H&S Daily Report Rev 1

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Behavioural Observation (TSTO)

• Was a TSTO conducted this shift?

  Yes

  No

  N/A

Job Hazard Analysis (JHA)

• Was a JHA review completed this shift?

  Yes

  No

  N/A

Loss Prevention Inspection

• Was a LPI completed conducted this shift?

  Yes

  No

  N/A

Pre- Start Meeting

• Attendance at Contractor Pre-Start Meeting?

  Yes

  No

  N/A

Safety Walks

• Safety Walks with Gorgon and Contractor Supervisor/HSR conducted?

  Yes

  No

  N/A

Personal Contact

• Workforce personal contact during Safety Walks?

  Yes

  No

  N/A

Hazard Intervention and Reporting (HIRC)

• HIRC submitted this shift?

  Yes

  No

  N/A

Issues/Concerns

• Any issues/concerns requiring actioning?

  Safe

  At Risk

  N/A

Coaching/Intervention

• Coaching/Intervention during shift?

  Safe

  At Risk

  N/A

Incidents

• Incidents or Near Misses Reported?

  Near Miss

  Personal Injury

  Property Damage

  Environment

  No Event Reported

General

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