Information
Safety Observation Report (SOR)
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Conducted on
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Client
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Document No.
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Prepared by
- SOR
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Observation
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Imminent Danger
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Date/Time:
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Observation Type:
- Unsafe Act
- Safe Act
- Unsafe Conditions
- Safe Conditions
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Add media
Action Taken:
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Add media
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Date/Time Action Taken:
Indirect Cause:
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Training
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Resources
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Belief
Safety Checklist:
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Safety Checklists
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Safety Checklist:
- Housekeeping
- Fall Protection
- Scaffolds, Ladders, Stairways
- Personal Protective Equipment
- Excavations
- Material Handling
- Vehicles, Mobile Equipment
- Tools and Equipment
- Fire Protection
- Confined Space
- Planing, Communication
- LO/TO and Electrical
- Work Practices
- Chemical Exposure
- Permit/Hazard Evaluations
- Other
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Housekeeping:
- Trash
- Tripping Hazards
- Cords
- Material Storage
- Access
- N/A
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Fall Protection:
- Railings
- Tie-Offs
- Anchorage
- PPE
- Inspection
- N/A
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Scaffolds, Ladders, Stairways:
- Inspect
- Tag
- Position
- Tie-off
- N/A
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Personal Protective Equipment:
- Head
- Face
- Hands
- Hearing
- Feet
- Clothing
- N/A
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Excavations:
- Inspected
- Slope/Benched
- Shore
- Vibration
- Air Tested
- Permit
- N/A
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Material Handling:
- Hoisting
- Rigging
- Proper Use
- Inspection
- N/A
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Vehicles, Mobile Equipment:
- Inspections
- Operation
- N/A
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Tools and Equipment:
- Selection
- Use
- Maintenance
- N/A
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Fire Protection:
- Ignition Control
- Permit
- Extinguishing Equipment
- Watch Training
- N/A
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Confined Space:
- Permit
- Testing
- Attendant Training
- Retrieval Equipment
- N/A
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Planning, Communication:
- Communications
- Safe Plan of Action (SPA)
- Resources
- Toolbox Safety Meeting
- N/A
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LO/TO and Electrical:
- Verify Energy Control Steps
- GFCI
- Cords
- N/A
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Work Practices:
- Body Position
- Cheaters
- Pinch Points
- Proper Tools
- N/A
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Chemical Exposure:
- Hazard Communication
- Air Monitoring
- H2S Meter
- N/A
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Permit / Hazard Evaluations:
- Permit Complete
- Hazard ID
- Effective Controls
- N/A
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Other:
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Description of Other Line Item:
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Signature