Safety Audit

• Client / Site

• Conducted on

  Date

• Prepared by

Tasks Inspected

• ISS Crew Trained in Disconnecting RTD Hose Procedure?

  Yes

  No

  N/A

• Add media

  Media

General Conditions

• Safety Information Posted (Bulletin Boards)

  Yes

  No

  N/A

• Lighting

  Yes

  No

  N/A

• Noise

  Yes

  No

  N/A

• Safe Work Zones / Barricades

  Yes

  No

  N/A

• Tool / Equipment Staging

  Yes

  No

  N/A

• Ladder / Scaffold Use

  Yes

  No

  N/A

• Equipment Inspections

  Yes

  No

  N/A

• Environmental Spill Kits

  Yes

  No

  N/A

• Chemical Labels

  Yes

  No

  N/A

• Restroom Facilities

  Yes

  No

  N/A

• Elevated Work (>6') Guardrail of Fall Protection System

  Yes

  No

  N/A

• Fire Extinguishers (Inspected and Suitable for Location)

  Yes

  No

  N/A

• General Entry / Exit (Doors and Stairs)

  Yes

  No

  N/A

• Walkways /Pathways (In Good Condition)

  Yes

  No

  N/A

• Temperature Control

  Yes

  No

  N/A

• Hazard Communication Signs / Labels

  Yes

  No

  N/A

• Body Mechanics / Ergonomics

  Yes

  No

  N/A

• Exits, Alarms, Emergency Lighting

  Yes

  No

  N/A

• First Aid Kits / Emergency Plan

  Yes

  No

  N/A

• Chemical Storage

  Yes

  No

  N/A

• SDS Book

  Yes

  No

  N/A

• Waste Handling Disposal

  Yes

  No

  N/A

• Electrical Equipment and GFCI

  Yes

  No

  N/A

• Ventilation (General and Localized)

  Yes

  No

  N/A
Other Conditions

• Yes

  No

  N/A

Personal Protective Equipment

Protective Clothing

• Gloves

• Safety Footwear

• Reflective Vests

• Hard Hat
Other

Eye Protection

• Glasses

• Face Shield

• Goggles

Hearing Protection

• Ear Plugs

• Ear Muffs

• Combination

Respiratory Protection

• Disposable Mask

• Half Mask

Deficiencies / Observations & Corrective / Preventive Actions

• Deficiency or Observation

• Suggested Corrective / Preventive Action

• Assigned to

• Date

  Date

• Add Photo

  Media

Overall Assessment

• Site Condition

  Great

  Good

  Adequate

  Poor

• Potential Risk

  High

  Moderate

  Low

Reviewed by Site Manager

• Print Name

  Sign