Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

Office

  • Does this location have a "manned" office?

Safety Plans/Documentation/Emergency Equipment

  • There is a readily available site specific Emergency Action/Response Plan.

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  • Observation

  • Corrected By and Date Corrected:

  • There is a readily available proof of training (sign in sheet, meeting minutes, etc...) regarding the information in the Emergency Action/Response Plan.

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  • Observation

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  • There is random proof of knowledge regarding the information in the Emergency Action/Response Plan.

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  • Observation

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  • The safety board is readily available to all employees and meets company standards for content and compliance.

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  • Observation

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  • The first aid kit and related supplies are readily available to all employees and meets company standards for content and compliance.

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  • Observation

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  • There is a plan in place to ensure all forklift and/or front end loader operators have been adequately trained, evaluated, and certified.

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  • Observation

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  • There is a site specific LOTO program, appropriate equipment, and proof of training/review.

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  • Observation

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  • Fire extinguishers are hung properly, monthly inspections have been documented, and appropriate signage is hung up.

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  • Observation

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  • Electrical breakers are properly labeled and have appropriate clearance.

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  • Observation

  • Corrected By and Date Corrected:

  • Exits and non-exits are labeled properly.

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

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  • Observation

  • Corrected By and Date Corrected:

Maintenance Shop and General Warehouses

  • Does this location have a maintenance shop or general warehouse?

  • Does this facility have used oil or internal use fuel tanks?

Used oil

  • Used oil containment is properly labeled.

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  • Observation

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  • Used oil is stored in proper receptacle.

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  • Observation

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  • Proper disposal information is posted/available.

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  • Observation

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Internal use fuel tanks

  • Tanks are properly labeled.

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  • Observation

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  • Vehicle impact protection is in place.

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  • Observation

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  • Spill kit is fully stocked and accessible.

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  • Observation

  • Corrected By and Date Corrected:

Guarding

  • Does this area have equipment requiring a 6 sided guard?

  • 6 sided guards are in good repair and installed properly.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this area have a bench grinder?

  • Guards on grinder are set properly. 1/4" Tongue and 1/8" Rest

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  • Observation

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  • Does this area have any other machines requiring guards?

  • Guards on other machines are set properly.

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  • Observation

  • Corrected By and Date Corrected:

Signage/Emergency Equipment

  • Fire extinguishers are hung properly, monthly inspections have been documented, and appropriate signage is hung up.

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  • Observation

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  • Are there areas requiring eye protection?

  • Appropriate eye protection warning signs are posted.

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  • Observation

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  • Exits and Non-Exits are properly labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • Proper and adequate eyewash is available.

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  • Observation

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  • Does this area have electrical overhead doors?

  • All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled and have appropriate clearance.

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  • Observation

  • Corrected By and Date Corrected:

  • Combustible materials/trash are in a steel can with lid.

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  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of this area promotes prevention of slips, trips, and falls.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this area have ladders?

  • Ladders are maintained in good condition and properly stored.

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  • Observation

  • Corrected By and Date Corrected:

  • Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Forklift and Front End Loaders

  • Does this location have a forklift or front end loader?

General

  • Horn is in working order.

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  • Observation

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  • Seatbelt is in working order.

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  • Observation

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  • Documented proof of inspection is readily available.

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  • Observation

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Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

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  • Observation

  • Corrected By and Date Corrected:

Liquid Operations

  • Does this location have Liquid Operations?

General

  • Tanks and their contents are properly labeled.

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  • Observation

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  • Does this facility have elevated walkways and/or platforms?

  • Access to elevated walkways, platforms, and tanks is controlled to industry standards.

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  • Observation

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  • Elevated walkways and platforms are constructed to industry standards.

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  • Observation

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  • Adequate measures have been taken to provide site security.

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  • Observation

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  • Containment structures are in good repair and appear to be functioning properly.

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  • Observation

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  • There is a proper and adequate eyewash/safety shower station located on site.

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  • Observation

  • Corrected By and Date Corrected:

Signage

  • Exits and Non-Exits are properly labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • Proper and adequate warning signs have been posted.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this facility have electrical overhead doors?

  • All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)

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  • Observation

  • Corrected By and Date Corrected:

Fire Extinguishers

  • Fire extinguishers are hung properly, monthly inspections have been documented, and appropriate signage is hung up.

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled and have appropriate clearance.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this facility have shelving and storage?

  • Shelving and storage is properly anchored.

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  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of this area promotes prevention of slips, trips, and falls.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this area have equipment requiring a 6 sided guard?

  • 6 sided guards are in good repair and installed properly.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Dry Operations

  • Does this location have Dry Operations?

General

  • The contents of all bins are properly labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this facility have elevated walkways and platforms?

  • Access to elevated walkways and platforms is controlled to industry standards.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Elevated walkways and platforms are constructed to industry standards.

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  • Observation

  • Corrected By and Date Corrected:

  • Adequate measures have been taken to provide site security.

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  • Observation

  • Corrected By and Date Corrected:

Signage

  • Exits and Non-Exits are properly labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • Proper and adequate signage has been posted.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this facility have electrical overhead doors?

