Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Job Site Condition

  • Was the job site evaluated and checked for critical systems in the immediate area? Take site and area photos.

ESH Section

  • Did the technician perform their UTake5?

  • Have hazards been identified and mitigated?<br>

  • Is work area free of slips trips and falls?

  • Are barricades in place with proper signage?

  • Are proper tools available for the task, being used correctly and in good working condition? (ladders, Electrical Cords, Etc.)

  • Are tool carts and work benches neatly originised?

  • Is PPE per SOW/JHA being worn (tyvek, gloves, respirator, fall protection, etc.) and in good working condition?

Lockout /Tagout Procedures

  • Is LOTO required?

  • Has LOTO procedures been reviewed with employees?

  • Are all LOTO isolation points identified?

  • Have the energy dissipation been verified?

  • Have LOTO measures been implemented effectively?

  • Is paper work reviewed and signed by workers before starting the work? (SOW / Daily JHA / LOTO, etc)

Reliability, Manufacturing and Mechanical Systems

  • Do workers understand the job task?

  • Is the work scope described in the work permit consistent with the work being performed in the field?

  • Are work procedures adequate, up to date and allow for safe completion of task?

  • Are EMO's covered with in the work zone?

  • Has the information been properly passed down from the morning work permit meeting?

  • Are spotters being used in congested areas and potential areas of interference been identified and accounted for?

  • Are slip rings being used properly? (Blue & Green)

  • Is 5's being implemented? (before, during and after)

  • Have proper actions been taken to minimize risk to critical tools as shown on the Big Board?

  • Have proper actions been taken to minimize risk to critical tools?

Environmental

  • Are chemical containers properly labeled?

  • Are storm drains protected from potential work run-off?

  • Is potential waste addressed for proper disposal? (recycling bins, waste bins or DSC)

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.