Information

  • Document No.

  • Audit Title

  • Site

  • Conducted on

  • Prepared by

  • Location
  • Safety Associate

  • Second Auditor/ If Applicable

  • Primary/Department Contact

Personal Protective Equipment

  • Are the employee(s) wearing the minimum required PPE ? (e.g safety glasses, hearing protection)<br>

  • Do the employee(s) wear the respirator correctly if applicable? (e.g., tight‐fitting respirators' head straps correctly positioned, PAPR faceshield kept closed, etc.)<br>

  • Is all PPE available within the area or zone, ie. Hearing protection, respirators?

  • Are employees wearing harnesses and lanyards for task requiring fall protection?

  • Are contractors wearing appropriate PPE when required?

Equipment Safety

  • Where applicable Is the equipment/room properly locked out and tagged out? <br><br><br>

  • Are all electrical cords in good condition? Do all electrical cord plugs in the room have their grounding prongs intact?<br>

  • Operating equipment/tools have all machine guards in place.

  • Are all LOTO tags filled out correctly? (e.g information legible, no tape, contains name, date and reason for LOTO)

  • Has all equipment been properly grounded or bonded?

  • Are all required warning tags on equipment accounted for, visible, and identifiable?

Ergonomics

  • Are the following basic lifting techniques being followed? Back straight, knees bent, load close to body, lifts with legs, does not twist at the waist.<br>

  • Are employees using mechanical lift assist devices (drum dumpers, inverters, hoists, etc.) properly?

Housekeeping & Walking/Working Surfaces

  • Are materials staged/stored in stable, neat and orderly fashion?

  • Are ladders in good working order, no noticeable damage?

  • Are ladders stored and keep in an orderly fashion?

  • Are all egress and exit areas clear of obstruction? <br>

  • Area all walking surfaces, platforms free of clutter and debris?

  • Are pallets stored appropriately in the area or zone?

  • In Construction or Maintenance areas, is the work area, ladder, lift, etc., appropriately marked, attended, or barricaded?

  • Are wet floor areas appropriately marked?

Emergency Equipment & Evacuation

  • Are emergency equipment and exits in the area free from obstructions and available for use?<br>

  • Do the employee(s) know their evacuation routes and evacuation assembly areas? <br>

  • Does emergency equipment (e.g eyewash, fire extinguisher) have inspection tag in place?

Flammable/Combustible Material Handling

  • Flammable/combustible liquids are being stored in proper containers and in designated storage areas?<br>

  • Are chemicals stored in their appropriate location?

  • Is bonding and grounding equipment being used properly? Is the equipment in good condition? (Such as no fraying or broken connections)

  • Is LEL detection present and working appropriately?

  • Are appropriate GHS labels present?

Environmental Compliance

  • Waste drums are closed, grounded (flammable only), properly labeled and in good condition/clean?

  • Sanitary drains are plugged during all acetone processing and/or washing?

  • Containment dike drain valves are locked in a closed position?

  • Are spill kits appropriately stocked?

Permits

  • Are Hot Work permits being utilized, and filled out correctly?

  • Are Red Tag Permits being utilized and filled out correctly?

PIT/Scissor lift

  • PIT/Scissor lift log books filled out correctly and up to date.

  • PIT/Scissor lift charging stations are in good conditions.

  • Are the Scissor lift correctly equipped with a fire extinguisher?

Documentation

  • Photos

  • Corrective Action Plan

Validation

  • Safety Rep Signature

  • Second Auditor Signature

Communication

  • Forward to

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.