Information
-
Audit Title
-
Document No.
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
JHA / Take 5
-
Completed & checked by Supervisor?
-
On job (or nearby)
-
Being followed?
-
Are permits complete?
Position of People
-
Task Layout
-
Work Area
-
Storage
Compliance to Procedures
-
Follow & understand procedures
-
Procedures adequate?
Corrective Action Effectiveness (if applicable)
-
Are the actions being implemented?
-
Are they effective?
-
Is the hazard or risk reduced?
Isolation / Tagging
-
Positive isolation?
-
Procedures followed?
Housekeeping
-
Passageways clear?
-
Slips / trips
-
Area free of spillage / clutter?
Driving
-
Are seat belts being worn?
-
Driving to conditions / regulations?
-
Do they have the correct license?
-
Prestart check completed / vehicle condition
PPE
-
Are they wearing safety glasses, safety boots & correct clothing?
-
Are hard hats being worn?
-
Hearing protection?
-
Gloves / hand protection?
-
Task specific PPE being used?
Tools / Equipment
-
Good condition & correct use?
-
Appropriate tools for the job?
-
MSDS available / Chemicals approved?
-
Correct lifting equipment being used / current tags?
-
Correct harness / lanyard used and with current tags?
Environmental
-
Correct waste disposal
-
Adequate dust suppression?
Additional Comments
-
Comments
