• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Name (s)

Hazard Source

Type/ Class of Hazard

  • Existing hazards

  • Generated Hazard

  • Potential Hazard

  • Physical - Unsafe conditions ( eg mud/ice/blocked exit)

  • Atmospheric/Environmental- Unsafe conditions (eg temperature)

  • Inadequate training- Unsafe Acts

  • Invisible - Indirect causes of accidents(eg noise)

Recommended Control Measure

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