Safety Test Template

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Location Section

• Please enter the name of audit location:
  Address

• Date of location audit

  Date

People section

• Was the manager at the site for the audit?

  Yes

  No

  N/A

• Enter staff members name for audit

cleanliness report

• If the site is clean tick this box

• Upload photo of clean site area

  Media

• Enter details of any other concerns

Upcoming visit

• When is next audit required?

  Date

• How many people need to attend the next audit?

• Has the site agreed to the outcomes of the audit?

  Yes

  No

  N/A