• Electrocution

  • Conducted on:

  • Auditor:

  • Person being Audited:

Electrical Training and Competency

  • Have you identified hazards and controls are in place and effective to safely work with Electricity?

  • Do you have a current procedure in place and on the job to complete this electrical task?

  • Are you trained and have the require licenses to work with electricity?

  • Has all fixed, mobile, portable, and hand held electrical equipment been inspected and tagged in date prior to use?

Section: Electrical PPE

  • Have you checked your electrical PPE to ensure it is fit for purpose and has the correct protection rating?

  • Have you inspected your Electrical PPE prior to use and it is free of holes, nicks and other damage?

  • Is your electrical PPE in date and labelled with checked/issue date (test date)?

Isolation Confirmation

  • Have all hazardous energy sources associated with the task been identified?

  • Have all energy sources been contained / de-energised and a try test or a test before touch been completed to confirm the integrity of the isolation and ensure a zero energy state?

  • Have all personnel isolated and applied their personnel lock to all isolation points?

  • Have all personnel confirmed they are working on the correct isolated equipment?

  • Additional comments/observation

  • Observation
  • Add observations/comments here.


  • I hereby certify that all information is accurate and that an actual inspection was conducted.

  • Auditor's Printed Name & 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.