• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date


  • Head Protection - Hard Hat

  • Eye Protection

  • Hand Protection - Proper Gloves

  • Hearing Protection

  • Foot Protection - Metatarsals if Required

  • Respirator/Supplied Air Hood

  • Arc Flash Gear - Gloves, FR Clothing, Face Shield

  • Welding/Torch Cutting Eye Shade

Manual Lifting

  • Correct Body Position

  • Weight Under 50 lbs for Solo Lift

  • Use Lifting Equipment for Weight Over 50 lbs

Line of Fire

  • Hand/Body Position

  • Overhead Hazards

  • Rotating Equipment

  • Eyes on Path

  • Pinch/Sharp Edges Identified & Protected


  • Trash/Debris

  • Cords/Hoses Orderly

  • Barricades Used

  • Protruding Items

Trip & Fall Protection

  • Trip Hazards

  • Fall Arrest Equipment Used

  • Correct Ladder Use

Tool Use

  • Correct Tool

  • Used Correctly

  • Guards Used

  • Material Secured

  • Damage to Cords or Tool

  • GFCI Used in Wet Conditions

Equipment/Vehicle Use

  • Seat Belt

  • Safe Driving

  • Fortlift Inspected (Driver's Shift)

  • Overhead Crane Inspected (Daily)

  • Backing - Looking/Sounding Horn

Nearby Work

  • Aware of Vehicle Traffic

  • Aware of Work Performed in Vicinity


  • Lockout/Tagout Procedures Followed

  • Confined Space Permit Issued

  • Confined Space Ventilator Used - 15 min Before & During Entry

  • Confined Space Gas Detector Used - Before & During Entry

Ergonomic/Unnatural Body Position

  • Awkward Bending/Leaning/Twisting/Squatting

  • Stays in Same Position for Extended Time

  • Holds Heavy Item/Tool for Longer Than 30 seconds


  • Positive Feedback or Corrective Action

  • Positive Feedback or Corrective Action

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.