Audit

1. Volunteer Habits and Actions

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

2. Lockout/Tagout

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

3. Personal Protective Equipment

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

4. Equipment Safeguards

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

5. Hand and Power Tools

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

6. Heavy Equipment/Materials Handling

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

7. Ergonomics

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

8. Personal Safety/Passersby Hazards

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

9. Hazards (chemical, electrical, environmental, fire, etc.)

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

10. Emergency Response

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

11. Fall Prevention

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

12. Ladders

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

13. Housekeeping/Storage Methods

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

14. Building Integrity

Add an issue

Incident

Specific Location

Describe Unsafe Condition and Recommended Solution

Date

Initials

Sign Off
Coordinator:
Assisted By:
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.