Title Page

  • Select manufacturing area:

  • Conducted on

  • Prepared by

  • Document No.

RISK ASSESSMENTS

  • 1. Enter brief description of the task being conducted:

  • 2. Enter the work order number: (Example: 30012345)

  • 3. Enter the operation number:

  • 4. Is the work being performed covered by a risk assessment within the zone?

  • STOP WORK and Contact your Supervisor.
    Enter the Supervisors Name:

  • Enter the risk assessment number: Example TRSA1234

COSHH - CONTROL OF SUBSTANCES HAZARDOUS TO HEALTH

  • 5. Is the operator exposed to substances or at risk of exposure to substances covered by COSHH regulations?

  • Please record the corresponding COSHH assessment number. (Example: HAZ001)

  • STOP WORK and contact your Supervisor.
    Enter name of Supervisor:

  • Are the controls being adhered to?

  • STOP WORK and contact your Supervisor.
    Enter name of Supervisor:

  • Photograph the chemical in use and show suitable control measures.

5S - HOUSEKEEPING

SORT

  • Is all unwanted material removed from the area?

  • Are there clear standards for storage?

  • Is waste disposed of correctly?

SHINE

  • Is the floor clear of debris?

  • Are all tools stored correctly and labelled?

  • Is there a cleaning schedule in place?

STRAIGHTEN

  • Is all material stored correctly?

  • Are all areas clearly identified?

  • Are all tools on shadow boards?

STANDARDISE

  • Are scheduled audits completed?

  • Is the Zone Control carrousel up to date?

  • Are training charts up to date?

SUSTAIN

  • Are all audit actions closed?

  • Are all risk assessments in place?

  • Are all measures up to date?

QUALITY REQUIREMENTS

  • Are all operations signed and up-to-date on the routing?

  • STOP WORK and contact your Supervisor.
    Enter name of Supervisor:

GENERAL NOTES / FINDINGS

  • Add media

AUDITOR DETAILS

  • Select zone number:

  • Enter Auditor Name:

  • Select Auditors Role:

INDEPENDENT REVIEW

  • Enter reviewers name:

  • Select Reviewers role:

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.