• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

List the area(s)of concern.

List the concerns in this area(s).

Who is affected by this concern?

Will it cost the organization anything to fix the problem?

If yes, how much? (Any amount over $500.00 must be approved by Mr. Carter first.)

Is it feasible to fix this at this time? If no, then please explain below.

What is the plan of action to correct this concern?

List a estimated completion time on fixing the concern.

Persons approving this risk assement

  • 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.