Title Page

  • Site Name

  • Customer

  • Date

  • Segment

  • Location (Region & Country)
  • Inspector(s)

  • Site Manager

  • Work Area

  • Instructions

    1. Assess the level of compliance for each question with either "High Risk", "Medium Risk", "Low Risk" or "N/A"
    2. Add comments, observations, notes and images by clicking on the paperclip icon
    3. To add corrective actions, click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date
    4. Complete audit by providing digital signature
    5. Share your report by exporting as PDF, Word, Excel or Web Link

1.0 Access / Egress

  • 1.1 Safe, adequately illuminated, access/egress to work areas (including working platforms) and clear of transient materials including trailing cables and hoses?

  • Reason ausit item was not applicable

  • 1.2 Separate pedestrian / vehicle routes wherever possible or adequate segregation observed?

  • 1.3 Floor and wall openings protected with rigid barriers / solid coverings?

  • 1.4 Emergency escape routes and muster point routes provided, clearly identified and free from obstruction?

  • 1.5 Adequate hazard signs and warning devices provided?

2.0 Welfare

  • 2.1 Welfare facilities adequate, easily accessible to all who need to use them and kept clean and tidy?

  • 2.2 Access to a supply of drinking water?

  • 2.3 Facilities for obtaining hot food/ heating food and boiling water?

  • 2.4 Adequate number of toilets, wash basins and showers - soap, gel dispensers and hot water provided?

  • 2.5 Sufficient 'Cool Rooms' or areas to rest when working in elevated temperatures?

3.0 PPE

  • 3.1 Minimum PPE of hard hat, coveralls, safety glasses and safety boots available to and worn by all employees and contractors?

  • 3.2 Is other PPE/ RPE available and used when required task-specific risk assessment?

  • 3.3 Do the gloves observed have the correct mechanical rating for the task?

  • 3.4 Are there sufficient PPE storage and cleaning facilities available and being used correctly?

  • 3.5 Have any issues of PPE compatibility been observed e.g. conflict with other PPE or the wearer?

4.0 Emergency Arrangements

  • 4.1 Is there a site specific Emergency Response Plan (evacuation plan, etc) and is it posted?

  • 4.2 Emergency telephone numbers and Contacts clearly displayed?

  • 4.3 Is there a means of raising the alarm and does it work?

  • 4.4 Person(s) trained in first aid on site and up to date details displayed?

  • 4.5 First aid kit(s) available and other medical supplies including eye wash stations, available, adequate and in date?

5.0 Fire Prevention

  • 5.1 Smoking in designated areas only and other ignition sources prohibited in areas where gases or flammable liquids are stored / used?

  • 5.2 All loose oily rags and combustible waste regularly removed from work area or stored in proper covered containers?

  • 5.3 All fire extinguishers easily accessible, marked for type of fire to be used on and tagged with in date inspection status?

  • 5.4 Flammable liquids and gases, properly segregated?

  • 5.5 Quantity of flammable material on site kept to a minimum and the whereabouts of gas cylinders known?

6.0 Hot Works

  • 6.1 For observed work, is the Hot work Permit accessible to or posted within the work area until all work is completed?

  • 6.2 Spark containment, anti-flash screens, fire blankets, fire extinguishers in place?

  • 6.3 Have combustible materials been removed a minimum of 11m /35 ft away from the working area or suitably covered?

  • 6.4 Is PPE suitable for the task, available and used as required by risk assessment?

  • 6.5 Are the fire alarm points known by those undertaking hot work?

7.0 Electrical Safety

  • 7.1 Cables and leads protected from damage by sheathing, protective enclosures or positioned away from potential sources of damage?

  • 7.2 All portable electric power tools either grounded or double insulated?

  • 7.3 Extension cords and drop lights in good condition (not frayed, broken) and temporary lights equipped with guards to prevent accidental contact with the bulb?

  • 7.4 Frames or cases of all arc welding and cutting machines (except engine-driven machines) grounded / earthed?

  • 7.5 Portable electric lighting used in moist and/or other hazardous locations (e.g. drums, tanks and vessels) is operated at a maximum of 12 volts?

