SAFETY AUDIT REPORT

• Date

  Date

• Plant Location

• Auditor

• Prepared by

• Audit Location
  Address

• 
  INSTRUCTIONS:
  -------------------------------------
  
  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.
  
  

PERSONNEL

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• SAFETY : Are the Safety rules being followed?

  Yes

  No

  N/A

• CLEANLINESS : Is area free of debris?

  Yes

  No

  N/A

FIRE PRECAUTIONS

• EXITS : Fire exits are kept clear

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are extinguishers being checked monthly?

  Yes

  No

  N/A

ELECTRICAL SAFETY

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

MACHINE GUARDING

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

  Yes

  No

  N/A

• MISSING GUARDS : There are no missing guards

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• VISION PANELS-CLEAR : Vision panels are clear

  Yes

  No

  N/A

PIT SAFETY

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• STOP : Complete STOP or Rolling STOP?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• SEAT BELT : Is seat belt utilized?

  Yes

  No

  N/A

• CERTIFICATION : Is PIT certification current?

  Yes

  No

  N/A

GENERAL OBSERVATIONS

• EMPLOYEES / OPERATORS : Observe operators at work?

  Yes

  No

  N/A

• Should anything be changed to help in operations?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Can the hazards be eliminated?

  Yes

  No

  N/A

COMPLETION

• Auditor's Name and Signature

  Sign