Safety Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Date:

  Date

• Time Started:

  Date

• Checks performed by:

  Bob Bachman

  Andre Bauer

  Chuck Dunn

  Bob Wilt

1. Safety Related Housekeeping

• 1.1 Are aisle ways clear of obstructions?

  Yes

  No

  N/A

• 1.2 Are there any trip hazards?

  Yes

  No

  N/A

• 1.3 Are floors appropriately clean and dry?

  Yes

  No

  N/A

2. Electrical

• 2.1 Are electrical cords in good condition?

  Yes

  No

  N/A

• 2.2 Are extension cords used properly?

  Yes

  No

  N/A

• 2.3 Are electrical panel doors closed and in good repair?

  Yes

  No

  N/A

• 2.4. Are E-stops available and in good repair?

  Yes

  No

  N/A

3. Fire Protection

• 3.1 Are fire exits clearly marked?

  Yes

  No

  N/A

• 3.2 Are fire exits unobstructed?

  Yes

  No

  N/A

• 3.3 Are fire extinguishers available, marked and inspections up to date?

  Yes

  No

  N/A

4. Material Handling and Storage

• 4.1 Are hand trucks in good working condition and have required pre-shift<br> inspections been completed?

  Yes

  No

  N/A

• 4.2 Are combo lifts in good condition?

  Yes

  No

  N/A

• 4.3 Are there ergonomic risks? If so, explain.

  Yes

  No

  N/A

5. Hazard Identification

• 5.1 Are hazardous equipment areas properly labeled?

  Yes

  No

  N/A

• 5.2 Is equipment labeled and is label in good repair?

  Yes

  No

  N/A

• 5.3 Are hazardous materials and containers properly labeled and stored?

  Yes

  No

  N/A

6. Machine Guarding

• 6.1 Are moving parts properly guarded?

  Yes

  No

  N/A

• 6.2 Is proper PPE used (earplugs, cut-resistant gloves)?

  Yes

  No

  N/A

• 6.3 Are eyewash stations available and clean?

  Yes

  No

  N/A

7. Hand and Portable Power Tools

• 7.1 Are the correct tools provided, in good repair and being used?

  Yes

  No

  N/A

• 7.2 Are the tools properly guarded?

  Yes

  No

  N/A

• 7.3 Are the tools stored properly?

  Yes

  No

  N/A

8. Ladders

• 8.1 Are ladders chained and properly stored when not in use?

  Yes

  No

  N/A

• 8.2 Are ladders used properly?

  Yes

  No

  N/A

• 8.3 Are ladders in good condition with no welded repairs?

  Yes

  No

  N/A

9. Lockout/Tagout.

• 9.1. Are machines being locked out if necessary?

  Yes

  No

  N/A

• 9.2. If machines are being locked out, is it correctly? Please list machine and employee involved.

  name

10. Departmental Monitoring

• 10.1 Have required checklists been completed?

  Yes

  No

  N/A

• 10.2 Have unacceptable conditions been reported to the appropriate personnel?

  Yes

  No

  N/A

• 10.3 Have reported results been resolved within an acceptable timeframe?

  Yes

  No

  N/A

• Time Completed:

  Date

• Please sign

  Sign

• Additional comments; Suggestions or Questions.