  • All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Guarding

  • 6 sided guards are in good repair and have been installed properly.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Fire Extinguishers

  • Fire extinguishers are hung properly, monthly inspections have been documented, and appropriate signage is hung up.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled and have appropriate clearance.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of this area promotes prevention of slips, trips, and falls.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Chemical Warehouse, Seed Storage, Treatment

  • Does this location have a Chemical Warehouse, Seed Storage, Treatment area?

Signage

  • Exits and Non-Exits are properly labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • Proper and adequate warning signs have been posted.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this facility have electrical overhead doors?

  • All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Guarding

  • Does this facility have equipment requiring 6 sided guards?

  • 6 sided guards are in good repair and installed properly.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this facility have other equipment requiring guards?

  • Other guards are complete and installed properly.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Emergency Equipment

  • Fire extinguishers are hung properly, monthly inspections have been documented, and appropriate signage is hung up.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Spill kit is readily available and fully stocked.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The first aid kit and related supplies are readily available to all employees and meets company standards for content and compliance.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Proper eyewash station is available and accessible.

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled and have appropriate clearance.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Does this facility have shelving and storage?

  • Shelving and storage is properly anchored to floor or wall.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of this area promotes prevention of slips, trips, and falls.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Adequate measures have been taken to provide site security.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Grain Elevators

  • Does this location have Grain Operations?

Grain Elevators - Storage (Bins, Silos, Pads); Dryers; Pits; Scales; Legs; Conveyors; Augers

  • Adequate and proper crash protection is installed as necessary.

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  • Observation

  • Corrected By and Date Corrected:

  • Adequate measures have been taken to provide site security.

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  • Observation

  • Corrected By and Date Corrected:

  • All guarding is installed, in good repair, and appears to be appropriately effective.

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  • Observation

  • Corrected By and Date Corrected:

  • Elevated walking/working surfaces are constructed to industry standards.

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  • Observation

  • Corrected By and Date Corrected:

  • Confined spaces and other potentially dangerous environments are marked according to company policy.

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  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of working areas promotes prevention of slips, trips, and falls.

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  • Observation

  • Corrected By and Date Corrected:

  • Energy sources are properly labeled and accounted for during operations as well as shutdown.

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Railway Operations

  • Does this facility have railroad operations?

Railroad Loadout

  • Adequate measures have been taken to provide site security.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • All guarding is installed, intact, and appears to be appropriately effective.

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  • Observation

  • Corrected By and Date Corrected:

  • Elevated walking/working surfaces are constructed to industry standards.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Confined spaces and other potentially dangerous environments are marked according to company policy.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of working areas promotes, prevention of slips, trips, and falls.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Energy sources are properly labeled and accounted for during operations as well as shutdown.

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  • Observation

  • Corrected By and Date Corrected:

  • Visible signage stating the required PPE usage.

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  • Observation

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  • Railcar movers appear to be inspected and maintained in accordance with manufacturer's recommendations

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Bulk Propane Operations

  • Does this location have bulk propane operations?

General

  • Adequate and proper crash protection is installed.

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  • Observation

  • Corrected By and Date Corrected:

  • Adequate measures have been taken to provide site security.

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  • Observation

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  • Tank is properly labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • Emergency shutdowns are properly labeled and in working order.

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  • Observation

  • Corrected By and Date Corrected:

Guarding

  • 6 sided guards are complete and properly installed.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Fire Extinguishers

  • Fire extinguishers are hung properly, monthly inspections have been documented, and appropriate signage is hung up.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Monthly inspections have been properly documented.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled and have appropriate clearance.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of this area promotes prevention of slips, trips, and falls.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Bulk Fuel Operations

  • Does this location have bulk fuel operations?

Emergency Equipment

  • Fire extinguishers are hung properly, monthly inspections have been documented, and appropriate signage is hung up.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Spill kit is readily available and fully stocked.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The first aid kit and related supplies are readily available to all employees and meets company standards for content and compliance.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Proper eyewash station is available and accessible.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

General

  • All tanks are properly and adequately labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • All loadout racks are constructed and maintained to industry standards.

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  • Observation

  • Corrected By and Date Corrected:

  • Adequate measures have been taken to provide site security.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Means of containment are in good repair and appear to be working properly.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Proper and adequate crash protection is installed to industry standards.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Electrical breakers are properly labeled and have appropriate clearance.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of this area promotes prevention of slips, trips, and falls.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Bulk DEF Operations

  • Does this location have bulk DEF operations?

General

  • All tanks are properly and adequately labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • All loadout racks are constructed and maintained to industry standards.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Adequate measures have been taken to provide site security.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Means of containment are in good repair and appear to be working properly.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Proper and adequate crash protection is installed to industry standards.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Ladders and/or stairs are properly maintained.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Racking and shelving are in good repair, with product properly stored.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • The general cleanliness of this area promotes prevention of slips, trips, and falls.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Racking and shelving are in good repair, with product properly stored.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • Proper and adequate crash protection is installed to industry standards.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Emergency Information

Contact Information

  • Emergency contact information sign and postings are up to date.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Other Areas

Other Concerns

    Additional Safety Issues
  • If this box is not checked you have the following additional concerns to address:

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Review and Sign

Review and Sign

  • Erin Byram

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.