Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
General Information
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List the names of the employees involved in the task
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Description of task being inspected
Work Area
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The area is neat, clean, and free from debris, dirt, or other materials
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Illumination is adequate for the tasks to be performed
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Ventilation is adequate for the task being performed
Personal Protective Equipment (PPE) and Quality Protective Equipment (QPE)
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Employees are wearing appropriate PPE & QPE
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PPE and QPE is in good condition and sized correctly
Hazardous Work Permit (HWP)
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HWP is posted and visible
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HWP is properly filled out and signed
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Employees are following precautions listed on the HWP
Safety Equipment
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An eyewash station is within 10 seconds of the worksite
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A fire extinguisher is staged at the worksite where hot work is being performed
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Inspections on safety equipment have been perfromed within the required frequency
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All safety equipment is clearly labelled and accessible
Chemical/Flammable Storage
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Chemicals are stored in appropriate containers and leak free
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Secondary containers are clearly labeled with contents and MSDS information
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Compressed gas cylinders are adequately secured
Tools/Equipment
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Tools are stored properly
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Tools are effectively grounded
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Machine guards are in place for rotating parts and/or pinch points
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Ladders and/or ramps are in good condition
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Required equipment inspections are complete
Lockout and Tagout (LOTO)
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LOTO devices are in place
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LOTO form has been completed correctly
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LOTO devices adequately isolate energy from the employee
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LOTO devices are attached correctly and provide a warning and deterant for employees
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Employee is following LOTO procedure
Emergency Preparedness
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Spill kit is available for material spills
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First aid kit is on station or available
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Signature of inspector