General Premises Inspection

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

2.0 - Fire Prevention

• 2.3 - Extinguishers in place, clearly marked for type of fire?

  Yes

  No

  N/A

• 2.4 - Extinguishers recently serviced? (Check 12 monthly punch mark on tabs.)

  Yes

  No

  N/A

• 2.5 - Extinguishers clear of obstructions?

  Yes

  No

  N/A

3.0 - General Lighting

• 3.1 - Good natural lighting?

  Yes

  No

  N/A

• 3.2 Adequate lighting available for low-light conditions.

  Yes

  No

  N/A

• 3.3 - Light fittings clean and in good condition?

  Yes

  No

  N/A

4.0 - Building Safety

• 4.1 - Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• 4.2 - Walkways adequately and clearly marked?

  Yes

  No

  N/A

• 4.3 - Entry and walkways kept clear?

  Yes

  No

  N/A

• 4.4 - Intersections kept clear and presents no blind spots?

  Yes

  No

  N/A

• 4.5 - Stair and risers kept clear?

  Yes

  No

  N/A

• 4.6 - Furniture in sound condition?

  Yes

  No

  N/A

• 4.7 - Loading area clean and tidy?

  Yes

  No

  N/A

• 4.8 Structure and other concerns apparent?

  Safe

  At Risk

  N/A

5.0 - Rubbish Removal

• 5.1 - Bins located at suitable points around site?

  Yes

  No

  N/A

• 5.2 - Bins emptied regularly?

  Yes

  No

  N/A

Employee Training

• Is safety training conducted with employees at least monthly?

  Yes

  No

  N/A

Sign Off

• On site representative

  Sign

• Chuck Vancura Director of Loss Control Leavitt Group Insurance Services

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