Information
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Document No.
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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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Areas Inspected
- Zone 1
- Zone 2
- Zone 3
- Zone 4
- Zone 5
- Zone 6
- Zone 7
- Zone 8
- Zone 9
- Zone 10
- Zone 11
- Zone 12
1. Topics
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1. Are hazard assessments performed and identified protective measures realized? Documented and updated?<br>
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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2. Are work instructions for work safety, environmental protection and emergency response present at the work place? ( Hazards and risks at work, machines, environmental risks, hazardous material, emergency instructions)
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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3. Are work specific trainings conducted including documentation before first start of work and also regularly afterwards? (Emergency behavior)<br>
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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4. Are conditions, function and documentation of safety and environmental relevant machines, equipment, buildings and infrastructural facilities installed as required? ( e.g. lack or defect of emergency stop switch, safety windows, two-handed control device, exhaust system)
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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5. Are safety signs sufficient and legible? (Personal protective equipment, warning signs, information signs, emergency signs, hazardous materials)
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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6. Are inspections of machines, equipment, buildings and infrastructural facilities required by law regularly performed and documented? (e.g. Visual inspections, practical control of protective devices, technical inspections)
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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7. Are the protective devices used by employees and is a manipulation of protective devices prevented? (Manipulation of safety equipment, e.g. Bridging of circuit breakers is strictly prohibited!)
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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8. Is required personal protective clothing/equipment consequently used?<br>
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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9. Is cleanliness and order organized and sustained in the checked areas?
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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10. Are tripping,slipping and falling zones immediately eliminated? Also applied to outdoor areas and outside production areas.
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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11. Are dripping pans of machinery and equipment kept clean and free of liquids?
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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12. Are employees of contractors instructed before start of work and is the proper performance of protective measures checked by the contractor coordinator?
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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13. Are hazardous materials properly used at workplaces and stored? (e.g. Minimum quantities at workplaces, storage in chemical storage rooms or safety cabinets, containers properly labeled, do not use containers for food, avoid unnecessary emissions).
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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14. Are sufficient first aiders present on every shift? Updated list of 1st aiders? <br><br>
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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15. Are emergency exits and escape routes kept free at any time, clear structured and are the emergency exits opened easily at any time?
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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16. Is emergency equipment such as fire extinguishers, first aid equipment sufficiently available, easily visible and at all times kept free?
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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17. Do supervisors make safety controls in their area of responsibility and is it documented?
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
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18. Is a root cause analysis in case of a work accident done, the clauses eliminated and the lessons learned transferee to other areas and/or transferred to a standard?
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Assign responsibility
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Enter corrective action due date
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Status
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Verified by:
Signatures & finalization
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Plant Manager
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Operations Manager
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EHS Representative
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Supervisor
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Enter Name
