Information
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Task being Observed:
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Personnel being Observed:
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Date and Time:
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Observer:
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Work Area:
- Administration
- Field Operations
- Huskers / Sorting
- Plant Operations
- Treating
- Warehouse
- Lab
- Bulk Storage
- Loadout Area
- Dryer
- Sheller
- Conditioning Tower
- Packaging
- Maintenance Shop
- Treating / Bagging
- Facility Operations
Body Positioning / Ergonomics
Body Movement
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Body Bending, Twisting, Standing, Sitting
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Manual Lifting, Carrying or Lowering
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Grip, Pinch, Grab
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Pushing, Pulling, Reaching
Body Position
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Balance and Traction
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Comfortable and Neutral Postures
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Field of Vision, Eyes on Task
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Line of Fire
Machines, Vehicle, Tools
Machines
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Industrial Process
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Lab
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Material Handling Equipment
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Motorized Equipment, Forklift, Tractor, Combine
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Other Machines
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Personnel Lift, Boom, Scissor, Basket
Tools
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Farm Tool, Post Hole, Shovel, Rake
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Hand Tool Mechanical, Hammer, Screwdriver, Knife
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Hand Tool Powered, Electrical, Air, Hydraulic
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Lab
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Other Tools
Vehicles
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Motor Vehicle, Car, Truck
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Trailer
Personal Protective Equipment (PPE)
Arm / Hand / Wrist
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General Purpose Work Gloves
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Protective Sleeves
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Special Use Glove (Cut, Chemical, etc.)
Body
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Fall Protection
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Special Use Clothing (Coverall, Apron, Hi-Vis)
Eyes / Face / Ear
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Ear Protection
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Face Shield
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Goggles
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Safety Glasses
Feet & Legs
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Leg Protection
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Safety Shoes
Head
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Arabian Cap, Hat, Hood
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Arc Flash, Fire Resistant
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Hard Hat, Bump Cap
Respiratory
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Dust Mask - Type A
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Half or Full - Type B
Procedure Application
Chemical Procedure
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Handling, Storage, Disposal
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Pesticide, Herbicide
Safety Procedure
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Energy Control Procedure (LOTO)
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Job Safety Analysis, Hazard Recognition
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Other Site Procedure
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Warning Signage
Work Permits
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Confined Space Permit
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Elevated Work Permit
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Hot Work Permit
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Lockout Tagout Permit
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Other Work Permit
