Information

  • Plant:

  • Document No.

  • Company

  • Conducted on

  • Prepared by

  • Location

1.0 - Environmental

  • 1.1 - Air Pollution permit available for review?

  • 1.2 - Daily air records up to date?

  • 1.3 - PM10 records up to date?

  • 1.4 - In compliance with air permit conditions?

  • 1.5 - Stormwater Pollution permit available for review?

  • 1.6 - SWPPP records up to date?

  • 1.7 - In compliance with water permit conditions?

  • 1.8 - Outfalls are marked and sufficient?

2.0 - Fire Prevention

  • 2.1 - Evacuation plan posted in common areas?

  • 2.2 - Employees trained on evacuation procedures?

  • 2.3 - Extinguishers in place and clearly marked?

  • 2.4 - Extinguishers annual service complete?

  • 2.5 - Monthly extinguisher inspections complete?

  • 2.6 - Extinguishers clear of obstructions?

  • 2.7 - Adequate direction notices for fire exits?

  • 2.8 - Exit doors easily opened from inside?

  • 2.9 - Exits clear of obstructions?

  • 2.10 - Functional alarm/alert system in place?

3.0 - General Lighting

  • 3.1 - Light fixtures in good repair (not temporary)?

  • 3.2 - Emergency exit lighting operable?

  • 3.3 - Bulbs below 8' protected?

4.0 - Building Safety

  • 4.1 - Floor surfaces even and uncluttered?

  • 4.2 - Entry and egress paths kept clear?

  • 4.3 - Stair and risers kept clear?

  • 4.4 - Railings in place where required (48" elevation)

  • 4.5 - Are railings in good condition?

  • 4.6 - Are fall preventive measures in place and used where gaps occur in railings?

  • 4.7 - Are floor holes covered/protected?

  • 4.8 - Are footpaths in good condition?

  • 4.9 - Are harnesses in good condition?

5.0 - Work Benches

  • 5.1 - Clear of rubbish?

  • 5.2 - Tools not in use kept in place?

  • 5.3 - No damaged hand tools in use?

  • 5.4 - No damaged power tools in use?

  • 5.5 - Overhead light bulbs protected?

  • 5.6 - Are bottle jacks labeled with their capacity?

6.0 - Waste/Trash

  • 6.1 - Bins located at suitable points around site?

  • 6.2 - Bins emptied regularly?

  • 6.3 - Bins are covered and kept closed?

  • 6.4 - Oily rags kept in covered metal containers?

  • 6.5 - Steel drums stored elevated off of the ground?

  • 6.6 - Special waste disposed of properly?

7.0 - Plant and Machinery

  • 7.1 - Plant and machinery kept clean?

  • 7.2 - Guards installed where required?

  • 7.3 - Guards in good condition?

  • 7.4 - Starting and stopping devices within easy reach of operator?

  • 7.5 - Drip pans on floor where required?

  • 7.6 - Equipment specific lockout procedures available?

  • 7.7 - Are lockout procedures implemented and followed?

  • 7.8 - Adequate lockout equipment available?

  • 7.9 - Oxygen and Acetylene cylinders separated when not in use?

  • 7.10 - Stored cylinders are capped?

  • 7.11 - Are gas cylinders secured upright?

  • 7.12 - Gas torches are equipped with backflow and flash protection?

  • 7.13 - Cylinder valves are kept closed when not in use?

  • 7.14 - Personnel operating special equipment are properly trained?

  • 7.15 - PPE stored properly and clean?

8.0 - Signage

  • 8.1 - Confined space signs adequate?

  • 8.2 - Lockout signs adequate?

  • 8.3 - DOL postings are available and current?

  • 8.4 - Other required signage appropriate?

9.0 - Electrical Safety

  • 9.1 - Wiring is installed properly and in good condition?

  • 9.2 - GFCI protection used in wet locations?

  • 9.3 - No multi adapters in use?

  • 9.4 - No broken plugs, sockets or switches?

  • 9.5 - No power leads across walkways?

  • 9.6 - No frayed or damaged cords?

  • 9.7 - No strained leads?

  • 9.8 - No exposed electrical components?

  • 9.9 - Breakers and disconnects are labeled

  • 9.10 - Electrical panels compliant and accessible?

  • 9.11 - Portable power tools in good condition?

10.0 - Chemical Safety

  • 10.1 - MSDS available for all chemicals?

  • 10.2 - All containers labelled correctly?

  • 10.3 - Unused substances disposed of?

  • 10.4 - Storage tanks properly labeled?

  • 10.5 - Fuel tanks have proper containment?

  • 10.6 - If applicable are special storage conditions followed?

  • 10.7 - Where required is PPE available?

  • 10.8 - Spills are immediately cleaned up?

  • 10.9 - Eyewash stations easily accessed?

  • 10.10 - Eyewash stations maintained and compliant?

11.0 Ladders

  • 11.1 - Are all ladders Industrial strength? (Non Household rated, check label.)

  • 11.2 - Are ladders in good condition?

  • 11.3 - Used according to instructions?

  • 11.4 - For extension ladders are ropes, pulleys and treads in a good state of repair?

12.0 - First Aid Facilities

  • 12.1 - Are cabinets and contents clean and orderly?

  • 12.2 - Are contents regularly checked?

  • 12.3 - No contents past their expiry date?

  • 12.4 - Cabinets clearly labelled?

  • 12.5 - Is there easy access to cabinets?

13.0 - Miscellaneous

  • 13.1 - General Duty Clause

Sign Off

  • On site representative

  • Auditor's signature

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