Workplace Inspection Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Consequence Likelihood Very Likely Likely Unlikely Very Unlikely Could happen Could happen Could happen Could happen at any time

Notices and Signs

• Check that all actions from the last inspection have been completed – if not carry them forward to this review

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Last date checked:

  Date

• Actions taken and/or comments:

• All relevant policies are displayed – OH&S, Rehab, Environmental, Management System

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• OH&S Performance chart and safety information noticeboard is updated within last month

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All safety signage in place and visible (exit signs, PPE signage etc.)

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Relevant Safe Work Procedures are readily identifiable

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Are ‘Out of Service’/’Do Not Operate’ tags available and staff trained in the procedures?

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• OHS Representatives photo, names and details displayed on noticeboard

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

Training

• All new staff have attended induction – verify records on file

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Toolbox training modules for period have been completed and records kept on file

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All staff are wearing correct or appropriate uniform/ PPE?

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

Facilities and building structures

• Facilities are provided for clothing & personal belongings

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Adequate decontamination facility is available and operational (i.e. eye wash stations)

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All lighting is adequate and clean; emergency lighting is adequate – test if practical

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All surfaces are clean and free of damage

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All toilets and ablutions are clean and hygienic

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All entrances, exits & walkways clear and identifiable

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All steps & stairways have non slip treads & damage free as well as have evenly-spaced steps and/or handrails

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Safety steps are available for accessing higher areas

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Ventilation is clean and adequate

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Area is free of manual handling hazards – if unsure a manual handling risk assessment can be completed

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• There is adequate storage for all goods and equipment

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All storage is stowed in a safe and orderly manner (e.g. good housekeeping)

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• No heavy or awkward items are stored above shoulder height or below waist height

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Adequate rubbish bins are available

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• There is a regular garbage disposal system

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Rubbish bins and disposal areas are clean and odour free

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

Equipment and tools

• Furniture, equipment and tools are clean & free of damage

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• There is preventative maintenance program in place for all equipment

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All machinery & equipment is in a safe and clean condition

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Safe Working Load (SWL) displayed on lifting equipment

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All machinery/ equipment guards are in place and in good working order – where applicable

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Workers are not exposed to noise exceeding 85dB

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All plant & machinery have risk assessments completed and have been reviewed in the last 12 months

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Trolleys are clean and serviceable, castors are maintained and debris removed

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Relevant PPE is provided for all tasks & maintained

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

First Aid

• Adequate first aid kits with appropriate contents are available – must also be clean and identifiable

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Contents of kit are correct as per first aid box contents list and content use by dates have not expired

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Emergency resuscitation instructions and injury/illness procedures are displayed near first aid kits

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Names of qualified First Aiders and emergency numbers are displayed near kits

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

Electrical

• Electrical switchboards are labelled and free of obstruction

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Electrical equipment and leads are free of damage

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Electrical equipment has been tested and tag date is within service period

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Portable Residual Current Devices/Earth Leakage Breakers are used on portable electrical equipment & leads

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• High voltage areas are well sign posted

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Electrical air vents and fans are free from blockage

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• There is no dust build up on electrical equipment

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Power boards are fitted with an overload protection button

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• No evidence of extension cords joined together

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• No evidence of double adapters in use

  Yes

  No

  N/A

• Extension cords do not exceed 25m

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Power point switches and sockets are in good condition (e.g. not cracked); no burn marks on power switches/outlets

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Permanent electrical appliances (such as workshop equipment, photocopiers, fridges) have their own power point

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

Emergency Planning

• Employees have been trained in emergency procedures in last 6 months

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Sufficient Emergency Wardens are allocated & trained

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Adequate appropriate fire fighting equipment is available, visible & readily accessible

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Fire equipment is clean and has been checked in last 6 months

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Fire equipment is clean and has been checked in last 6 months. Last date checked:

  Date

• Emergency procedures and maps are displayed showing fire extinguishers/blanket locations/evacuation points

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Emergency procedures and maps are displayed showing fire extinguishers/blanket locations/evacuation points. Date of last review:

  Date

• Are all EXIT signs visible? Are all exits marked with proper signage and illuminated?

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Are all exit doors unlocked, accessible and free of obstruction?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• No chemicals are stored near food or with paper products

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Spill tray / labelled plastic drip containment is in place for chemicals with taps – if applicable

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• There is a Material Safety Data Sheet for each product and have not expired their 5 year life

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• A chemical register is available in office & store areas

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Chemicals are sealed and clearly labelled

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Are proper containers with labels used for storage of flammable and/or combustible liquids?

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Are chemical storage areas properly ventilated?

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Hazardous Substance/DG Risk Assessments have been completed

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Automatic dispense has the correct chemical and is in working order

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• All appropriate workers chemical trained with the supplier and records maintained

  Select 1 Likely 1a Very Likely 1b Very Likely 2 Very Likely 2 Likely 2 Unlikely 3 Very Likely 3 Likely 3 Unlikely 3 Very Unlikely 4 Likely 4 Unlikely 4 Very Unlikely 5 Unlikely 5 Very Unlikely 6 Very Unlikely

  • 1 Likely
  • 1a Very Likely
  • 1b Very Likely
  • 2 Very Likely
  • 2 Likely
  • 2 Unlikely
  • 3 Very Likely
  • 3 Likely
  • 3 Unlikely
  • 3 Very Unlikely
  • 4 Likely
  • 4 Unlikely
  • 4 Very Unlikely
  • 5 Unlikely
  • 5 Very Unlikely
  • 6 Very Unlikely

• Note: A Hazard Report is to be completed for identified hazards or risks. A Business Improvement Report is to be raised via Knowledge SPOT for each “X” or unacceptable outcome in this report.Actions taken and/or comments