Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Date / Time of Observation

  • Contractor Observed

  • Specific Location

  • Insert column Location, a Picture or Other Comments Here for Clarification

  • Number of Employees Observed

  • Observer

Any Marked "At Risk" Must Include Details and a photo.

  • Face / Eye PPE

  • Foot PPE

  • Hand / Arm PPE

  • Head PPE

  • Hearing PPE

  • Respiratory PPE

  • Fall Protection

  • Mobile Equipment

  • Electrical / GFCI

  • Lockout / Tagout

  • Work Permits

  • Excavations

  • Hot Work

  • Storage Area

  • Manual Lifting

  • Ladders

  • Scaffolds

  • Access

  • Aerial Lifts

  • Barricades / Signs

  • Slips / Trips / Falls

  • Lifting / Rigging

  • Confined Space

  • Equipment / Tools

  • Housekeeping

  • Lighting

  • Chemical

  • Other

  • Name of Auditor and Signature

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.