Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Location
  • Personnel

Job To Perform

  • Enter the Job to be performed

  • Enter the Job to be performed

  • Other Task Details

Checklist

  • Work Instruction Available

  • All hazards detailed in work instruction identified and safe

  • All required PPE available to perform task

  • Additional Hazards identified?

Additional Hazards and Controls

  • Hazard 1

  • Control 1

  • Hazard 2

  • Control 2

  • Hazard 3

  • Control 3

  • Additional Hazards

  • Controls

Overall Risk Ranking

  • Enter ranking

  • If the risk is HIGH contact your Area Manager to discuss/ agree how the work can be done safely.

  • If the job cannot be done safely then do not do it.

Finish

  • Add signature

  • Add media

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.