• 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?


  • 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?


  • 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?


  • Photos

  • Corrective Action Plan


  • Safety Rep Signature

  • Second Auditor Signature


  • Forward to

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