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General Information
Date
Observed by
Location
Site Conditions
Weather conditions
Lighting adequate
Housekeeping satisfactory
Slip/trip hazards present
Worker Behavior
Use of personal protective equipment
Safe work practices followed
Level of engagement in safety
Equipment and Tools
Equipment in good condition
Tools in good condition
Guarding/safety devices functional
Electrical cords in good condition
Observations and Follow-up
Positive observations
Areas for improvement
Corrective actions required
Target completion date