FRM-Visible Felt Leadership Shutdown Observation

• Site conducted

  Select AC1 AC2 AC3 AC4 CCD1 CCD2 CCD3 CCD4 Other

  • AC1
  • AC2
  • AC3
  • AC4
  • CCD1
  • CCD2
  • CCD3
  • CCD4
  • Other

• Conducted on

  Date

• HSE Representative

  Dave Parker

  Andrew MacFarlane

• Observer 1

• Observer 2

• Department

  Select Safety Mechanical Cranes & Rigging E&I Bricklayers Welders TICS Other

  • Safety
  • Mechanical
  • Cranes & Rigging
  • E&I
  • Bricklayers
  • Welders
  • TICS
  • Other

• Permit No. If appicable

• Work area management positives identified

  Yes

  No

• What were they?

• Opportunities to improve work area management.

  Yes

  No

• What are they?

• Did this observation present an opportunity to complete a CCV

  Yes

  No

• If YES-Title of CCV verification

• Person completing CCV

• Were there Non-Compliances found.

  Compliant

  Non-Compliant

  N/A

• If Yes what were they?

Sign Off

• Name Signature-HSE Rep

  Sign

• Name Signature-Observer 1

  Sign

• Name Signature Observer 2

  Sign