Task being undertaking during Observation.
Was Training provided? If so, what was shown? Who was shown?
Was the training understood?
Corrective Actions Needed: Reported to:
Any compliance or behavioural issues identified that should be entered into the Nitro Incident Report System
Incident Report No: And Reported to:
Correct SWP or JHA in place
All Persons aware
SWP followed correctly
Correct type / Appropriate for job
Correct type / appropriate for job
Tool used correctly
In serviceable condition
Trapped in, on or between moving parts
Strain / Over-exertion
Constant repetitive actions
Contact extreme hot or cold
Hazardous substances? MSDS? Storage?
Area assessed for suitability before start
Area kept tidy during the task
Area left tidy after task completed
All isolation points identified
Isolation performed correctly
Pre starts preformed as required