Information

  • Document No.

  • Audit Title

  • Site

  • Conducted on

  • Prepared by

  • Location
  • Observation Team

  • Duration

Observations

  • In then line of fire

  • Caught in, on or between

  • In the path of machinery

  • Communication

  • Use of radio / hand signals

  • Identifying potential hazards

  • Work permits

  • Adequate

  • Understood

  • Prestart followed

  • Controlled physical movement

  • Lifting or moving

  • Repetitive movements

  • Access Area

  • Housekeeping & Layout

  • Securing equipment

  • Barricade & Signage

  • Work permits

  • Tools and PPE selection

  • Condition of tools

  • Availability of tools

  • Use of correct PPE

  • Vehicles and machinery

  • Electrical hazards

  • Other energy sources

  • Hazardous substances

  • Eyes on path

  • Exerting or rushing

  • Ascending or descending

  • Look before moving

  • Clear access

  • Spotters

  • Trip Hazards

Safe and at risk behaviours observed

  • Picture of behaviours

Action taken, Discussions held

Future actions

  • Actions - Assigned Person - Date Due

Sign off observation team

  • Add signature

  • Add signature

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