Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
PPE
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PPE supplies are readily available (what PPE supply areas did you inspect?)
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Is PPE being worn as requested?<br>(Who did you see wearing/not wearing the correct PPE? Do not use names)
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Is PPE adequate for the job?<br>(What task did you observe?)
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Other information
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Plant/Tools & Equipment
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Are tools in good working condition?<br>(List tools inspected)
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All guarding is in place and not tampered with<br>(What machine/s did you inspect)
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Existing guarding is sufficient<br>(What machine/s did you inspect?)
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No hazards in the Plant/Equipment design?<br>(What machine/s did you inspect)
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Plant/Equipment working well and not breaking down frequently? <br>(What machine/s did you inspect)
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Other
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Chemical Management
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Chemicals are stored appropriately and segregated according to type and class?<br>(What storage areas were inspected)
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Substances labelled appropriately?<br>(What substance did you look at?)
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Safe Transportation means for chemicals is available?<br>(What are these methods)
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Workers know where to find Safety Data Sheets (SDS)<br>(Find two and provide the substance names)<br>
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Other observations?
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Walking/Working Surfaces
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Work platforms are non-slip and free of debris and clutter?<br>(Where did you inspect)
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Railings/handrails in place where appropriate?<br>(List some examples you looked at)
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Fall protection is in place for working at heights?<br>(What examples did you inspect)<br><br>
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Labels in place for access and working environment are clear and legible?<br>(What signs did you look at)
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Any working or floors surface is non slip even and clear of any items or debris<br>(Where did you inspect)
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Other information
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Emergency Response/Fire Protection
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Fire Extinguishers are in place, inspected and tags marked 6 monthly<br>(Where were the extinguishers identified?)
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Workers are aware of where emergency evacuation points are located?<br>(Who did you talk to? List at least 2 people)
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Emergency Eyewash/Shower stations are in place and tested?<br>(What did you inspect?)
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Spill kits are available, stocked as required and in good condition?<br>(Where are the spill kits you inspected?)
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Emergency exits not blocked and identified by signage?<br>(What exists did you look at?)
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Other observations
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Mobile Equipment/Forklifts
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Forklifts and other mobile plant are checked daily?<br>(List checklist samples or equipment inspected details)
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Mobile equipment including forklifts are in good working condition?<br>(What items did you inspect?)
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Traffic Management rules are appropriate and in place and no markings, bollards etc are worn out or damaged?<br>(What areas did you observe?)
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Other observations
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Electrical Hazards
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Electrical equipment is tagged within current test date as listed on tag?<br>(What equipment did you inspect?)
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Newly purchased equipment has been included in the preventative maintenance schedule (SAP)?
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Areas where electrical items are used are clear from debris and suitable for task?<br>(What items did you look at?)
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High Voltage signs in place and visible?<br>(Where are these signs located?)
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Electrical leads are up off the floor and not obstructing walkways or work areas
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Other observation
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Lockout Tagout (isolation)
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Workers who conducted LOTO are trained and appropriately equipped?<br>(Names of workers you spoke to)
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LOTO procedures are in place and operating as intended <br>(Isolation that you inspected)
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Electrical isolations are locked and tagged<br>(Isolation that you inspected)
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Other observations
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Crane/Hoist Safety
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Inspections are completed as required?<br>(What crane/hoist did you inspect, when we're the inspection dates?)
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Workers are not working under suspended loads?<br>(What areas did you inspect?)
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Are Safe Working Loads (SWL) listed on all equipment?<br>(What lifting equipment did you inspect?)
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Other observations
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General Safety and Housekeeping
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Warden and HSR signs are up to date and in place as required<br>(Name Warden and HSR that is listed)
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Equipment is free of excessive dust, rust, oil or other contaminants?<br>(What equipment did you inspect?)
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General tripping hazards are not present<br>(Where did you inspect)
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Other observations
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