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Information
Audit Title
Document No.
Client / Site
Conducted on
Prepared by
Location
Personnel
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Select date
1 EMERGENCY RESPONSE
1.1 Current Emergency Evacuation Plan & Procedure displayed in appropriate positions
around site?
Yes No N/A
Yes No N/A
1.3 Emergency assembly & Muster points are highlighted on the evacuation plan?
Yes No N/A
1.4 Location of First Aid kits are marked on the evacuation plan?
Yes No N/A
Yes No N/A
Yes No N/A
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Local Hospital
Gas
Chemwatch
Yes No N/A
Yes No N/A
Yes No N/A
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1.10 Fire extinguishers are serviced every 12 months and fitted with anti-tamper tags?
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
1.17 Emergency assembly / muster area(s) have a clear path to them and are free of
debris?
Yes No N/A
1.18 First Aid kits are available with correct signage displayed?
Yes No N/A
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1.19 First Aid kits in good condition and fully stocked (contents list is located on inside of
kit - check)?
Yes No N/A
1.20 Are names of first aiders on site located on the first aid kit?
Yes No N/A
Yes No N/A
1.22 Emergency 'exit' signs present and illuminates (above fire doors and directing
exits)?
Yes No N/A
Yes No N/A
2 House Keeping
Yes No N/A
Yes No N/A
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
2.12 Do employees pick up stock / litter / spillages off floor & site area?
Yes No N/A
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Yes No N/A
3.2 Floors are clean, clear with a safe path of travel throughout area?
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
3.7 Access and Egress; trip hazards, condition of flooring, anti-slip, handrails?
Yes No N/A
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
3.14 Office equipment; Shredder protected, good height, ventilation, noise - all
adequate?
Yes No N/A
3.15 Equipment such as chairs, desks, computers, etc. are in good working condition?
Yes No N/A
3.16 Lights are working, covers in place where required and adequate for the job?
Yes No N/A
Yes No N/A
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3.18 Electrically operated machines have current testing and tagging (includes kitchen
appliances older than 12 months)?
Yes No N/A
3.19 Power points and power leads are good condition (no leads across floors or on wet
surfaces)?
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
5 Mechanical / Workshop
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
5.9 Hand held tools are in good condition and stored appropriately?
Yes No N/A
Yes No N/A
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Yes No N/A
5.12 Gas bottles secured / protected from damage or falling over ( e.g strapped or
chained to secured fixture)?
Yes No N/A
Yes No N/A
Manual Handling
Eye protection
Chemicals
Yes No N/A
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Yes No N/A
Yes No N/A
6 Electrical
Yes No N/A
6.2 ELCB / RCD used for portable tools - adequate upon assessment?
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
7.4 Weekly pre-start inspection completed and logged on all light vehicle?<br>Refer to
Daily Re-start Inspection Checklist
Yes No N/A
7.5 Daily Pre-start inspection completed and logged on all machinery?<br>Refer to Daily
Pre-start inspection checklist
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
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8 Traffic Management
8.1 Full segregation of Light Vehicle & Surface Mining Equipment is in place?
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
11 Job Start
11.1 Job Hazard Analysis (JHA) appropriate & completed?<br>Refer to JHA checklist
Yes No N/A
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Yes No N/A
11.3 Field Level Risk Assessments (FLRA) have been undertaken?<br>Refer to FLRA
cheklist
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
11.7 Material Safety Data Sheets (MSDS) for chemicals at the workplace?
Yes No N/A
Yes No N/A
12 Occupational Health
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
13 Hot Work
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
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14 Working at Heights
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
15 Craneage Operations
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
16 Confined Space
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
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17 Hydrocarbon Storage
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
17.5 Fuel-containing equipment and plant in trays or provided with other bunding?
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
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Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
19 Water Management
Yes No N/A
Yes No N/A
19.3 Water holding facilities stock fenced & have exit ropes?
Yes No N/A
20 Erosion
Yes No N/A
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Yes No N/A
21 Sewerage Treatment
Yes No N/A
Yes No N/A
21.3 Receiving effluent tank higher capacity then freshwater input tank?
Yes No N/A
22.1 Is there a procedure for personnel to refuse working where they feel that injury or
harm could occur to themselves or to other people?
Yes No N/A
Yes No N/A
Yes No N/A
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22.4 Incident / Accident Recording, Reporting & Investigation Folder is available and
current?
Yes No N/A
22.5 Danger Tags are available and being used correctly site wide?
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
22.9 Is the Site Specific Risk Assessment Current? (Risk Assessment must be no older
than 2 years old.)
Yes No N/A
22.10 Have controls been put in place to control hazards identified? (review site specific
risk assessment)
Yes No N/A
22.11 Does the Site conduct regular evacuation drills? Did the employees participate
(Review the last few Fire Drill Records)
Yes No N/A
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22.12 Has the employee completed Specific Training (review on the job training records)
Yes No N/A
22.13 Has the employee received / or has the ability to access Safe Work Procedures?
(review employee file for sign off)
Yes No N/A
Yes No N/A
22.15 Employees who conduct specialist tasks have received appropriate training in
OH&S Related Matters? (check employee personnel files for record of training (certificate
or attendance registers)
Yes No N/A
22.16 Employees have received appropriate training in return to work? (check training
matrix)
Yes No N/A
22.37 Has OH&S Training been conducted for OH&S Representatives within 12 months
of accepting the position? (review personnel files or training matrix)
Yes No N/A
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23 Chemicals
23.1 Are only approved chemicals being used as per the Approved Chemical Register?
Yes No N/A
Yes No N/A
23.3 Chemicals are not decanted? (substances must be in original containers with
original labels)
Yes No N/A
Yes No N/A
23.5 Material Safety Data Sheets present at location where Chemicals are kept and easily
accessible?
Yes No N/A
23.6 Containers in which chemicals are stored are in good condition and are not
leaking?
Yes No N/A
23.7 Nominated area in which chemicals are stored is locked allowing only restricted
access and bundled?
Yes No N/A
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23.8 Gas bottles secured/ protected from damage or falling over? (e.g strapped or
chained to secured fixture)
Yes No N/A
Yes No N/A
Yes No N/A
23.11 Are emergency showers or eye wash stations available & easily assessable?
Yes No N/A
Review
Remarks
Witness/Participant
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.
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