iSOT & Hazard Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Positive concern

• Safe Actions

  Yes

  No

  N/A

• Good Practice

  Yes

  No

  N/A

Area to improvement/concern

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

Agreement and Signature

• Area Owner

  Sign

• SOT Leader

  Sign

• SOT Member

  Sign

• SOT Member

  Sign

• SOT Member

  Sign