Title Page

  • Date

  • Plant Location

  • Auditor

  • Prepared by

  • Audit Location


    1. Answer "Yes", "No", "N/A" for the questions below.
    2. Fill out required fields and answer other questions as needed.
    3. Add photos and notes/comments by clicking on the paperclip icon.
    4. To add a Corrective Measure, click on the paperclip icon then click on "Add Action". Provide a description, assign to a member, set priority and then set the due date.
    5. Complete audit by providing a digital signature.
    6. Share your report by exporting as PDF, Word, Excel or Web Link.


  • GMP'S : Is the GMP policy being followed?

  • PPE'S : Is the PPE policy being followed?

  • SAFETY : Are the Safety rules being followed?

  • CLEANLINESS : Is area free of debris?


  • EXITS : Fire exits are kept clear

  • ESCAPE ROUTES : Escape routes are clear, items are not stored here

  • SIGNAGE : Signage is in place across site (escape routes can be easily followed)

  • EXTINGUISHERS : Extinguishers are of the correct type and can be clearly seen?

  • Are extinguishers being checked monthly?


  • ELECTRIC PANELS : No visible damage or defects to electrical panels, and they are secured against unauthorised access

  • CABLE DAMAGE : No visible damage to cables. Cables do not trail across walkways

  • WARNING SIGNS : Warning signs are displayed on high voltage equipment

  • SWITCHES : All switches are in good order and work correctly

  • EXTENSION CORDS : Are extension cords being used as a permanent power source?


  • DANGEROUS PARTS GUARDED : Dangerous parts of the machine are guarded

  • MISSING GUARDS : There are no missing guards

  • DAMAGE/DEFECTS-GUARDS : No visible damage or defects to any guards

  • INTERLOCKS-WORKING : All interlocks are working and are checked regularly

  • VISION PANELS-CLEAR : Vision panels are clear


  • HORN : Are drivers sounding horn before approaching the intersection?

  • YIELD THE RIGHT AWAY : Yield right away to pedestrians?

  • STOP : Complete STOP or Rolling STOP?

  • SAFETY ZONE : PIT operator oberving the 4-foot rule?

  • SEAT BELT : Is seat belt utilized?

  • CERTIFICATION : Is PIT certification current?


  • EMPLOYEES / OPERATORS : Observe operators at work?

  • Should anything be changed to help in operations?

  • HAZARDS IN THE AREA : Are they any Hazards in the area?

  • Can the hazards be eliminated?


  • Auditor's Name and 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.