Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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FOCUS ON .... Eyes on Hands, Eyes on path and line of fire
STOP and think through the job
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Are you fit to perform the required task
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Do you understand the job
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Are you competent to do the work and familiar with the equipment
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Are the tools and equipment in a safe condition
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Do you have an SWI and JHA for the task
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Have you informed others that may be affected by your work
ASSESS THE WORK. Dose the job involve any of the following?
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Equipment isolation
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Confined space work
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Working at heights
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Use of cranes or other lifting devices
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Use of mobile equipment
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Hot work
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Assistance from others
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Use of barricades
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Communication in noisy areas
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Potential environmental impacts
SEE THE HAZARDS- Look to identify any potential hazards
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Gravity
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Vehicles
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Human
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Electrical
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Mechanical
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Vibration
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Hazardous atmosphere
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Chemicals
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Thermal
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Pressurized system
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Radiation
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Flying objects
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Trip Hazards
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Manual handling
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Caught in- rotating or moving equipment
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Noise
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Engulfment
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Sunlight
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Fibres
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Cold surfaces
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Gases
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Dust
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Other
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Name of auditor
