Undertaken By :
Person Observed :
Summary of Safety Contact :
Overall, are you satisfied the person was working safely (I.e. check against the SOP or JSA)?
Had a risk assessment (Job Start Check, JSA) been done before the task was started?
Was the correct procedure being followed (refer to the SOP)?
Was the person in a safe position (I.e. not in the line of fire of potential hazards) ?
Was the required PPE being used?
Were the correct tools and equipment being used?
Was the equipment properly isolated and in accordance with site isolation SOP?
Was the standard of housekeeping appropriate to maintaining a safe work area?
Did this Safety Contact result in changes to the activity or actions being observed?
Immediate Action Taken :
Follow Up Actions :
Assigned to :
Due Date :
Entered into INX InControl (Operations - Inspections - Safety Contact) Ref No: