• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Section 1: Leadership

  • 1.1 Does the company have a policy statement reflecting management’s commitment to HSE, which is clearly disseminated through displayed policies, in manuals and training programmes, displayed statements and specific positions on the organisation chart?

  • 1.2 Has an HSE co-ordinator been appointed who reports directly to senior management?

  • 1.3 Is there a reference manual that communicates Management Policies and Practices?

  • 1.4 Are annual HSE objectives established for the company?

  • 1.5 Are personnel aware of HSE objectives?

  • 1.6 Are HSE objectives being met?

  • 1.7 Are there formal tours and inspections by management personnel?

  • 1.8 Does the company have periodic major HSE audits or surveys?

  • 1.9 Is there a structured follow-up system that establishes priorities for follow-up actions, identifies critical items to be corrected, establishes time frames for corrections, and assigns responsibility to ensure that corrective action is taken?<br>

  • 1.10 Have recommendations from previous major audits or surveys been implemented?<br>

  • 1.11 Does the company have a drugs and alcohol policy?<br>

  • 1.12 Does the company operate a policy for safe use of electrical items whilst on company business? e.g. mobile phones and computers?<br>

Section 2: Manning and Training

  • 2.1 Are there sufficient qualified personnel available at each treatment to operate in a safe and effective manner?<br>

  • 2.2 Is there an organisational chart?<br>

  • 2.3 Are there individual job descriptions available?<br>

  • 2.4 Has a systematic approach been adopted to identify all employee training needs?<br>

  • 2.5 Has training been established for all identified training needs?<br>

  • 2.6 Are training needs formally reviewed and updated annually?<br>

  • 2.7 Do contractors and employees undergo site-specific safety courses before working in refineries, terminals, or other inspection sites?<br>

  • 2.8 Are training courses in house?<br>

  • 2.9 Are external training courses used?<br>

Procedures and Documentation

  • 3.1 Does the company hold Employer’s Liability insurance?<br>

  • 3.3 Does the company have readily available operating manuals?<br>

  • 3.4 Are operating manuals updated to reflect changes to inspection requirements from the original concept?<br>

  • 3.5 Are relevant industry standards and codes, and individual client instructions periodically reviewed to ensure compliance?<br>

  • 3.7 Are there written general health, safety and environmental rules translated into sufficient languages for all employees to understand?<br>

  • 3.2 Does the company hold Professional Indemnity insurance?<br>

  • 3.10 Are portable devices available to test for flammable gas, oxygen and hydrogen sulphide?<br>

  • 3.9 Are formal risk assessments carried out for all inspection tasks conducted at the regional sites with Method Statements developed for complex jobs?<br>

  • 3.8 Does the company ensure inspectors operate under a formal work permit system especially when operating at the ship/shore terminal or when engaged in Confined Space Entry?<br>

  • 3.12 When using subcontractors for treatments, is Annex A of RADDS completed and retained?<br>

  • 3.11 Are portable gas testing devices calibrated regularly and calibrated before use?<br>

  • 3.13 Does the Company Hold MSDS for all additive products used?

Management of Change

  • 4.1 Are systematic reviews used to identify hazards and assess risks associated with change – i.e. new and modified facilities and operating procedures?<br>

  • 4.2 Has RADDS been incorporated?<br>

Accident/Incident Investigation

  • 5.1 Is there an accident/incident/non-conformance investigation system?<br>

  • 5.2 Does the investigation procedure require that injuries, occupational illnesses, non-conformances, property damage, environmental damage/complaints, security breaches and other accidents and incidents (near misses) be reported?<br>

  • 5.3 Is there a designated safety officer/representative who has received formal training in accident/incident investigation and reporting?<br>

  • 5.4 Is there a standard form for accident/incident investigation?<br>

  • 5.6 Are safety statistics maintained for contractors?<br>

  • 5.7 Is a system being used by appropriate personnel, which ensures that remedial actions, and follow-up of those actions, are carried out as recommended in the accident/incident (near-miss) investigation report?<br>

  • 5.8 Is a blank form available for viewing?<br>

  • 5.9 Is there an example of a completed form available?<br>


  • 6.1 Is communication between the inspection company and clients (direct/indirect, contact personnel) effective and reliable?<br>

  • 6.2 Are any group meetings held with employees to discuss current topics relating to health, safety and environmental control?<br>

  • 6.3 Are these group meetings formalised and documented (i.e. agenda, minutes, etc.)?<br>

  • 6.5 Is there a new employee general orientation/induction programme?<br>

  • 6.4 Are there adequate bulletin boards around the company offices for HSE purposes?<br>

  • 6.6 Does the induction cover: a) Hazard awareness and reporting, b) General rules and procedures, c) Organisational health, safety and environmental policy and local environmental sensitivities., d) Legislative requirements<br>

Other Comments or Information

  • Select date

  • Add 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.