Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Rating Scale: How Bad is it? What to do

  • -1 Dangerous Extreme Potential for Incident / Accident Fix / Control Immediately

  • 0 Poor High Potential for Incident / Accident - Nil Compliance Fix / Control immediately

  • 1 Fair Medium Potential. Nil to Some compliance Fix within two weeks

  • 2 Average Low Potential - Moderate compliance Fix within two months

  • 3 Good Low Potential - Mostly in compliance Improve when possible

  • 4 Excellent Complies fully with legal, company & site requirements

  • N/A* (Not applicable):

1.0 - Previous inspection

  • 1.1 - Has the last inspection been reviewed?

  • 1.2 - Are there no outstanding actions?

2.0 - Building and Structures

2.1 Lighting

  • No lights out/broken

  • Sufficient lighting

  • Windows clean and undamaged

2.2 Ventilation

  • Natural air flow and air extraction

  • Mechanical (include A/C, fans etc)

  • Filters clean/inspected

  • Filters clean/inspected • No build up of hazards or flammable material

2.3 Amenities

  • Adequate supply of drinking water

  • Hygienic showers/change rooms

  • Cleanliness of fridge and cooking appliances

  • Hygienic kitchen/crib room

  • Hygienic toilets/urinals

2.4 Emergency

  • Exits identified

  • Exit doors and equipment unobstructed

  • Evacuation plan in place

  • Emergency lighting

  • Eye Wash clean, accessible & serviceable

  • Emergency shower accessible & serviceable

2.5 First Aid Facilities

  • Clean,

  • Fully stocked,

  • First aiders names visible

  • Emergency procedure & Numbers visiblea

2.6 Fire Protection & Prevention

  • Extinguisher Location accessible

  • Signs visible

  • Signs indicated type of equipment

  • Signs to standard

  • Current Tags/seals in place

  • Condition good

2.7 Buildings and Floors

  • No building damage

  • No floors damaged/dirty

  • Aisles good width, safe & free from obstruction

  • Stairs to approved standard - gradient

  • Floors good surface, oil free

3.0 Housekeeping

3.1 Aisles and Storage

  • Good demarcation/ not worn

  • Not cluttered/obstructed

  • Clear access to emergency equipment & exits

3.2 Stacking and Storage

  • Racks secure against falling,

  • Doesn’t obstruct flow and services

  • Sufficient racks/areas for storage

  • Clear access and egress

  • Load ratings obvious

3.3 Wash Down Bay

  • Clean

  • Pumped out regularly

  • Operating instructions on oil separator

3.4 Plant and Yard

  • No redundant plant

  • No redundant material

  • Tidy

3.5 Waste / Scrap Removal System

  • Sufficient bins

  • Adequate removal/emptied

  • Waste segregated correctly

  • Waste oil from bins captured

4.0 Electrical Safeguarding

4.1 Portable Electrical Equipment

  • Identified and on register

  • No damaged cables/plugs

  • Earthing

  • Protection from liquids and dust

  • Current inspection tag (> 32v)

  • Appropriate storage

  • No visible damaged to tools or electrical leads

4.2 Earth Leakage

  • Complete coverage – distribution board/temp supply

  • Tested regularly by competent person

  • Documentation

  • Inspection tag

4.3 Electrical Installations Safe

  • Electrical equipment safe

  • Wiring safe

  • Unauthorised access to switch gear/substations restricted

  • Terminal/distribution cupboards labeled

  • Earthing and polarity correct

  • No exposed wires

  • No damage to protective sheath/cable guide or conduit

5.0 Plant & Equipment

5.1 Machine Guarding

  • Machines comply with appropriate standards

  • Guards in place when operating preventing reaching into moving parts

  • Guards secure while machine operating

  • interlocks prevent machine operating when open

  • guards protect against hazards to the rear and sides of machines

  • All nip points guarded and signed

  • Not loose, broken or inadequate

5.2 Bench Grinders, Drills & Saws

  • Guards in place & serviceable

  • Operating Instructions visible

  • Bench grinder wheel condition

  • No damage to saw blades

  • Bench grinder tool reset 3mm

  • Face shield available &clean (double face protection)

