Information

  • Conducted on:

  • Audit by:

  • Plant

  • Departament

  • Area

  • Risk Level Classification

    Risk Class.png

Chemicals

  • Containers are closed and are adequate

  • Risk Level

  • Responsible to Close

  • Due Date

  • Container free of leakage

  • Risk Level

  • Responsible to Close

  • Due Date

  • Metallic containers for flammable materials are grounded<br>

  • Risk Level

  • Responsible to Close

  • Due Date

  • Correct Storage: Name and risk label clear

  • Risk Level

  • Responsible to Close

  • Due Date

  • There is a updated chemical inventory

  • Risk Level

  • Responsible to Close

  • Due Date

  • Anti-Spill material available

  • Risk Level

  • Responsible to Close

  • Due Date

  • SDS available, complete and in local language

  • Risk Level

  • Responsible to Close

  • Due Date

  • Flammable material at least 2 meters away from any ignition source

  • Risk Level

  • Responsible to Close

  • Due Date

  • No aditional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Safety Devices and Guards

  • Agregar Estación

  • Estacion
  • Nombre y No. de Estacion

  • All fixed guards are complete and with screws

  • Risk Level

  • Responsible to Close

  • Due Date

  • All risk points are protected

  • Risk Level

  • Responsible to Close

  • Due Date

  • Daily revision to the safety devices was performed

  • Risk Level

  • Responsible to Close

  • Due Date

  • Machine have risk signs in good condition

  • Risk Level

  • Responsible to Close

  • Due Date

  • Operator knows the risk of his machine

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Material Handling

  • Industrial vehicle license is update

  • Risk Level

  • Responsible to Close

  • Due Date

  • Daily checklist was performed

  • Risk Level

  • Responsible to Close

  • Due Date

  • Industrial vehicle in god condition

  • Risk Level

  • Responsible to Close

  • Due Date

  • Driver use the safety belt

  • Risk Level

  • Responsible to Close

  • Due Date

  • Load capacity of the vehicle is indicated and clear

  • Risk Level

  • Responsible to Close

  • Due Date

  • Lifting devices like slings, chains or other are certificated and in good condition

  • Risk Level

  • Responsible to Close

  • Due Date

  • Controls of the Industrial vehicle are legible

  • Risk Level

  • Responsible to Close

  • Due Date

  • Maximum stowage is respected

  • Risk Level

  • Responsible to Close

  • Due Date

  • Material only storage in placed designated for that propose

  • Risk Level

  • Responsible to Close

  • Due Date

  • Racks in good conditions

  • Risk Level

  • Responsible to Close

  • Due Date

  • Pallets and/or wrapping material in good condition

  • Risk Level

  • Responsible to Close

  • Due Date

  • No aditional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Emergency Response

  • The evacuation route is marked and clear

  • Risk Level

  • Responsible to Close

  • Due Date

  • Operator knows the evacuation route and the rally point

  • Risk Level

  • Responsible to Close

  • Due Date

  • Emergency response equipment is in good condition and not obstructed

  • Risk Level

  • Responsible to Close

  • Due Date

  • Emergency response equipment is marked in the floor and wall

  • Risk Level

  • Responsible to Close

  • Due Date

  • Firefighter cabinet complete and in good condition

  • Risk Level

  • Responsible to Close

  • Due Date

  • Member of the emergency brigade in the current shift and identify

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

LOTO

  • LOTO Procedure Available

  • Risk Level

  • Responsible to Close

  • Due Date

  • Authorized personal had Lock and Tags

  • Risk Level

  • Responsible to Close

  • Due Date

  • Authorized personal had LOTO devices Availables

  • Risk Level

  • Responsible to Close

  • Due Date

  • LOTO can be apply in the equipment and in all energy sources

  • Risk Level

  • Responsible to Close

  • Due Date

  • LOTO is been apply correctly

  • Risk Level

  • Responsible to Close

  • Due Date

  • Safe Stop is been apply correctly

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Walking and Working Surface

  • Platforms and stairs over 1.5 meters had handrail and are in good conditions

  • Risk Level

  • Responsible to Close

  • Due Date

  • Corridors are in good condition, no materials obstructing, no holes o tripping points or liquids in the floor

  • Risk Level

  • Responsible to Close

  • Due Date

  • Working area is isolated. (including pedestrian corridors)

  • Risk Level

  • Responsible to Close

  • Due Date

  • If there is a temporary open in the floor, it is identify and has protection and warnings to prevent the falling risk.

