Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

Office

  • Does this location have a "manned" office?

Safety Plans/Documentation

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

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  • Observation

  • Corrected By and Date Corrected:

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

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  • Observation

  • Corrected By and Date Corrected:

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

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  • Observation

  • Corrected By and Date Corrected:

  • The first aid kit and related supplies is readily available to all employees and appears to meet 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 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

  • Corrected By and Date Corrected:

Fire Extinguishers

  • Fire extinguishers are hung properly.

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  • Observation

  • Corrected By and Date Corrected:

  • Monthly inspections have been properly documented.

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled.

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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:

  • 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:

Shop

  • Does this location have a shop?

  • Does this facility have used oil?

Used Oil

  • Used oil is properly labeled.

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  • Observation

  • Corrected By and Date Corrected:

  • Used oil is stored in proper receptacle.

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  • Observation

  • Corrected By and Date Corrected:

  • Proper disposal information is posted/available.

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  • Observation

  • Corrected By and Date Corrected:

Fire Extinguishers

  • Fire extinguishers are hung properly.

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  • Observation

  • Corrected By and Date Corrected:

  • Monthly inspections have been properly documented.

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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 complete 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

  • Corrected By and Date Corrected:

  • 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

  • Are there areas requiring eye protection?

  • Appropriate eye protection warning signs are posted.

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  • Observation

  • Corrected By and Date Corrected:

  • 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

  • Corrected By and Date Corrected:

  • 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.

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  • Observation

  • Corrected By and Date Corrected:

  • Does this area have shelving and storage?

  • Shelving and storage is properly anchored.

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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:

  • 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

  • Corrected By and Date Corrected:

  • 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

  • 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:

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

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  • Observation

  • Corrected By and Date Corrected:

  • 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

  • Is this facility required to have a fire extinguisher?

  • Fire extinguishers are hung properly.

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  • Observation

  • Corrected By and Date Corrected:

  • Monthly inspections have been properly documented.

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled.

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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:

  • 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.

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  • Observation

  • Corrected By and Date Corrected:

  • Elevated walkways and platforms are constructed 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:

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 complete and have been installed properly.

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  • Observation

  • Corrected By and Date Corrected:

Fire Extinguishers

  • Fire extinguishers are hung properly.

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  • Observation

  • Corrected By and Date Corrected:

  • Monthly inspections have been properly documented.

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  • Observation

  • Corrected By and Date Corrected:

Other Concerns

  • Electrical breakers are properly labeled.

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  • 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 complete 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:

Fire Extinguishers

  • Fire extinguishers are hung properly.

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  • 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.

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  • 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 Operations

  • Does this location have Grain Operations?

Grain Storage

  • 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.

  • 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.

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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.

  • 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:

Grain Legs, Augers, Conveyors

  • 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.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

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

  • Add media

  • 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.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Grain Pits

  • 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.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

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

  • Add media

  • 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.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

Grain Dryers

  • Adequate and proper crash protection is installed as necessary.

  • 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:

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

  • Add media

  • 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.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • 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.

  • Add media

  • 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.

  • 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:

LP Operations

  • Does this location have LP 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.

  • Add media

  • Observation

  • Corrected By and Date Corrected:

  • 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.

  • 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.

  • 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?

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:

Fire Extinguishers

  • Fire extinguishers are hung properly.

  • 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.

  • 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:

911 Information

Contact Information

  • 911 contact information sign is up to date.

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  • Observation

  • Corrected By and Date Corrected:

  • Non-essential 911 information is updated or removed.

  • 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:

Forklift

  • Does this location have a forklift?

General

  • Horn is in working order.

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  • Observation

  • Corrected By and Date Corrected:

  • Seatbelt is in working order.

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  • Observation

  • Corrected By and Date Corrected:

  • Documented proof of visual inspection is readily available.

  • 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

  • Add signature

  • Add signature

  • Add signature

  • Add signature

  • Add signature

  • Add signature

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.