Information
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Personnel
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Is there adequate lighting in the area?
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Person responsible for repair:
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Completion Date:
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Is there adequate guarding on lights?
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Person responsible for repair:
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Completion Date:
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Emergency lights checked and working properly?
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Person responsible for repair:
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Completion Date:
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Emergency evacuation posted?
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Person responsible for repair:
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Completion Date:
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First aid kits readily available and stocked?
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Person responsible for repair:
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Completion Date:
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Fire extinguishers readily available?
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Person responsible for repair:
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Completion Date:
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Fire extinguishers are in compliance on all inspections?
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Person responsible for repair:
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Completion Date:
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Refrigerator, coffee pot and microwave clean?
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Person responsible for repair:
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Completion Date:
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Housekeeping in workstations is acceptable?
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Person responsible for repair:
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Completion Date:
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Walkways are clear of clutter?
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Person responsible for repair:
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Completion Date:
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Proper storage of materials?
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Person responsible for repair:
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Completion Date:
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Proper trash containers with lids?
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Person responsible for repair:
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Completion Date:
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Ground checks are current?
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Person responsible for repair:
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Completion Date:
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GFCI protection on applicable outlets?
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Person responsible for repair:
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Completion Date:
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All power distribution circuits are properly labeled?
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Person responsible for repair:
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Completion Date:
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Breakers, controls and switches are labeled correctly?
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Person responsible for repair:
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Completion Date:
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Are there any missing knock-outs?
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Person responsible for repair:
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Completion Date:
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Is the work are inspection form completed properly?
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Person responsible for repair:
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Completion Date:
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Is there any debris or spills present?
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Person responsible for repair:
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Completion Date:
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Do all equipment have proper guards installed and provide effective protection?
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Person responsible for repair:
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Completion Date:
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Are eyewash stations in good order and properly inspected?
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Person responsible for repair:
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Completion Date:
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Are all hand tools properly stored?
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Person responsible for repair:
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Completion Date:
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Is the proper PPE readily available and being used?
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Person responsible for repair:
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Completion Date:
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Are all cylinders properly stored and secured?
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Person responsible for repair:
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Completion Date:
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Are valves protected when not in use?
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Person responsible for repair:
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Completion Date:
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Are lines bled of residual pressure?
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Person responsible for repair:
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Completion Date:
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Are power cords in good condition?
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Person responsible for repair:
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Completion Date:
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Is aerosol can management in pale and not heaping?
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Person responsible for repair:
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Completion Date:
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Fixed equipment clean and access is clear?
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Person responsible for repair:
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Completion Date:
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Is the area free of combustibles?
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Person responsible for repair:
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Completion Date:
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Are ladders in good condition and inspected?
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Person responsible for repair:
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Completion Date:
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Doors and windows are in good condition?
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Person responsible for repair:
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Completion Date:
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No leaky sources anywhere?
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Person responsible for repair:
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Completion Date:
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Heating and cooling work properly?
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Person responsible for repair:
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Completion Date:
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Drains are clear?
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Person responsible for repair:
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Completion Date:
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Is garbage management in place?
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Person responsible for repair:
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Completion Date:
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Are parts washers being used properly?
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Person responsible for repair:
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Completion Date:
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Are tanks inspected regularly?
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Person responsible for repair:
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Completion Date:
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Auditor(s) Signature
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Revision 1.0 iCloud posted document is the controlled copy. 07/08/13
