Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Positive concern

  • Safe Actions

  • Good Practice

Area to improvement/concern

  • Unsafe Actions; eg. Position, Handling, Unsafe Operation, etc.

  • Unsafe Conditions; eg. Machine, Equipment, Portable tools, etc. (fix and mobile type)

  • Unsafe Material; eg. Chemical, Electricity, Radiation, etc.

  • Unsafe Environment; Temperature, Biological, Noise, Dust, etc.

Agreement and Signature

  • Area Owner

  • SOT Leader

  • SOT Member

  • SOT Member

  • SOT Member

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.