SAFETY OBSERVATION REPORT

Project Name Company Name: Observation Date:

Responsible Person: SOR NO.
Project Location
Specific Location: Revison Date:
Activity:

PRIORITY
Others Please Specify:
Emergency / Urgent UNSAFE ACT
Three days (Max) UNSAFE CONDITION
One week

ATTACHMENTS / PHOTO :

ITEM NO. Hazard / deficiency description Recommended Corrective Actions:

Inspected by: Noted by:

ESTII-SHEQ PERSONEL Attending Personnel

Issued Date: Date:

Received by: Expected date of completion:

Name and Signature / Date

FOLLOW-UP STATUS :
VERIFIED BY :
On going Completed ESTII-SHEQ PERSONEL

Date: ____________________ Date: _________________________

Remarks :

Note: All observations must be closed within 24 hours upon notice, All unclosed observation lapsed on the expected date of completion shall be given Notice of Violation.
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