Internal audit and evaluation form (form 5.1)

Your Name*
Date*

DayMonthYear
Date
Your position
The purpose of this form is to ensure all staff and contractors are carrying out there duties correctly, efficiently in a safe working manner with due consideration to the client and all people around.
Name of person being audited
Company they are from
**Please base your evaluation of their services based only on what you have observed.

The services being carried out exceed Enviropoles standards

Observing them whilst working they appear to be...

Occupational Health, Safety and Welfare are extremely important to Enviropoles, it is important to understand that everyone adheres to the requirements. Whilst observing, you need to ascertain the correct Health and safety precautions are being implemented. Risks assessed.
Describe the activity they appear to be carrying out.
Did you notice them carrying out risk assessment or JSA"s prior to commencing work?

YesNo
Add any Comments
Indicate which safety methods are being used.

Safety lights on vehicleSafety BollardsSafety tapeSafety glassesGlovesHigh Viz vestLong sleevesSun glassesSun screenHatWet weather jacketHead lamp torchNone of the aboveOther
Describe the environment in which they are working.

SunnyCloudyOvercastHotColdWetStormyWindyOther
What time of day is it?

Early morning (1am-5am)Sunrise (5am-9am)Mid Morning (9am-11am)Midday (11am-1pm)Early afternoon (1pm-5pm)Sunset (5pm-8pm)Late Night (8pm-12pm)Other
Please describe the activity environment

Empty (No one around)Quite (a couple of people around)Active (a number of people around)Busy, (many people around)Crowded (self explanatory)Other
Please detail any information that you feel needs to be added as part of this audit
Attach any supporting documents, images.

Select File

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Any additional comments relating to this form.
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