• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Customer details

  • Please give a brief description of company operations at this site:

  • What material handling equipment is used on site?

  • Average speed of mobile equipment travels on site (kp/h)

  • 'TICK' If new equipment is to be purchased within the next 12 months?

  • List equipment, quantities and details of equipment to be purchased.

  • How large is the fleet of MHE? (Include trolleys pallet jacks etc)

  • List attachments on site

  • Please list other attachments on site


  • Are pedestrians and MHE utilising the same door openings?

  • Add photo of door ways

  • Are there separate access doors for pedestrians available?

  • Add photo of door ways etc

  • Is there adequate lighting and vision for pedestrians and MHE around openings?

  • Are there blind corners or obstructions that may reduce vision?

  • Add photo of corners, obstructions etc

  • Is there 2 way traffic going through door ways?

  • Does traffic move fast around door openings and corners?

  • Are pedestrian walkways located near equipment openings?<br>i.e. Next to pallet wrappers, racking etc

  • Add photo of locations of concern

  • Are floors adequately marked and designated for traffic flow and isle ways etc?

  • Add photos of floor markings or areas of concern

  • Is there segregation for MHE and Pedestrians?

  • Add photos of pedestrian segregation or lack of

  • Is there any 'vision aids' at pedestrian cross overs, door openings or blind spots?<br>Eg: mirrors, flashing lights or audible alarms etc

  • List aids used to assist vision if applicable

  • Indicate if any of these are visible on site

  • Add photos of damage or areas of concern


  • Please list what doors are currently on site

  • Please list number of each type of door and detail if external or internal opening.


  • Has the steel pallet racking had it's annual inspection as per AS4084-2012?

  • When was the inspection last carried out? And by who?

  • Is racking signage displayed as per AS4094-2012 / 8.1.2 and racking loading in accordance?

  • Please take photos of racking ensuring visibility of total number of shelf heights can be seen.

  • Is there protection on each END upright to protect from MHE impact?

  • Is there any visible damage to racking uprights, beams or clips missing?

  • Add photos of damage and/or missing clips. Take note of location.


  • Does the site have a raised loading dock area?

  • Is there a designated safe zone for vehicles to be loaded and unloaded?

  • What measures and processes are put in place to ensure segregation and safe unloading for all operators, truck drivers and pedestrians?

  • Please add photo of loading/unloading zone

  • Does the site use loading aids such as dock ramps, dock levellers or lift tables?

  • List types of loading aids:

  • Please add photo of loading dock area

  • Is there adequate fall protection around the raised dock?

  • What measures are in place (if any) to prevent vehicle driving off whilst still being unloaded?


  • Please list items requiring discussion, areas of concern and points to follow up.

  • As an employer, you are legally obliged to protect the health, safety and welfare of your workers and other people who could be adversely affected by work carried out by your business under the Work Health and Safety Act 2012.

    As an employer You are responsible for providing:

    a safe and healthy working environment
    safe systems of work
    plant (eg, machinery and equipment) and substances in a safe condition
    adequate facilities
    adequate information, instruction and training.

    Whilst this audit provides information as part if providing a safe work place, it is to be used as an assisting tool and does relieve the employer of responsibly for providing a safe work place.

    By signing this document you as the customer acknowledge your requirements under the safe work act to 'make good' as and where required.

  • Please sign on completion

  • Name and position within company

  • Select date

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.