Information
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Document No.
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Audit Title
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Site
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Conducted on
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Prepared by
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Location
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Observation Team
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Duration
Observations
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In then line of fire
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Caught in, on or between
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In the path of machinery
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Communication
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Use of radio / hand signals
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Identifying potential hazards
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Work permits
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Adequate
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Understood
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Prestart followed
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Controlled physical movement
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Lifting or moving
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Repetitive movements
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Access Area
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Housekeeping & Layout
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Securing equipment
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Barricade & Signage
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Work permits
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Tools and PPE selection
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Condition of tools
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Availability of tools
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Use of correct PPE
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Vehicles and machinery
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Electrical hazards
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Other energy sources
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Hazardous substances
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Eyes on path
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Exerting or rushing
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Ascending or descending
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Look before moving
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Clear access
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Spotters
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Trip Hazards
Safe and at risk behaviours observed
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Picture of behaviours
Action taken, Discussions held
Future actions
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Actions - Assigned Person - Date Due
Sign off observation team
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Add signature
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Add signature