Project Safety Audit

• Document No.

• Activity name

• Building &. Room#

• Conducted on

  Date

• Prepared by

• Personnel

General Information

• Description of the activity

Physical Hazards

• Mechanical Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Electrical Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Temperature Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Electromagnetic Radiation Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Work Environment Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Ergonomic Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Environmental Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Fire & Explosion Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Particulate & Vapour Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Other Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

Chemical Hazards

• Reaction & Storage Hazards

Hazard

• Risk

• Consequences

• Probability<br><br>0 = Wont Occur <br>1 = May Occur<br>2 = Occur Rarely<br>3 = Likely to Occur<br>4 = Is Occuring

  0

  1

  2

  3

  4

• Seriousness<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Exposure<br><br>0 = None<br>1 = Minor<br>2 = Moderate<br>3 = Major<br>4 = Critical

  0

  1

  2

  3

  4

• Risk Index<br><br>P X S X E = Risk Index<br><br>Min < 10<br>Med > 10 < 30<br>High > 30

  Minimum

  Medium

  High

• Safe Work Procedure

• Chemical List

Chemical

• Name, CAS, Formula

• State

  Liquid

  Solid

  Gas

  Vapour

  Particulate

• Quantity

Key Equipments

• Research Equipment

Equipment

• Description

• Equipment Photo

  Media

• Safety Equipment

Equipment

• Description

• Equipment Photo

  Media

Emergency Planning

• Are there any special procedures required?

  Yes

  No

  N/A

• Is there anything the ERT should be aware of?

  Yes

  No

  N/A

• Could an accident affect other workers or other part of the building?

  Yes

  No

  N/A

Waste Handling

• What waste will be produced and what provision have been made for disposal?

  Yes

  No

  N/A

Preventive Maintenance

Equipment

• Equipment Names

• Type of Maintenance

  Insp

  Adjust

  Clean

  Lube

• Date

  Date

Endorsement

• Employees involved in this activity

Employee

• Name & Position

  Sign

Reviewed by

• Supervisor

  Sign

• Group Leader

  Sign

• COSH Co-Chair or H & S Advisor

  Sign

• Valid up to :

  Date