Title Page
-
Client / Site - where audit undertaken
-
Conducted on
-
Prepared by
-
Location / Address
-
Employee Reviewed
Items
-
Is the hard hat "in date" of manufacture?
-
Is the hard hat in good order and free of splits and cracks?
-
Are the ear muffs in good order, clean, and free of splits and cracks?
-
Is the eye protection safety screen attached to the hard hat?
-
Is the eye protection safety screen clean, and free of splits and damage?
-
Is the operator's hi-viz clothing visible at a distance, clean, and free from grease and oil stains?
-
Are the operator's steel capped boots in good condition and free of splits and damage?
-
Are the spikes on the operator's safety boots in good condition and not too worn?
-
Are the operator's protective leg wear/chaps in good order and free from cuts (e.g. chainsaw damage)?
-
Is the wet weather gear clean and free from cuts, tears, and rips?
-
Are the safety gloves in good order with no rips, tears, or damage?
Corrective Actions
-
Corrective Actions Required
Action Required
-
What corrective action is required?
Audit Sign Off
-
Sign Off
Employee
-
Signature
-
Job Title