• 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 respirator correctly? (e.g., tight‐fitting respirators' head straps correctly positioned, PAPR faceshield kept closed, etc.)<br>

  • Has the employee(s) properly stored their reusable respirator during breaks (i.e., placed the half‐mask respirator or the head gear of the PAPR into a clean bag)?

  • Is all PPE available within the area (hallways/corridor)

  • Is the employee(s) donning and doffing the indicated PPE correctly?

  • Are employees wearing appropriate hearing and eye protection? (if 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 has all machine guards in place.

  • Are employee(s) following LOTO guides if applicable for tasks being completed?

  • Are plug locks being used when necessary?

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

  • Has all applicable equipment been properly grounded and/or bonded? (reference red B&G binders if needed)

  • Is explosion proof equipment being used where required?

  • 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 there mechanical lift assist devices available in the room?

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

  • Are department specific referencing available ergonomic guides?

  • Are rooms set up to shorten distances of material handling?

Housekeeping & Walking/Working Surfaces

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

  • Are ladders and/or platforms in good repair, no noticeable damage and rubber "feet" are in place?

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

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

  • Does the room have a housekeeping vacuum available?

  • Are pallets stored appropriately?

  • Are any wet floor areas appropriately marked?

  • Are employees wearing the appropriate footwear for the cleaning processes as specified in the SOP?

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 primary and secondary evacuation routes from their current location?<br>

  • Do the employees know where their designated outside evacuation assembly area is located?

  • 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>

  • Is bonding and grounding equipment being used properly?

  • IS XP equipment being used with flammable liquids/solvents where required?

  • Are equipment or containers appropriately grounded to grounding bars, exhaust drops, etc.?

  • Is LEL detection working appropriately where required?

  • Are SSTVs appropriately grounded and bonded?

  • Are appropriate GHS labels present?

Environmental Compliance

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

  • Low pH and acetone waste drums are located inside processing rooms, where applicable?

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

PIT/Scissor lift

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

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


  • Photos

  • Corrective Action Plan


  • Safety Rep Signature

  • Second Auditor Signature


  • 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.