• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Guarding of dangerous parts

  • Is access possible to any moving parts that could cause injury? Please record machine part / location / part of body at risk / estimated type of injury?

  • For the parts identified above, what method of safeguarding is necessary to minimise the risk?

  • Where guards are currently provided, do they satisfy the following criteria? Are they suitable?

  • Where guards are currently provided, do they satisfy the following criteria? Are they of good construction?

  • Where guards are currently provided, do they satisfy the following criteria? Are they easily by-passed or disabled?

  • Where guards are currently provided, do they satisfy the following criteria? Are they an adequate distance from danger? Is there an adequate view of the dangers?


  • What maintenance is required for guards and protective devices? Is maintenance required and if so is it up to date? How often is maintenance required?


  • Is inspection of the work equipment necessary? Please log details of inspection and frequency?

Information, instruction and training

  • What information, instruction and training must be provided for the following groups?<br>Operators.<br>Maintenance staff<br>Managers / Supervisors

Other Hazards- what action is needed in respect of the following possible additional hazards?

  • Any article or substance falling or being ejected from the machine

  • Any rupture or disintegration

  • Overheating or fire?

  • Unintentional or premature discharge of dust, gas, liquid or vapour or other substance?

  • Any part of the machine at a high or low temperature likely to cause injury?

  • Any other hazards?

Emergency stop control

  • Is a suitable design of emergency stop located at an appropriate control and operating point? If no emergency stop is in place please indicate preferred type?

Isolation - How is the machine isolated or locked of from the following energy sources (Where relevant).

  • Electricity

  • Compressed air or gas?

  • Hydraulic fluid or oil

  • Steam

  • Other I.e. Gravity, fall etc


  • Are the controls clearly visible, identifiable, and clearly marked where necessary?

  • Are the controls located to ensure that operators are not exposed to risk?

  • Can the operator see any other person/s who may be at risk, when the controls are operated?

  • Are there ant systems of work to ensure that no one is likely to be at risk when the machine starts?

  • Are there suitable audible, visual or other warnings if needed?

Workplace environment

  • Is there adequate natural and artificial light?

  • Is lighting of controls satisfactory, without glare?

  • Is lighting of parts of the equipment that have to be viewed adequate?

  • Is the workplace temperature in the range of comfort for the operators?

  • Is suitable seating required?

  • Is there adequate space around the machine to allow safe and easy access?

  • Is storage for the machine parts and special tools needed?

  • Are fire extinguishers needed close to the machine - if so, what type?

Personal Protective Equipment

  • Is PPE required / necessary?

  • If yes what type?

  • Are operators aware that PPE is required and are they wearing it?

  • Do operators know how PPE should be worn? Is more training needed?

  • Is local storage necessary and provided?

  • Is PPE subject to routine maintenance checks?

Safety signs and warnings - are adequate signs fitted to the equipment as follows?

  • Hazardous surfaces

  • Hazardous materials

  • Hazardous parts and/or their movement

  • Prohibited actions

  • Correct operation

  • Required PPE ( Personal Protective Equipment)

  • Emergency 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.