• Document No.

  • Audit Title

  • Picture of machine

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • New installation or transferred machine?

  • For new machine, has PM program been documented?

  • For transferred machine were PM records received?

  • Are there training manuals / documentation for operators & maintenance?

1.) Machine Guarding

  • 1.1 Are all pulleys and belts, chains, sprockets and other power transmission sources guarded?

  • 1.2 Are operations that have rotating parts, pinch points, nip points, etc., guarded?

  • 1.3 If the machine is designed for a fixed location is it securely anchored?

  • 1.4 Are commonly used tools at hand so people are not encouraged to improvise, at risk of doing unsafe activities?

2.) Equipment Shutdown

  • 2.1 Is there a single, lockable, clearly marked electrical power disconnect?

  • 2.2 Are isolation valves for air, steam and other utilities accessible and marked?

  • 2.3 Is there an adequate number of properly labeled manual reset emergency stops?

  • 2.4 If equipment has pneumatic or hydraulic cylinders or motors, does the fluid power circuit have a solenoid block and bleed valves-interlocked to the emergency stop circuit?

  • 2.5 Have employees who will perform repairs, maintenance and servicing operations been trained in the equipment specific lockout/tag out or chemical handling procedures before they have to perform these operations?

  • 2.6 Have the equipment- specific procedures been put in writing and are they easily accessible?

3.) Walking Surfaces

  • 3.1 Are floors and aisles clear of any slippery areas or other trip hazards?

  • 3.2 Are changes in floor elevations clearly identified by color coding where necessary?

  • 3.3 The equipment does not produce discharge on the floor that are not adequately contained or directed towards drains?

  • 3.4 Should non-slip surface coatings be applied around the equipment?

  • 3.5 Has all construction debris, packaging materials, and setup equipment been removed from working areas?

4.) Electrical

  • 4.1 Is all conduit, cable, and wire properly attached to all supports and tightly connected to junction and outlet boxes?

  • 4.2 There is no evidence of fraying on electrical cords?

  • 4.3 Are cords free of Grease, oil, and chemical?

  • 4.4 Are cords used so they are not on pipes, nails, etc.?

  • 4.5 Is all electrical equipment secured to a surface?

  • 4.6 Are switches mounted in a clean, tightly closed metal box?

  • 4.7 Switches do not show signs of overheating?

  • 4.8 Are switches easily accessible and the paths to them free of obstructions?

  • 4.9 Are all unused openings in junction boxes plugged?

  • 4.10 Are all controls properly labeled?

  • 4.11 Do electrical push buttons have correct color coding? ( Only stop buttons should be red)

  • 4.12 Have all employees who may be exposed to electrical voltage equal or greater than 50 volts been given electrical safety training?

  • 4.13 Are all load center panel areas accessible and clear of obstructions?

5.) Ladders, platforms and stairs.

  • 5.1 Are platforms that are more than 4 feet above the floor level equipped with standard railing and toe boards?

  • 5.2 Are fixed ladders properly secured against movement?

  • 5.3 Are ladders that are more than 20 feet in unbroken lengths provided with safety cages that start between 7 & 8 feet off the floor and extends at least 42" above the top landing?

  • 5.4 Do stairs have handrails on them?

  • 5.5 Is there a mid-rail?

  • 5.6 Do crossovers over equipment have handrails?

6.) Personal Protective Equipment

  • 6.1 Has a PPE assessment been completed for this equipment?

  • 6.2 Has engineered solutions been investigated before the implementation of PPE?

  • 6.3 There are no special PPE requirements for the equipment or operations?

  • 6.4 Has the appropriate PPE been provided to the employees?

  • 6.5 Have employees been trained in the proper use/care of PPE?


  • 7.1 Does the equipment require employees to manually handle raw materials or finished product?

  • 7.2 If it does, have the ergonomic risk associated with those task been evaluated from a standpoint of weight, distance, frequency of task?

  • 7.3 Are controls easy to reach and laid out in a manner that makes them easy to read and use for the equipment operator?

  • 7.4 Does operation of equipment require employees to stand for extended periods of time?

  • 7.5 If so are there mats?

  • 7.6 Have operators been trained in the operation of the equipment, manufacturer's requirements for operating and maintaining, equipment safeguards, warning systems, etc.?

  • 7.7 Are there sharp edges on the equipment that could cut the operator or others passing by the equipment?

  • 7.8 Does operation of the equipment require the operator to engage in highly repetitive hand, wrist, arm, and finger movement or exertion?

  • 7.9 Is frequent bending, twisting, and reaching required?

8.) Industrial Hygiene

  • 8.1 If any chemical agents are required for the operation, servicing, or maintenance of the equipment, have MSDSs been obtained?

  • 8.2 Have the employees been trained in the chemical hazards, exposures and required PPE?

  • 8.3 Does the equipment emit any hazardous chemicals?

  • 8.4 Are there excessive noise levels?

  • 8.5 are there excessive temperatures or heat being put off?

  • 8.6 Is there radiation or other physical hazards?

  • 8.7 Have those hazards been evaluated?

  • 8.8 Are there hot surfaces that require quarrying or labeling and if so has it been done?

  • 8.9 Are appropriate warning labels provided on the equipment?

  • 8.10 If ventilation systems are required on the equipment, are flow indicators provided and have the operators been trained in using and interpretation of them?

  • 8.11 Are low-flow alarms installed on critical ventilation systems?

9.) emergency Procedures

  • 9.1 Have employees been trained in emergency shut-Dow procedures?

  • 9.2 Does the placement of the equipment present any evacuation hazards in the event of a serious equipment malfunction?

10.) Fire Hazards

  • 10.1 Does the equipment present any inherent fire hazards such as open flames, flammable liquids, solid and gases, etc.?

  • 10.2 are these hazards properly controlled by safeguards built into the equipment or provided outside, over and around the equipment?

  • 10.3 Are fire extinguishers or other fixed extinguisher system required?


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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.