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  • Safety Observation Report

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    rnath336
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    The document is a safety observation report form used to document any unsafe conditions, acts, or risks observed during safety inspections. It includes categories for classifying observations such as unsafe conditions, acts, procedures, use of protective equipment. The form provides space to describe the location, work, or event observed, the unsafe condition or act, the potential worst injury that could result, and classification.

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    Safety Observation report

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    The document is a safety observation report form used to document any unsafe conditions, acts, or risks observed during safety inspections. It includes categories for classifying observations such as unsafe conditions, acts, procedures, use of protective equipment. The form provides space to describe the location, work, or event observed, the unsafe condition or act, the potential worst injury that could result, and classification.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    12 views2 pages

    Safety Observation Report

    Uploaded by

    rnath336
    The document is a safety observation report form used to document any unsafe conditions, acts, or risks observed during safety inspections. It includes categories for classifying observations such as unsafe conditions, acts, procedures, use of protective equipment. The form provides space to describe the location, work, or event observed, the unsafe condition or act, the potential worst injury that could result, and classification.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    SAFETY OBSERVATION REPORT FORM

    AREA: __________________ OBS.TEAM: _____________________


    DATE: __________________ _____________________
    OBS.HOURS: __________________ _____________________
    _____________________

    Categories Type
    RP = Reactions of people UC = Unsafe condition
    PP = Positions of people SC = Safe condition
    PPE = Personal protective equipment UA = Unsafe act
    TE = Tools and equipment SA = Safe act
    PRO = Procedures
    OS = Orderliness standards

    DESCRIPTION OF THE UNSAFE/HIGH RISK OR UNSAFE ACT


    WORK/LOCATION/EVENT TYPE
    CONDITION CATEGORY

    Example: Receiving Two unsheathedknives on cluttered bench Procedures UC


    Example: repair shop Machinist grinding without eye protection PPE UA
    Example: Polymer B Operating valve on pipe, unsecured @10" Tool & Equipment UA
    ___________
    ___________
    ___________
    _________

    condition
    dition
    ct

    WORST
    POTENTIAL
    INJURY

    Minor
    Serious
    Fatal

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