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)

  • Employees are wearing appropriate PPE

  • PPE is in good condition and sized correctly

Job Briefing and Planning

  • JSA is properly filled out and signed

  • JSA and any other applicable work permits are properly communicated via tailboard meeting

  • Employees are following precautions listed on the JSA and any other required work permits

Safety Equipment

  • GFI protection in place and extension cords, grounding clusters in good condition

  • 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

Electrical NFPA 70E

  • Electrical hazards identified

  • Proper electrical PPE used (shock/arc flash)

  • Protective grounds as needed (PPE and grounds tested & inspected)

Tools/Equipment

  • Tools are in good condition

  • Tools are effectively grounded

  • Tools, equipment, and PPE tested and calibrated as needed

  • Ladders, scaffolds, lifts, working at height platforms properly inspected and secured

  • Fall protection equipment used, appropriate, and inspected

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

  • Emergency preparedness is in place and evacuation procedures understood

  • First aid kit and spill 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.