• Safety Device Audit

  • Device
  • Device id#

  • Location of the Device (location, machine, column number, area, etc)

  • Take a picture of the device being audited

  • Type of device being audited (multiple choice)

  • Is the device accounted for in the "Safety Device Inventory" for this location?

  • What is purpose/function of the device? (ie: the saw stops when the door is opened)

  • Does the device operate or function at intended? (Add notes for NO or N/A selections)

  • Comments (ie: more suitable device required, control not effective, etc)

  • Auditor's Name & Signature

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