Safety Spot Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safety Spot Inspection

• Organization, unit, activity, or work area being inspected:

• Spot Inspection Date & Time

  Date

• Inspector Name/Office Symbol

  Sign

• Description of the areas, equipment or processes/procedures reviewed as well as observations (positive findings, hazards, or unsafe work practices):

• Add media

  Media

• Causes of deficiencies and hazards:

  Select Training Equipment Technical Data Human Error Misconduct Process Inadequate or Faulty Leadership/Supervision Other

  • Training
  • Equipment
  • Technical Data
  • Human Error
  • Misconduct
  • Process Inadequate or Faulty
  • Leadership/Supervision
  • Other

• Comments:

• Recommendations for corrective action:

• Name and phone number of person responsible for implementing corrective action:

• Notes, corrective action taken, 332 Work Order number, Request RAC/Safety Office:

• Follow-up date (30 days):

  Date

• Date closed:

  Date