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Field Safety Obersation Card Template

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Field Safety Obersation Card Template

Audit

Select date
Contractor
EPCM Audit No:
Site Audit No:
Priority (H-high, M-medium, L-low)

"At Risk" answer to the following questions requires immediate action!

A. WORKING HABITS/COMPETENCY/BEHAVIOURS

PPE
Risk awareness
Positions of people
Competency and training
Supervisor (action condoned)
Emergency procedure

B. HOUSEKEEPING/WORK ENVIROMENT

Access/ Egress
Safe working platforms
Slips/trips/falls/tidy
Lighting
Scaffolding
Hygiene

C. COMMUNICATION & PROCEDURES/JSA/RA

Registers
Signage
Toolbox talks/DSTI
JHA/RA covering job
SWP covering activity
Critical procedures
Permits & lock-out
SMI board (adequate)
Non-verbal/verbal

D. MANUAL HANDLING & ERGONOMICS

Awkward positions/posture
Repetitive motions
Over exertion

E. PROTECTION & ELEVATED WORK/RESCUE

Attached at all times
Barricading
Overhead protection
Elevated work
Lanyards on all tools
Stacking and storage
Rescue plan/procedures

F. PLANT & EQUIPMENT

Mechanical
Electrical/energy
Tools & portable equipment
Mobile / transport
Lifting & rigging

G. HAZARDS & HAZARDOUS WORK

Physical
Chemical
Biological
Environmental
Confined space
Hot work

SAFE ACTS OBSERVED & COMMENDATIONS

(check name not set)

AT RISK BEHAVIOURS OBSERVED

(check name not set)

CORRECTIVE ACTIONS REQUIRED

(check name not set)
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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.