  • Risk Level

  • Responsible to Close

  • Due Date

  • Emergency exits and signs are free of obstacles and available

  • Risk Level

  • Responsible to Close

  • Due Date

  • The warning sign are clear and enough for the risk

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Electrical Instalations

  • Electrical panels and boxes are closed and clearly identify with risk and voltage sign

  • Risk Level

  • Responsible to Close

  • Due Date

  • Electrical panels and boxes are completely seal. (without holes and with all the switches) and free of other materials

  • Risk Level

  • Responsible to Close

  • Due Date

  • Electric extension are used only "Temporally" and is used with the correct voltage

  • Risk Level

  • Responsible to Close

  • Due Date

  • Electric wire are in order, in good shape without hand made connections and the plug with 3 terminals

  • Risk Level

  • Responsible to Close

  • Due Date

  • Areas that could generate static electricity had anti-static devices (ground connections)

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Confined Spaces

  • All confined spaces are identify and numbered

  • Risk Level

  • Responsible to Close

  • Due Date

  • Personal working in confined spaces is trained

  • Risk Level

  • Responsible to Close

  • Due Date

  • There is a Special Work permission authorized and valid

  • Risk Level

  • Responsible to Close

  • Due Date

  • There is always a monitor person available

  • Risk Level

  • Responsible to Close

  • Due Date

  • All confined spaces have a restriction entrances barrier to prevent unauthorized people going in

  • Risk Level

  • Responsible to Close

  • Due Date

  • In case of hazardus energies inside, LOTO is correctly apply

  • Risk Level

  • Responsible to Close

  • Due Date

  • No aditional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Crane and Hoist

Crane Condition

  • Maximum capacity in SI units

  • Risk Level

  • Responsible to Close

  • Due Date

  • Hook with safety stoper

  • Risk Level

  • Responsible to Close

  • Due Date

  • Slings and Chains in good condition

  • Risk Level

  • Responsible to Close

  • Due Date

  • Principal wires without damages (smashed, fracture)

  • Risk Level

  • Responsible to Close

  • Due Date

  • Button panel in good conditions, buttons are readable

  • Risk Level

  • Responsible to Close

  • Due Date

  • Direction sign visibles

  • Risk Level

  • Responsible to Close

  • Due Date

  • No abnormal noises or vibrations

  • Risk Level

  • Responsible to Close

  • Due Date

  • Daily checklist complete

  • Risk Level

  • Responsible to Close

  • Due Date

  • PM Evidence

  • Risk Level

  • Responsible to Close

  • Due Date

Crane Operator

  • Certified Operator

  • Risk Level

  • Responsible to Close

  • Due Date

  • Worker don't pass under overhead loads

  • Risk Level

  • Responsible to Close

  • Due Date

  • Operator use helmet

  • Risk Level

  • Responsible to Close

  • Due Date

  • Operator adjust the chains before fully raise the load.

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

PPE: Personal Protective Equipment

  • Personnel is wearing basic PPE (Glasses, Earplugs and Shoes)

  • Risk Level

  • Responsible to Close

  • Due Date

  • Work station has a sign specifying the correct PPE

  • Risk Level

  • Responsible to Close

  • Due Date

  • Personnel is wearing the specific PPE according with the risk evaluation and signs

  • Risk Level

  • Responsible to Close

  • Due Date

  • PPE is in good condition

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Waste Management

  • There are containers to segregate the Non hazardous wastes of the area

  • Risk Level

  • Responsible to Close

  • Due Date

  • Containers are properly identify

  • Risk Level

  • Responsible to Close

  • Due Date

  • Containers are in good conditions

  • Risk Level

  • Responsible to Close

  • Due Date

  • There are containers to segregate the Hazardous wastes of the area

  • Risk Level

  • Responsible to Close

  • Due Date

  • There is a good waste segregation

  • Risk Level

  • Responsible to Close

  • Due Date

  • No additional Unsafe Act or Condition

  • Risk Level

  • Responsible to Close

  • Due Date

Signs

  • Area Supervisor

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.