HSE FIELD INTERACTION

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

FIELD INTERACTION

Field Interaction Participation

• COACH / LEAD

• LEADERSHIP INVOLVED

• PERSONNEL INVOLVED

Filed Interaction Process

• Did you Take the Time to Observe the Task and Watch the Work in Motion?

  Yes

  No

  N/A

• Did you Discuss the Task with Personnel and Listen to Feedback?

  Yes

  No

  N/A

• Did you Provide any Positive or Negative Feedback?

  Yes

  No

  N/A

• Did you gain a Commitment to rectify any Negative Observations?

  Yes

  No

  N/A

Behaviours Observed

• Were personnel Carrying / Lifting / Pushing / Pulling Materials / Objects?

  Safe

  At Risk

  N/A

• Were personnel working in proximity to pinch points?

  Safe

  At Risk

  N/A

• Were personnel working in a restricted / confined area?

  Safe

  At Risk

  N/A

• Were personnel working in proximity to open edges?

  Safe

  At Risk

  N/A

• Were personnel in the line of fire?

  Safe

  At Risk

  N/A

• Were personnel exposed to sharp edges?

  Safe

  At Risk

  N/A

• Were personnel operating all equipment safely?

  Safe

  At Risk

  N/A

• Were personnel exposed to hazards such as Noise / Vibration / Dust?

  Safe

  At Risk

  N/A

• Was the work area in proximity to other work fronts/activities?

  Safe

  At Risk

  N/A

• Were personnel working in proximity to work overhead / overhead loads?

  Safe

  At Risk

  N/A

• Was there a potential for personnel to trip over materials?

  Safe

  At Risk

  N/A

• Were personnel exposed to Risk of Fire / Ignition from Hot Work Processes?

  Safe

  At Risk

  N/A

• Were personnel working in poorly lit / ventilated work area?

  Safe

  At Risk

  N/A

• Were personnel exposed to adverse temperature extremes/weather?

  Safe

  At Risk

  N/A

Discussion / Feedback

• Please Describe any Discussion or Feedback from Personnel

Actions / Innovations

• Please Describe any Actions or Innovations that came from this Interaction

• Who Is Responsible for the Action or Innovation?