Information

  • FDT Observation Worksheet. Capital Restoration Project

  • FD Thomas, Inc

  • Conducted on

  • Prepared by:

  • Prepared by:

Location: (Select only one)

  • Job Site or Job Number

  • Level or Area or Project

Use The Following Choices For The Observation (NI - Requires a comment)

  • EE = Exceeds Expectations. ME = Meets Expectations. NI = Needs Improvement.

Human Performance Tools

  • Pre-Task Plan or Job Safety Analysis or Pre/Post Job Brief

  • Crew discussion of the scope of the work for the day

  • Procedure Use and Adherence

Hazard Recognition

  • Line of Fire

  • Barrier Tape or Rope / Signage

  • Hard Barricades / Signage

  • Compressed Gas or Bottles (either flammable or non-flammable)

  • Electrical Cord(s) / Inspected / Good Condition

  • Air Hoses / Connections / Whip-checks / Pins

  • Tools (good condition / inspected before use)

  • Ventilation

Housekeeping and Material Conditions

  • General Housekeeping (cleanliness)

  • Combustibles (properly stored / secured, labeled)

  • Work Area (cleanliness, orderly, controlled)

  • Lay-down yard (clean, uncluttered, easy access)

Personnel Protective Equipment

  • Head

  • Hearing

  • Eyes / Face

  • Foot

  • Hand

  • Respirator(s)

  • Body (Coveralls, etc.)

  • Are there any PPE modifications in effect for this area or part of the project

Fall Protection

  • Use of Fall Protection

  • Properly worn / adjusted

  • Properly anchored while in use

  • Ladder Use and secure

  • Scaffold Use (mobile or permanent)

  • Dropped Object Control

Lifting and Rigging / Mechanical Material Handling

  • Vehicle usage procedures (aerial lift / forklift or lull)

  • Operator

  • Signal Person

  • Use of Spotter

  • Lift Area

  • Load Control

  • Softners

  • Cribbing

Manual Material Handling

  • Lifting and Carrying

  • Using assistance as needed

  • Using mechanical assistance (hand-truck, dolly, etc..)

You must answer both of these questions

  • Feedback Given to Crew or Individual

  • Debriefed Supervision

Number and Comments:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.