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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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