8.0 Industrial Hygiene

  • 8.1 Is worker exposure to chemicals including dust/contamination and welding fumes controlled?

  • 8.2 Unless confirmed an asbestos free worksite, is the location of all known or potential asbestos materials defined and controls in place to avoid disturbance and exposure?

  • 8.3 Is hearing protection available and being used in high noise areas, (>85dB), including during powered tool use?

  • 8.4 Are powered tools controlled to minimise worker hand/arm vibration exposure, with tools in good condition and tagged for vibration level and permitted usage time?

  • 8.5 Are  lifting aid/tools used during manual handling activities to minimise worker injury?

9.0 Environment

  • 9.1 No oil/fuel/chemical spillages, correctly stored, bunded labelled?

  • 9.2 Mobile plant - drip trays / secondary containment fitted and clean?

  • 9.3 Spill Kits available, in correct locations, and sealed ready for use?

  • 9.4 No unprotected storm water drains or uncovered soft ground close to work involving chemicals / oil / fuel?

  • 9.5 Waste stored in correct containers, labelled and segregated according to customer / legal requirements?

10.0 Plant and Equipment

  • 10.1 Equipment, plant and machinery are safe, maintained, in good condition and appropriately guarded?

  • 10.2 Are crane inspections completed, daily, monthly, annual?

  • 10.3 Pneumatic / hydraulic tools and hoses in good condition and whip-checks in place?

  • 10.4 Inspections conducted on aerial platforms and forklift trucks recorded and up to date?

  • 10.5 Equipment operators not wearing loose clothing, gloves, jewellery or long hair near machines or rotating equipment?

11.0 Lifting Operations

  • 11.1 Lift Plans and / or Risk Assessments prepared, approved and communicated before operations start?

  • 11.2 Load to be lifted verified to be within lifting capacity of lifting equipment and accessories?

  • 11.3 All lifting equipment and accessories has a valid manufacturer’s certificate or verifiable examination records?

  • 11.4 All persons maintain a safe distance from the load and potential crane movements; no-one is under a suspended load or between a suspended load and fixed objects?

  • 11.5 Suspended loads never left unattended?

12.0 LOTO

  • 12.1 Equipment Specific LOTO procedures or equivalent in available and implemented for all LOTO undertaken?

  • 12.2 Only competent Affected and Authorized Individuals performing LOTO?

  • 12.3 For Group LOTO, an authorized LOTO Supervisor has been appointed and appointment communicated (email, team or tool box meetings, etc.)?

  • 12.4 Each Authorized Individual controls their on LOTO - One Lock, One Key, One Person?

  • 12.5 Each Authorized Individual, either personally or by following alternative documented arrangements , verifies absence of energy?

13.0 Work at Height

  • 13.1 Only qualified scaffolders design, erect, commission, modify, repair, inspect and dismantle scaffolding?

  • 13.2 Scaffold inspection status identified (using a Scaff Tag or similar) at each scaffold entry point?

  • 13.3 All persons working at height use a full body harness that is always attached to a secure designated anchor point by a lifeline?

  • 13.4 Site specific Emergency Response/Suspension Rescue Plan in place and communicated?

  • 13.5 Measures developed and implemented to manage the risk of injury from falling objects?

14.0 Confined Space Entry

  • 14.1 Documented Risk Assessment performed (for each confined space) and verification that the required controls/defences are in place before an “Entry Permit” is issued?

  • 14.2 Rescue plan in place and arrangements validated (including 4-minute response time for serious hazards) by simulation of otherwise?

  • 14.3 Only trained and authorized employees and contractors permitted to serve as entrants and attendants for permit space entry?

  • 14.4 Observed confined spaces identified and clearly signed posted as a confined space and access forbidden and prevented to unauthorized personnel?

  • 14.5 An authorized attendant(s) positioned at the confined space entrance at all times during the work?

15.0 Additional Site Specific Questions

Inspection Completion

  • Are there additional site specific questions that you would like to add?

  • Click "Add Question" to enter more questions to the inspection

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  • Level of Compliance

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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.