on the respirators in the shop?

  • If answer was "no" what is the correction date

  • Cartridges have service date in writing?

  • If answer was "no" what is the correction date

  • Cartridge has < 30 days of service life?

  • If answer was "no" what is the correction date

  • Respirator and cartridge storage is sanitary?

  • If answer was "no" what is the correction date

  • Respirators are stored in a cinched bag on shop floor?

  • If answer was "no" what is the correction date

  • Ear plugs used in designated areas?

  • If answer was "no" what is the correction date

  • IX. Eye Protection

  • Eyewear meets Z87+, Z87-1+, Z87-2+ standard?

  • If answer was "no" what is the correction date

  • Safety glasses worn under weld helmet/face shield?

  • If answer was "no" what is the correction date

  • Double eye protection or goggles while grinding?

  • If answer was "no" what is the correction date

  • Double eye protection or goggles to blowdown? (3 ft Ext)

  • If answer was "no" what is the correction date

  • No readers with clip on side shields?

  • If answer was "no" what is the correction date

  • Goggles in use where required? Strap in place?

  • If answer was "no" what is the correction date

  • X. Fall Protection

  • Ladders free from damage?

  • If answer was "no" what is the correction date

  • Ladders used and stored correctly?

  • If answer was "no" what is the correction date

  • Employees above 4' on steel or platforms are using personal fall arrest protection?

  • If answer was "no" what is the correction date

  • PFAS in use is anchored securely?

  • If answer was "no" what is the correction date

  • SRL in place for falls high work below 20 feet?

  • If answer was "no" what is the correction date

  • XI. Yard and Roadway Safety

  • Shipping in all PPE with Reflective vests on roadways & job sites?

  • If answer was "no" what is the correction date

  • Employees working in Company Yards are wearing hard hats, safety glasses and steel toe boot/shoes? Including left truck drivers?

  • If answer was "no" what is the correction date

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.