Audit

Tour

Conversation

Condition Report

Describe what was seen.

What was the conversation? What was discussed?

What was agreed?

Observer
Leader

The Agreement

Reinforce Safe Behavior

Changed Unsafe Behavior / Condition

Job Position

Drill Crew

Deck Crew

Marine Crew

Maintenance Crew

Other

Third Party

Location

Rig Floor

Pipe Deck

Machinery Space

Accomodations

Other

Behaviors / Hazards

Poor Housekeeping

Tools & Equipment

Electrical Energy

Pressure

Struck By

Caught Between

Fire / Explosion

Other

Incorrect PPE

Impaired

Dropped Objects

Loss of Containment

Falling

Marine Integrity

Well Control

Environment

Requirements / Procedures

Not Known

Not followed

Not understood

Inadequate

I certify work is safe to restart

Observer

UWA

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.