Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • 1- project part of a property transaction? (Due diligence report, QESP issues)

  • 2- changes to the existing building layout? (Sprinkler, emergency lights, signs, evacuation maps, exit routes, aisle/exit width, and emergency procedure issues)

  • 3- hazardous material (e.g., asbestos, PCBs)? (Exposure control issue)

  • 4- facility ventilation? (Comfort and contaminant control issues)

  • 5- installing or moving equipment that can potentially emit chemical vapors, mists or fumes into the indoor air? (employee exposure/exhaust systems issue)

  • 6- installing or moving equipment that potentially emits hazardous materials into the outside air or water (sewer)? (pollution control issue)

  • 7- remediation, environmental monitoring, or treatment system/effort need to be initiated, modified or shut down? (regulatory approval, interim controls issues)

  • 8- project involve cutting, welding, brazing or other hot work? (hot work permit issue)

  • 9- changes to the compressed air system? (pressure control, tripping hazard issues)

  • 10- project involve the use, purchase, or installation of material handling equipment (forklifts, cranes, storage racks, etc.)? (material handling equipment issue)<br>

  • 11- physical (noise, vibration, radiation, etc.), chemical (compressed gas, flammable or toxic) or biological agents be introduced? (Data Sheet (e.g., MSDS) need, exposure control issues)

  • 12- waste be generated during and after this project? (Waste management issue)

  • 13- project involve electrical work or potential exposure to stored energy (pressurized air / water, restrained parts etc.)? (Lockout/tagout procedures, live electrical)

  • 14- project require any permits? (surface sealer, excavation, safe work permit)

  • 15- project involve transportation of any chemicals ?(DOT issue, heat pipes)

  • 16- project involve new or modified equipment with moving parts? (machine guarding)

  • 17- certification required for any new or relocated equipment? (UL, TUV, CE etc.)

  • 18- project involve a confined space (tanks, pits, vats, pipes, etc.) entry concern?

  • 19- employee activities (lifting, hand use, exposure to hot or cold, computer use) or work positions change due to this project? (Ergonomics issue)

  • 20- energy (electricity, gas, propane, oil) and/or water usage and costs increase? (Energy use minimization)<br>

  • 21- contractors (physical work) be used? (Contractor Management Plan issue)<br>

  • 22- project result in changes that will improve our market position or visibility to external customers? (marketing/image issues)

  • 23- Will employee or contractor training programs be impacted? (ESH Training)

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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.