EH&S Hazard Assessment / Safety Observation short- Sabre Industries

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Define and describe the EH&S concern. Identify the corrective action, the proposed date of the corrective action and name and signatures of the Sabre employees assigned to provide the corrective actions. Capture supporting media images of the concern initiating the hazard assessment.

• Environmental, Health or Safety Concern(s)

  Safe

  At Risk

  N/A

• Enter the date the EH&S concern was discovered.

  Date

• Enter the date that it is expected to have resolution of the EH&S concern or the date of planned EH&S follow up.

  Date

• Was additional follow through required to obtain a resolution to the EH&S concern?

  Yes

  No

  N/A

• Enter the date EH&S follow up was conducted if it was required.

  Date

• Signature of SABRE EH&S personnel conducting the hazard assessment.

  Sign

• Signature of SABRE Manager, Supervisor or Lead

  Sign

• Capture images of the completed EH&S concerns.

  Media