Title Page
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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
Start of inspection
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Laboratory Inspection
Laboratory inspection
Laboratory room inspection
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Laboratory room number and title
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Laboratory routine inspection
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Laboratory occupants present during the inspection
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Laboratory occupants are wearing the correct PPE (or if they are absent the correct PPE is available)
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A current health and safety handbook is readily available to the laboratory occupants (either in the laboratory or nearby)
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First aid equipment is readily available to the laboratory occupants. (This includes a stocked first aid kit and eye wash equipment)
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Operational Instruction Forms (Orange Forms) are displayed for experimental work. A sample of forms checked are completed correctly.
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Vessels containing chemicals are correctly and clearly labelled.
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Gas cylinders in the laboratory are in good order. This includes all cylinders secured upright and all regulators within retirement date.
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Area oxygen depletion and/or carbon monoxide alarms working.
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Laboratory non-routine inspection
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Non-Routine inspection item
Non-routine item
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Satisfactory finding during non-routine inspection
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Laboratory overdue remedial actions for attention
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Overdue remedial action for attention
Overdue remedial action
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Overdue remedial action in hand.
End of inspection
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Inspector(s) sign off
Inspector sign off
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Inspector sign off