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Sample Self Audit Form | Black Hawk County

Last Updated 08/18/2020

Performing an audit is not difficult, and it is not something that requires very much training.  You know what tools you use, how they perform, and if they are not operating properly. You also know where the eyewash, the shower, the first aid kits, and fire extinguishers are. Checking them and noting them on the tag or in a book is recommended and something to get into a habit of doing.  

This sample self-audit form will provide employers with a structure to develop and implement a safety self-audit process using the checklist for the different departments of their organization. This sample was used by Black Hawk County for all departments of the county.

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