Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Supervisor name

  • Location
  • Personnel

Hazards

  • Slips, trips or falls

  • Falls from height/Roof work

  • Chemicals

  • Falling objects

  • Asphyxiation

  • Heat/Fire/Explosion/Hot works

  • Asbestos

  • Stationary objects

  • Overturn/Collapse

  • Manual handling<br>

  • Insecure load<br>

  • Vehicles<br>

  • Confined spaces (Permit Req’d)<br>

  • Noise<br><br>

  • Temperature<br>

  • Vibration<br><br>

  • Electricity<br><br>

  • Contamination<br><br>

  • Radiation<br><br>

  • Poor lighting<br><br>

  • Adverse weather<br>

  • Uncertified equipment<br>

  • Dust/Fumes<br>

  • Additional notes

Completion

  • Supervisor signature

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.