Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • NAME OF SUPERVISOR

GENERAL SAFETY

  • CHEMICAL HYGIENE PLAN

  • Is the Chemical Hygiene Plan accessible in the lab?

  • Has the Plan been reviewed and signed by lab workers?

  • Has lab-specific safety information been updated (annually)?

  • REQUIRED SIGNS

  • Are eye protection and special signs posted on doors (if applicable)?

  • Are there signs on contaminated equipment?

  • PROHIBITED ITEMS IN LAB

  • Are food and drinks being excluded from the lab?

  • EYE PROTECTION

  • Are appropriate safety glasses/goggles being worn?

  • SECURITY

  • Are lab doors locked when not in use?

  • Are extra-lab areas blocked?

  • ELECTRICAL

  • Are extension cords being used properly and within limitations?

  • Are any outlet circuits being overloaded?

EMERGENCY

  • MEANS OF EGRESS AND EXITS

  • Are aisles free and is there at least 36 inches of clearance?

  • Are exits marked?

  • EMERGENCY PLANS

  • Is the evacuation plan posted?

  • Are emergency phone numbers near a phone or outside the door?

  • Are the locations of fire extinguishers and alarms posted?

  • Are the locations of eyewash stations/showers posted?

  • SPILL CLEAN-UP

  • Is there a plan for hazardous chemicals?

  • Is there a spill kit available in the lab with a posted/known location?

HOUSEKEEPING

  • FLAMMABLES

  • Are flammables stored in proper containers?

  • Is the flammable cabinet being used properly?

  • Are total flammable liquids under maximum amount allowed per lab?

  • COMPRESSED GASES

  • Are cylinders stored properly and capped if unused?

  • Are cylinders properly labeled and secured?

  • Are empty cylinders being managed or returned?

  • HOUSEKEEPING

  • Are floors, walls, workbenches, etc. clean?

  • Is the lab neat and clean in appearance?

  • Is there adequate space to perform work?

  • Is there at least 18 inches of ceiling clearance?

  • CHEMICAL STORAGE

  • Are storage containers compatible and appropriate?

  • Are breakables above eye level and away from shelf lips?

  • Are tubs in use?

  • CHEMICAL CONTAINER LABELS

  • Are containers labeled appropriately?

  • Are labels legible?

  • HAZARDOUS WASTE

  • Is there an identified central location for hazardous waste?

  • Is waste being appropriately segregated?

  • Are proper containers being used with appropriate labels?

  • CHEMICAL HOOD

  • Does hood chemical storage conflict with its designated use?

  • Is the sash placed in the proper position when not in use?

  • Are employees trained in hood use?

  • UNSAFE CONDITIONS

  • Is there any broken equipment?

  • Are there any leaking gas or water lines?

  • Is any of the lab shelving unstable?

  • Are there guards on sharp edges or drive belts?

  • SHARPS CONTAINERS

  • Is the proper container in use?

  • Are needles and syringes being stored appropriately?

DEPARTMENTAL ITEMS

  • RESPONSIBILITIES OF OTHER PERSONNEL*

  • Are eyewash station/shower inspections current?

  • Are chemical fume hood/biosafety cabinet inspections current?

  • Are chemical fume hoods functioning properly?

  • Are fire extinguisher inspections current?

  • * To be checked by inspection teams. Laboratory personnel should report to the Safety Officer if they notice that these items are not being done.

  • ADDITIONAL COMMENTS

  • INSPECTOR SIGNATURE

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.