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Safety Observation Report Template

Use this Template to Report Unsafe of Hazardouse conditions at Job site


Project/Site
Site Number
Location
Type of Observation Unsafe Action
Choose one Unsafe Condtions
Safe Behavior
Describe Your Observaiton

Did you take any


action to remediate YES NO
the hazard?
If so Describe

Urgency of situation Low


Choose one Medium
High
Who should this be
Reported to
Further Action Required YES NO
Name of Person Reporting
Department
Date / /
Time : AM/PM

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