Information

  • 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.

Signatures

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

  • Auditor's Printed Name & Signature

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