Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Conduct Inspection. If unsafe or missing etc. requires text description and photo if available.

(1). Crushing - Can anyone be crushed due to:

  • Material falling?

  • Parts collapsing?

  • Coming in contact with moving parts during testing, inspection, use, maintenance, cleaning or repair?

  • Being trapped between materials or fixed structures?

(2). Entanglement

  • Can be entangled due to:

  • Body parts, clothing, equipment or other materials being in contact with moving parts?

(3). Cutting, Stabbing and Puncturing

  • Can anyone be cut, stabbed or punctured due to?

  • Coming in contact with sharp or flying objects?

  • Coming in contact with moving parts during testing, inspection, operation, maintenance, cleaning or repair?

(4). High Pressure Fluid /Gases

  • Are Fluids/Gases under high pressure in normal use?

(5). Electrical

  • Can anyone be injured by electrical shock due to:

  • Contacting live electrical conductors?

  • Electrical Leads on the ground

  • Working close to electrical conductors?

  • Overload of electrical circuits?

  • Damaged or poorly maintenance electrical components &/or cables?

  • Water near electrical equipment?

  • Lack of isolation?

(6). Gases or Vapors

  • Can anyone’s health be affected by exposure to:

  • Gases, vapors, liquids, dusts or other hazardous substances used or released in an unsafe manner?

(7). Slips, Trips or Falls

  • Can anyone within the facility slip, trip or fall due to:

  • Uneven or slippery work surfaces?

  • Poor housekeeping, such as shavings in the vicinity of the plant, spillage not cleaned up?

(8). Materials Handling

  • Does use of the equipment involve repetitive lifting?

  • Does this task require employees to be working with their hands above their shoulder?

  • Are Powered Industrial Trucks operated safely and according to manufacturer's guidelines?

(9). Light

  • Is lighting acceptable on the shop floor?

(10). Noise

  • Is noise acceptable on the shop floor?

(11). Personal Protective Equipment

  • Is adequate PPE being worn by people in the area and is it relevant to the tasks and the environment?

(12). Housekeeping

  • Have hoses been put away after use?

  • Are walkways and fire exits and escape routes in the area clear and free from obstructions?

  • Have spillages been cleaned up, or identified with hazard signs while equipment is collected?

  • Has equipment been put away after use into the correct location?

(13). Powered Industrial Trucks and Other Workplace Transport.

  • Are the pre-shift use checks completed and up to date?

  • Have keys been removed from trucks not in use?

  • Are seat belts, where fitted, being worn while truck is in use?

  • Was any unsafe driving or truck operation practices witnessed?

(14). Machinery Safety

  • Are machines fixed guards in place, secure with no missing attachment fittings?

  • Are adjustable guards in place and being used correctly?

  • Are interlock switches attached, and have not been tampered with or damaged?

  • Are emergency stop buttons unobstructed with easy access and it is clear what they stop?

  • Have lock out procedures been followed if machinery has been isolated for maintenance work?

  • Is there any evidence of unsuitable repairs eg: tape engineering?

  • Select date

  • Auditor to sign here

  • Auditor to sign here

  • Auditor to sign here

  • Auditor to sign here

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.