Mock Assesment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Air

• Has Air condition 1 been met.

  Yes

  No

  N/A

• Has Air condition 2 been met

  Yes

  No

  N/A

Water

• Has Water Condition 1 been met

  Yes

  No

  N/A

• Has water condition 2 been met

  Yes

  No

  N/A

Substances

• Are MSDSs available?

  Yes

  No

  N/A

• Are MSDSs up to date?

  Yes

  No

  N/A

• Have precautions been observed

  Yes

  No

  N/A

Personal Protective Equipment

• Is PPE being used?

  Yes

  No

  N/A

• Is the PPE being used appropriate for the task

  Yes

  No

  N/A

• Is the PPE well maintained ie. clean, not broken

  Yes

  No

  N/A

Training

• Have all personnel been trained for the task

  Yes

  No

  N/A

General Environmental Duty

• Do personnel understand the general Environmental Duty ?

  Yes

  No

  N/A

Environmental Management System

• Is the site management plan being followed

  Yes

  No

  N/A

Comments

Signature

• Auditor

  Sign