Title Page

  • Conducted on

  • Prepared by

  • Site conducted

  • Location

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Administrative Controls

  • Does the company have a comprehensive written safety and health program that addresses management commitment;

  • Does the company have a comprehensive written safety and health program that addresses employee involvement;

  • Does the company have a comprehensive written safety and health program that addresses management and employee accountability;

  • Does the company have a comprehensive written safety and health program that addresses incident investigation procedure (AECI);

  • Does the company have a comprehensive written safety and health program that addresses safety training (Compliance & Zero Harm)

  • Does the company have a comprehensive written safety and health program that addresses risk profile signed and approved available to all staff;

  • Does the company have a comprehensive written safety and health program that addresses periodic review of all 8 elements of Zero Harm;

  • Does the company have an established Health and Safety Committee and meet al least quartile.

  • Are managers and supervisors carrying out their safety and health supervision, training, and enforcement responsibilities?

  • Are employees carrying out their safety and health compliance and reporting responsibilities?

  • Is there an accountability system for ensuring managers and supervisors carry out their safety and health supervision, training and enforcement responsibilities?

  • Is there an accountability system for ensuring employees comply with safety and health rules and hazard/injury reporting responsibilities?

  • Is there a system that provides communication with affected employees on occupational safety and health matters (meetings, training programs, posting, written communications, a system of hazard reporting, etc.)?

  • Does the communication system include provisions designed to encourage employees to inform the employer of hazards at the work site without fear of reprisal?

Operational Controls

  • Are all emergency evacuation plan displayed.

  • All emergency exits clearly marked.

  • Emergency Assembly Point marked.

  • Employees knowledge of emergency plan.

  • No Smoking Signs displayed at Flammable or explosive areas

  • High Risk Tasks supported by SWP/SOP/WI

  • Legal register register available and unto date.

  • H & S representatives appointed and attend H&S meetings

  • VFL Audits conducted by Snr Management of the company and Inspection Registers in place

  • Incident register available and up to date

  • Incident review /flash & learnings conducted and shared with all employees

  • LSB / CSB displayed for all staff.

  • LSB /CSB understood and used in daily activities (Permits, CRA, PTRA's)

  • CAR and PTRA's are conducted as per the AECI standards (Check one in the area)

  • SDS's for all materials available at point of use

  • Training matrix and registers available for each department as per the employee task profile

  • PJO / PTO's in place and available with line managers.

  • Forklift operators and drivers are all trained competent and carry mini training certificates/licenses.

  • QP (Qualified Persons) trained and appointed to handle HCA (Hazardous Chemical Agents)

  • Contractor / supplier managment process in place and all comply)

  • All site permits in place up to date and available (e.g. R638, Effluent, air emissions, flammable, occupancy.....)

Engendering Controls

  • All safety guards in place and in good condition

  • Distribution boards identified and control systems in place

  • Isolation Permit Procedures-Lock Out/Tag Out in place and PTRA's conducted for all permits.

  • All COC's for electrical installations available and unto date.

  • Ventilation at Welding areas and HCA areas

  • Valves/Pipework/Vessels identified and colour coded

  • Log Book /Register and checklists for Portable electrical equipment

  • Log Books up to date for all statutory equipment (e.g. Boilers, air receivers, compressors, safety devices.....)

  • Compliance to Dangerous Goods compatibility chart for storage of chemicals

  • All extraction systems, efficiency standards maintained

Personal Protective Equipment Controls

  • Appropriate PPE used in all demarcated areas.

  • Vessel/Confined Space PPE and Rescue equipment

  • First Aid Box available, stocked and first aiders identified.

  • Respirators / dust masks approved for particular application

  • Safety Showers/ Eye wash fountains

  • Chemical Tanker / vehicle Off-Loading /offloading PPE

  • PPE control systems in place (issuing, inspecting, disposal)

General Work Environment

  • Condition of Vehicles (roadworthy, cleanliness)

  • Condition of Plant and equipment

  • Work sites clean and orderly

  • Adequate Lighting

  • Adequate ventilation

  • Spillages cleaned up immediately

  • Any non standard storage areas

  • Cleanliness of canteens or eating areas

  • Cleanliness of change rooms, ablutions

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.