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ITS Technologies & Logistics Safety Observation
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Division
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Location / Site
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GPS - Location
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Type Of Observation ?
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Task Being Performed?
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Conducted on
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Person being Observed - Full Name
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Employee Number - Observed
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Prepared by (Person completing Observation) - Full Name
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Employee Number - Prepared
Observation
ITS Technologies & Logistics Safety Observation
Observations Will Never Result In Discipline
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INSTRUCTIONS: Only mark Behaviors that keep the employee safe or put them at risk while performing the task(s) being observed. DO NOT mark those Behaviors that don’t apply to the work being performed. Put detailed comments below for each At-Risk-Behavior.
1.0 PERSONAL PROTECTIVE EQUIPMENT
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1.1 PPE <br>
2.0 EQUIPMENT USE
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2.1 Inspection<br>
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2.2 Defense Driving<br>
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2.3 Hook-up/Coupling<br>
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2.4 Parking/Staging<br>
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2.5 Following Distance<br>
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2.6 Yields/Rail Crossings/Stop Signs<br>
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2.7 Load Secure/Height<br>
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2.8 Pedestrian/Ground Grew Safety<br>
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2.9 Seatbelt<br>
3.0 BODY MECHANIICS
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3.1 Hand Grip<br>
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3.2 Lifting<br>
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3.3 Twisting <br>
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3.4 Overextending<br>
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3.5 Push/Pull Force<br>
4.0 BODY POSITION
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4.1 Pinch Point<br>
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4.2 Eyes on Path<br>
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4.3 Eyes on Task<br>
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4.4 Three Point Contact<br>
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4.5 Line of Fire<br>
5.0 JOB/WORK AREA PREPARTION
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5.1 Track Protection<br>
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5.2 Walking/Work Surface<br>
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5.3 Communication - Verbal/Hand Signal
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5.4 Assistance If Needed<br>
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5.5 Red Zones<br>
6.0 TOOLS & EQUIPMENT
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6.1 Proper Use<br>
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6.2 Condition<br>
7.0 WORK PRACTICES/CONDITIONS
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7.1 Regulations/Procedures<br>
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