Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Clean It employees in area:

  • Name of employees:

Permits signed prior to commencing work.

  • Permit to Work

  • Confined Space Permit

  • JSEA been completed and signed for the job

  • All isolations and lock outs have been performed.

  • All safety aspects of the job are known and understood

  • Approved barricading, shade cloth and signage in place.

  • Relevant authority informed on arrival.

  • Evacuation procedures for the area are known and understood.

  • Correct PPE for the task is being worn and is in good condition.

  • Housekeeping in work area up to high standard.

  • Inspection of worksite carried out checking for hazards.

  • Hazards or safety concerns for the worksite are as follows:

  • Actions taken over any hazards or safety concerns:

  • Can I do this job safely?

  • Auditor 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.