Information
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Audit Title
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Document No.
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Site
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Conducted on
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Prepared by
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Location
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Personnel
Previous inspection
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Are there any outstanding items from the last visit report?
Work area inspected.
Observations
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Industrial Hygiene
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What type of IH hazards have been observed through your walk-through?
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Respirable dust
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Noise
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Welding fumes
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Other
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Please explain
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Using your cell phone's SLM(Sound Level Meter). Take readings and pictures of the top two noise sources at the site. Record below.
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Source 1 dBA level
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Source 1 picture
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Location
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Source 2 dBA level
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Source 2 picture
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Location
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Respirable dust sources (take pictures of up to three)
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Source 1
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Location
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Source 2
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Location
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Source 3
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Location
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Ask the site manager about the following:
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Does the site have past IH reports?
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Does the site have a sound map?
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Does the manager have any IH concerns/questions/things to be sampled for?
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Explain.
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Risk level?
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Low
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Moderate
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High
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Explanation of your decision
