Title Page

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Disclaimer and confidentiality statement

  • Disclaimer:
    The assessors believe the information contained within this report to be correct at the time of printing. The assessors do not accept any responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to the attention of the assessors during the day of the assessment and should not be relied upon as an exhaustive report of all possible issues, risk or hazards, that may exist or potential improvements that can be made.

  • Confidentiality Statement:
    In order to maintain the integrity and credibility of the assessment process and to protect all parties involves, it is understood that the assessors will not divulge to unauthorised persons any information obtained during this assessment unless legally obliged to do so.

  • Plant Rooms

  • Notice board: is appropriate? Certification (H&S at work, evacuation procedure, electric shock, gas escape, employer’s liability) displayed and in date?

  • Site log books available, checked and up to date, including emergency lighting, L8, F Gas, fire etc.?

  • Is the security/access control/ CCTV/ Intruder alarm appropriate and in working condition?

  • Is the access in and out of the plant areas clear and free from obstruction. Is the general housekeeping in good condition?<br>

  • Plant areas clear of dust / debris / spillages? General plant room area clear of rubbish?<br>

  • Plant Areas clear of dust / debris /spillages? General plant room area clear of rubbish?<br>

  • Are there spill kits available close to the plant?

  • Are eyewash bottles in place and solution in date?

  • Fire extinguishers - correct amount /located in correct areas / tested and in date?

  • Control panels are closed and locked with all panel lamps working / tested?

  • Are there any ladders/equipment. Is it correctly tagged/ tested / out of date?

  • Insulation and lagging of all pipework intact and valve housing in place? Gas/water blanks and plugs available on site?<br>

  • Is the general environment acceptable? Noise level, Light level, temperature, unusual sounds/smells?

  • Any other issues not stated above?

  • Critical Enviroments

  • Is the fuel storage facilities in good order?<br>

  • Is there a spill kit available close to the plant?<br>

  • Is the BMS system fully operational and maintenance up to date?<br>

  • Are the Fire suppression systems fully operational and maintenance up to date?<br>

  • Are all the critical cooling systems fully operational and maintenance up to date?<br>

  • Are all the critical cooling systems fully operational and maintenance up to date?<br>

  • It the Automatic fire system fully operational and maintenance up to date?<br>

  • Are there any significant current known issues?<br>

  • In Data halls only, are there any housekeeping/fabric or maintenance issues that need to be highlighted?<br>

  • Any other issues not stated above?

  • Any other issues not stated above?

  • Add signature

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.