Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General Information

  • List the names of the employees involved in the task

  • Description of task being inspected

Work Area

  • The area is neat, clean, and free from debris, dirt, or other materials

  • Illumination is adequate for the tasks to be performed

  • Ventilation is adequate for the task being performed

Personal Protective Equipment (PPE) and Quality Protective Equipment (QPE)

  • Employees are wearing appropriate PPE & QPE

  • PPE and QPE is in good condition and sized correctly

Hazardous Work Permit (HWP)

  • HWP is posted and visible

  • HWP is properly filled out and signed

  • Employees are following precautions listed on the HWP

Safety Equipment

  • An eyewash station is within 10 seconds of the worksite

  • A fire extinguisher is staged at the worksite where hot work is being performed

  • Inspections on safety equipment have been perfromed within the required frequency

  • All safety equipment is clearly labelled and accessible

Chemical/Flammable Storage

  • Chemicals are stored in appropriate containers and leak free

  • Secondary containers are clearly labeled with contents and MSDS information

  • Compressed gas cylinders are adequately secured

Tools/Equipment

  • Tools are stored properly

  • Tools are effectively grounded

  • Machine guards are in place for rotating parts and/or pinch points

  • Ladders and/or ramps are in good condition

  • Required equipment inspections are complete

Lockout and Tagout (LOTO)

  • LOTO devices are in place

  • LOTO form has been completed correctly

  • LOTO devices adequately isolate energy from the employee

  • LOTO devices are attached correctly and provide a warning and deterant for employees

  • Employee is following LOTO procedure

Emergency Preparedness

  • Spill kit is available for material spills

  • First aid kit is on station or available

  • Signature of inspector

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.