Information

  • Audit Title

  • Conducted on

  • Prepared by

  • Location

Section 1.0 PPE

  • 1.1 - PPE available and used before entering the work area

  • 1.2 Performance Measurement (Nominal - 3)

Section 2.0 Vehicles / Equipment

  • 2.1 - Walk around inspection performed on carts, vehicles, and mobile equipment

  • 2.2 - Horn and headlights are operational

  • Note: Take pictures of mobile equipment hazards

  • 2.3 Performance Measurement (Nominal - 3)

Section 3.0 - Overhead Work

  • 3.1 - Communicated with impacted process leaders

  • 3.2 Safety cones, barricades, warning tape, and spotter used to communicate hazard zones

  • 3.3 Performance Measurement (Nominal - 8)

Section 4.0 - Fire Prevention

  • 4.1 - ABC Fire extinguisher within 25 - 50 ft of work.

  • 4.2 How Work Permit obtained prior to beginning work

  • Note: Take pictures of any Fire hazard

  • 4.3 Performance Measurement (Nominal - 7)

Section 5.0 - Fall Protection

  • 5.1 - Task performed greater that 15 feet from an edge, hole, or opening

  • 5.2 - Harness, anchor, lanyard (retractable), and lifeline used to prevent 6 ft free fall

  • Note: Take pictures of any Fall hazard

  • 5.3 Performance Measurement (Nominal - 24)

Section 6.0 - Communication

  • 6.1 - Communicated work and location prior to beginning task

  • 6.2 Communicated unsafe task(s) or behavior(s) to responsible parties

  • 6.3 - Broken and defective equipment reported to maintenance.

  • 6.4 Performance Measurement (Nominal - 8)

Section 7.0 - Housekeeping

  • 7.1 - Trash and debris removed from work site daily

  • 7.2 - Trash and debris not blocking aisles, access, or doorways

  • Note: Take pictures of any Housekeeping hazard

  • 7.3 Performance Measurement (Nominal - 3)

Section 8.0 - Stairs and Ladders

  • 8.1 - Stairs and ladders are clear of obstructions

  • 8.2 - Ladder is 3 ft above landing and secured at top and bottom

  • 8.3 - Greases and slippery chemicals are removed from stairs, ladders, and work surfaces

  • Note: Take pictures of any Housekeeping hazards

  • 8.4 Performance Measurement (Nominal - 17)

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