Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Untitled Page

  • INSPECTION

  • This audit must be signed, completed and returned to the Safety Department for filing.

  • Item

  • Item

  • Compliance Achieved

  • Comments

  • Item

  • No. of activities / facilities

  • A

  • NI

  • UA

  • N/A

  • observed:

  • 1. Nip / crush points adequately guarded

  • 2. Belts and chain drives guarded

  • 3. Gears, sprockets, pulleys and flywheels guarded

  • 4. Guards are firmly secured and not easily removable

  • 5. All machine guards prevent body parts from making contact with moving parts

  • 6. Safety devices and emergency stop switches installed and functional

  • 7. Procedures established to ensure machine is shut down before guards are removed

  • 8. Material or fluid ejection points protected

  • 9. Electrical cords or connectors in good repair

  • 10. Conveyor net protection over walkways and thoroughfares

  • 11. Interlocking devices functional and are trip sequences effective

  • 12. Is guard construction substantial, compatible?

  • 13. Signage adequate and identifiable

  • 14. Previous inspection faults corrected

  • 15. Pre-start checks completed prior to shift start

  • 16. Service manuals and other information available to identify operation and preventative maintenance requirements

  • 17. Documented preventative maintenance schedules and repairs have been carried out (check maintenance records)

  • COPPER RESOURCES AUSTRALIA

  • ITEM REQUIRED ACTIONS / ADDITIONAL COMMENTS

  • INSPECTION TEAM

  • Name

  • Signature

  • Position Title

  • SUPERVISOR REVIEW / SIGN OFF

  • Name

  • Signature

  • Position Title

  • CRA_H&S_F_089

  • Date of Issue: 05/07/2024 - Version 1.1

  • Page 2 of 2

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.