5.3 Energy Lock-out System and Usage

  • Written procedure

  • positive lock out systems for all power/individually powered systems

  • Lockout permits multiple lock outs

  • Covers all sources of energy

  • lock out reduces energised equipment to a zero energy state

  • Switches lockable

  • Tags/locks available

5.4 Switches, Isolators, Valves & Controls

  • Labeled

  • guarded from damage

  • No labels missing

  • Emergency stop buttons red

  • Pipes all banded and labeled

5.5 Ladders, Handrails and Walkways

  • Uprights of ladders not damaged

  • Labels of SWL in place

  • Rubber footings

  • Rungs free from grease/oils

  • Metal ladders NOT used for electrical work

  • Stairways/landings toe-boards fitted

  • Stairways anti slip

  • Stairways at least one handrail

  • Portable ladders inspected/tested

  • Identified and on register

5.6 Lifting, Supporting Gear and Machinery

  • Identified and on register

  • No defective items

  • Standard of Jacks

  • Support Stands engineered

  • Safe working load marked with MRC * Ref below

  • Lifting hook safety latches in place

  • Regular inspections and tagged

  • Quarantine procedure and disposal

  • Stored correctly on rack

5.7 Compressed Air

  • Air Hoses undamaged

  • Air outlets face downwards

  • No air leaks evident

  • Safety Clips in place

  • Hose adequately secured to fittings

6.0 Portable Equipment & Hand tools

6.1 Angle Grinders & Sanders and Buffing Discs

  • Guards in place on all rotating tools

  • Second handle if fitted

  • Dead man switches

  • Good mechanical condition – handles/couplings to hold discs on

  • No dust or oil accessing electrics

  • 9” Versions restricted use

6.2 Hand tools

  • No damaged or defective tools

  • Sharp edges covered,

  • mushroomed hammers ends

  • No split handles

  • Stored correctly

  • Clean of oil & grease

  • Soft metal hammers clearly labeled

7.0 Gas Cylinders and Pressure Vessels

7.1 Pressure Vessels

  • Pressure vessel maintained

  • Register/certificates of inspection

  • Relief (safety) valve operational

  • Drained & free of moisture

7.2 Gas Cylinders

  • Cylinders correctly stored vertically, secure

  • Segregation distance > 3 M

  • Equipment safe condition

  • Correct flashback arrestors used on hand piece and valves

  • Transported correctly, secure

  • Stored out of direct sunlight

7.3 Connecting pipes fitting and hoses

  • In good condition, no leaks, no cracks, no bending at 90 degrees

  • Connecting pipes and lines labeled.

  • Safety clips used

8.0 Mobile Plant & Machines

8.1 Forklift • Condition of Vehicles/Plant

  • Daily check/documentation

  • No defective items

  • Operator competent

  • Isolated when unattended

  • Seat belts in use

  • Safe Access & Egress

  • Fire Extinguisher

  • Flashing light/reversing alarm

  • Maintenance records

8.2 Vehicle

  • Condition

  • Daily check/documentation

  • No defective items

  • Operator competent

  • Seat belts in use

  • Fire Extinguisher

  • First Aid Kit

  • Secured items in rear

9.0 Hazardous and Flammable Substances

9.1 Chemicals and Substances

  • Chemicals and Substances

  • Chemical register

  • Manifest and emergency plan

  • Products labeled

  • MSDS sheets up to date (Within 5 Years)

  • Stored appropriately, bunding & containment

  • Segregation distances

  • Fumes extracted

10.0 PPE & Signage & Notice boards

10.1 Head Protection

  • Area identified – sign

  • Hard hats provided

  • Being worn

10.2 Eye and Face Protection

  • Area identified – signs

  • Equipment provided

  • Worn correctly

10.3 Hearing Protection

  • Area identified –signs

  • Equipment provided

  • Worn correctly

10.4 Other PPE

  • Safety harness & lanyards

  • Hand protection (gloves etc)

  • Respiratory equipment

  • Sun protection, Sunscreen

  • Sun hat or attachment

  • Insect repellent

  • Welding PPE

10.5 Signage

  • Appropriate signs displayed

  • To standard requirements

  • Visible & correctly located

  • Good condition

10.6 Notice Boards

  • Conspicuous position

  • Suitable size

  • Up to date

  • Procedure in case of fire

  • Procedure in case of electric shock

Sign Off

  • On site representative

  • Auditor's signature

  • • Ensure this form is kept live while actions are outstanding.

  • • Original form to be kept as a record on site/premises.

  • • Findings tabled at Safety / Toolbox Meetings.

  • • Copy to Safety department of principal (if applicable)

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