• Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


Unit Safety Representatives (USRs)

  • Are USRs appointed in writing?

  • Are USRs trained & documented?

Safety Briefings & Inspections

  • Are Supervisors and/or USRs conducting & documenting safety briefings?

  • Are Supervisors and/or USRs conducting & documenting periodic safety inspections?

Job Safety Training Guide (JSTG)

  • Is the JSTG developed and available?

  • Is the JSTG reviewed annually and documented?

Safety Training Documentation (tracked in ARCNET)

  • Are all Workcenter personnel loaded in ARCNET?

  • Is all job safety training documented in ARCNET?

  • Have all supervisors completed Supervisor Safety Training?

  • Have all personnel completed annual Fire Extinguisher training?

  • Are all personnel current on CPR training? (Annually for SCSP, every two years for others)

  • Have all personnel completed initial Hazard Communication (HAZCOM) training?

  • Have all personnel completed Ladder Safety training?

Personal Protective Equipment (PPE) available in the workcenter

  • Eye & Face Protection

  • Hand & Arm Protection

  • Head Protection

  • Hearing Protection

  • Foot & Leg Protection

Lockout/Tagout (LOTO)

  • Is there a written LOTO program in the workcenter?

  • Is there an annual inspection/performance of Energy Control Procedures?

Emergency Lights & Fire Extinguishers

Hoists/Cranes (SCSP & SCSV Only)

  • Does the attached ID tag include: annual inspection, load test, capacity, & ID number?

  • Is there a written training outline/plan?

  • Is the training outline reviewed annually?

  • Is a list of approved instructors retained on file?

  • Does the user maintain a record of all tests performed on hoists/cranes?

  • Are emergency lights tested monthly for 30 seconds and documented?

  • Are emergency lights tested annually for 90 minutes and documented?

  • Are fire extinguishers mounted, charged, and in working order?

  • Are fire extinguisher monthly inspections documented?

Safety Bulletin Board

  • Is AFVA 91-301 posted?

  • Is AF Form 457 (Hazard Reporting Form) available?


Industrial Work Centers

  • Compressed Air Lines

  • Compressed Gas Cylinders

  • Hand Tools

  • Ladders

  • Machines firmly secured to floors, bases, or stands

  • Grinding Machines

  • Machine Guards

  • Hydraulic Floor Jacks - lubricated & inspected


  • Are MSDSs availalble?

  • Are chemical inventories available in the workcenter?

Office Equipment

  • Are file drawers closed when not in use?

  • Is the area clear of trip hazards? (cords, etc.)

  • Are areas kept in a neat manner?

Circuit Breakers/Disconnects

  • Plainly marked?

  • Accessible?

  • Guarding Live Parts?

Electrical Cords

  • In good condition?

  • Extension cords NOT used as permanent wiring?

  • Workcenter free of multiple plug adapters?


  • Workcenter free of broken, cracked, or missing receptacles/covers?

  • GFCI receptacles where required?

General Housekeeping

  • Are floors/walkways clean, free of oil, grease, water?

  • Are areas kept in a neat manner?

  • Are combustible materials NOT accumulating?

  • Are cabinets kept clear from stacked material?

Break Areas

  • Is the refrigerator used for food ONLY?

Emergency Shower & Eyewash Stations

Permanently Installed

  • Are monthly inspections documented?

Self-contained Units

  • Is fluid level checked monthly?

  • Is fluid replaced IAW manufacturer's instructions

  • If tap water is used, is fluid replaced monthly?

  • Is tag/label w/fluid change schedule available?


  • Is the workcenter free of other safety concerns?

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.