Safety W.A.L.K

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Date & Time of Safety W.A.L.K

  Date
• Location
  Address

• Personnel

SAFETY W.A.L.K DETAILS

• Safety W.A.L.K Completed by:

• Signature of Employee/s involved in Safety W.A.L.K

  Sign

• Signature of Employee/s involved in Safety W.A.L.K

  Sign

• Tasks Observed?

ACCEPTANCE SIGNATURES

• Supervisor's Signature

  Sign

• Employee/s Signature

  Sign

• Employee/s Signature

  Sign

• Employee/s Signature

  Sign

• Employee/s Signature

  Sign

1st TASK OBSERVED

• Risk Assessment in place?

  Yes

  No

  N/A

• Details of observations:

• Controls in place?

  Yes

  No

  N/A

• If you selected N/A for controls, please explain:

2nd TASK OBSERVED

• Risk Assessment in place?

  Yes

  No

  N/A

• Details of observations:

• Controls in place?

  Yes

  No

  N/A

• If you selected N/A for controls, please explain:

CORRECTIVE ACTIONS

• List the corrective actions dealt with immediately:

• List the Corrective Actions NOT dealt with immediately:

• Corrective Actions completed by:

  Sign

• Corrective Actions entered into the Safety System by:

  Sign