Corporate Safety Walk Through v.2

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Audited District

• A Rank - Finding could result in catastrophic injury to include loss of life or limb, high probability to cause government interference.

• B Rank - Finding could result in a recordable injury including restricted duty or lost time, potential to cause government interference.

• C Rank - Finding not likely to cause recordable injury or government interference.

Physical Item 1

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 2

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 3

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 4

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 5

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 6

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 7

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 8

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 9

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 10

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 11

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 12

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 13

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 14

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 15

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 16

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

  Media

Physical Item 17

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 18

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 19

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 20

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 21

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 22

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 23

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 24

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)

Physical Item 25

• Describe the Hazard

• Determine Hazard Category

  Select

• Determine Hazard Severity

  A Rank

  B Rank

  C Rank

• Add Photo(s) of the Hazard

  Media

• Describe Potential Counter Measure(s)