• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Is there an existing procedure or work instruction for the task?

  • Add media

  • List any previous non-compliances or issues with this task

During Task

  • Is there a copy of the work instruction with the machine/task?

  • Add media

  • Is the operator aware of the procedure?

  • Has the operator received training, where are the records?

  • Add media

  • Observe the operator performing the task, is it performed as per the procedure

  • Does the operator have any suggestions for improvement?

  • Is the correct PPE being worn?

  • Add media


  • What are the identified hazards?

  • Add media

  • What are the controls?

  • Add media

  • List all the chemicals being used for this task

  • Add media

  • Has the operator received information or training on the chemicals being used

  • Is PPE correct?

  • Add media

  • Does the operator require any additional resources for the job?


  • What quality controls are in place?

  • Add media

  • Can these controls be verified? (Are there records?)

  • Where are the records kept?

  • Add media

  • What happens to faulty or non-conforming product (ask the operator)

  • Any identified improvements?


  • Auditor

  • Name

  • Auditee/operator

  • Name

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.