Machine Safety Audit

• Machine Audit Form

• Document No.

• Department

• Machine Audited

• Personnel

• Conducted on

  Date

• Prepared by

• INSTRUCTIONS
  
  1. Review each question
  2. Answer the question and rate the answer from the multiple choice answers
  3. Add photos of non compliant items
  4. Record the corrective action
  5. Add any comments if necessary
  6. Add name and sign
  

SAFETY Is the area safe to work in?

• Is the fire extinguisher in this location tagged & tested (6 monthly) specify serial #

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Is anything blocking an entrance way, fire extinguisher or pathway?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are there any trip hazards (hose, electrical cords etc) in the area?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Is sufficient clearance provided around machines to allow for safe operation?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Is all machinery and equipment viewed clean & damage free, properly maintained?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are all electrical cords, adaptor sand equipment damage free, tagged and tested?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are all electrical connections, boxes etc closed and secure?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

SORT

• Are materials and substances in the area correctly labeled. This includes Chemicals, Raw Materials and Lubricants?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are previous jobs tooling or materials still evident in or around the production area?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are there any unneeded materials from previous jobs still stored on the line?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are personal belongings properly stored?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are there obsolete, worn, broken, out of service items, equipment, tooling, supplies etc in the area?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

PLANT AND EQUIPMENT

• Check the contents of the nearest spill kit against the lid label, anything missing? Please record spill kit #

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Does lifting gear and equipment ( strops, slings, handles ) have any defects?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Does the lifting gear have a coloured tag attached? If YES, what colour is it?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are there any tools that are kept at all times in the operating area in a specific locations or are they simply resting on the machinery or other places?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are all platforms/step ladders present on the line in good condition and do they possess a serial number? State condition of steps and serial number.

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

SWEEP AND SHINE

• Are the cleaning/sanitising materials D2 & D4 present at the workstation?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Is the machinery and work station clean and free of oil, grease and debris?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are the designated walkways/stairs free from dirt, oil, grease and dust debris?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Does the INSIDE of the machinery or its surrounding area require vacuuming?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are all lights in the area in good condition that is working and free from dust?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Is the sharps container overflowing, does it require emptying?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are substances/chemical storage containers clean, tidy and damage free?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

SAFEGUARDS

• Can the machine be oiled without removing guards?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Do the safety guards ensure that no objects can fall into moving parts?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Is there evidence of temporary materials being used on the guards and/or machine?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Is there evidence that safety guards may have been tampered with or removed?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are guards damaged or pose a hazard? (Sharp edge, loose fittings)

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

MACHINE GUARDING

• Is equipment & machinery securely placed & anchored when necessary to prevent tipping or other movement that could result in personal injury?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are machinery guards firmly secured, not easily removed? Are tamper proof screws/bolts, interlocks evident, in good condition or are any missing?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are all moving chain drives, belts, gears, in going nip points, rotating parts properly guarded?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are guards, splash guards mounted of presses preventing contact with ingoing nip points, rotating parts, gears and substances contact

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are equipment controls, valves, switches, buttons, knobs controlling the operation of equipment & machinery clearly identified regarding function?

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Are foot operated switches guarded or arranged to prevent accidental actuation by personnel or falling objects (bag press machines & strappers)

  Select 0 - Poor 1 - Poor 2 - Marginal 3 - Marginal 4 - Good 5 - Good

  • 0 - Poor
  • 1 - Poor
  • 2 - Marginal
  • 3 - Marginal
  • 4 - Good
  • 5 - Good

• Tap to add photo

  Media

• Action taken

• By Whom

• Comments

• Insert name and sign

  Sign