Sample: General Workplace

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Yes

  No

  N/A

Housekeeping

Rubbish Removal

• 6.1 - Bins located at suitable points around site?

  Yes

  No

  N/A

• 6.2 - Bins emptied regularly?

  Yes

  No

  N/A

• 6.3 - Oily rags and combustible refuse in covered metal containers?

  Yes

  No

  N/A

Machines

• 1- Are they kept clean?

  Yes

  No

  N/A

• 2.Are the floors around the machines kept clean?

  Yes

  No

  N/A

• 3.Guards in good condition?

  Yes

  No

  N/A

• 4. Starting and stopping devices within easy reach of operator?

  Yes

  No

  N/A

• 5.Waste/off cuts removed and stored safely?

  Yes

  No

  N/A

• 6.Is lighting adequate?

  Yes

  No

  N/A

• 7.Noise levels controlled?

  Yes

  No

  N/A

• 9.Operators trained/inducted into the operation of the machines?

  Yes

  No

  N/A

• 10.Is the training recorded?

  Yes

  No

  N/A

• 11.Do operators comply with the training?

  Yes

  No

  N/A

• 12.Are lockout procedures implemented and followed?

  Yes

  No

  N/A

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign