Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Tick appropriate box

  • Improvement suggestion

  • Hazard observation

  • Design sleeper

  • Location of: Hazard/sleeper/improvements

Hazard type

  • Workplace layout/housekeeping

  • Plant and equipment

  • Fall protection

  • Unsecured objects

  • Work practices

  • Fire

  • Enviroment

  • Health and hygiene

  • Traffic

  • Chemical

  • Other

  • Description of Hazard/sleeper/improvements

  • Additional information

Agreed actions

  • Action items

  • By Who

  • By When

  • Has Hazob been closed out

  • Date closed out

  • Name and signature of who closed out

  • Photo1

  • Photo 2

  • Photo 3

  • Photo 4

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.