Title Page

  • Where is the inspection being conducted?

  • Conducted on (Date and Time)

  • Inspected by

References

  • The following diagrams have been included as 'guides' only. Please review and use measures that apply to the hazards you are likely to identify.

  • Risk Matrix Reference

    risk matrix.png
  • Hierarchy of Controls Reference

    controls.jpg

Hazards Identified #

  • Click the "+ Hazard" button each time you identify a potential hazard

  • Hazard

HAZARD ANALYSIS

  • What kind of hazard have you Identified?

  • Describe the hazard

  • Photograph the Hazard

  • Describe the hazard

  • Photograph the Hazard

  • Describe the hazard

  • Photograph the Hazard

RISK ASSESSMENT

Risk rating

  • What's the consequence of not addressing this hazard

  • How likely is this to occur?

  • Risk rating

Controls

  • Select control measures

  • Enter other control measures

  • What steps/processes do you recommend taking?

  • Is this a significant hazard?

Completion

  • Full Name and Signature of the Inspector

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.