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Scan this QR code to use this paper checklist on your smartphone or tablet. Visit www.iauditor.com
Is machine Chocked correctly?
Does the job require the Isolator on?
Is the Isolator in the correct state?
If an Out of Service Tag is required is it attached?
Are all Tags filled out correctly, signed & dated?
If there is no Out of Service Tag fitted is a Test Tag fitted to the designated control point?
Was there any follow up that was required?
Sign once Audit is completed
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to
take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment;
or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is
permissible in your workplace or jurisdiction.
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