Safety Observation Record

• Marcom Communications safety observation record Ver. 1.1

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Description of activity

• Is there a SWMS available for the activity

  Yes

  No

  N/A

Area of observation

• Is a copy of the SWMS present with crew

  Yes

  No

  N/A

• Has a JSA or equivalent been completed for given task

  Yes

  No

  N/A

• Does the SWMS cover all hazards

  Yes

  No

  N/A

• Are all personal using correct PPE for the task

  Yes

  No

  N/A

• Are tools and equipment been used correctly

  Yes

  No

  N/A

• Are the tasks being done as per SWMS

  Yes

  No

  N/A

Follow up

• Was the worker fully aware of all SWMS and understood how to implement

  Yes

  No

  N/A

• What was discussed

• Are they aware of potential hazards involved

  Yes

  No

  N/A

• Are they aware of control measures

  Yes

  No

  N/A

• What could be done to improve safety for the task

Overall observation

• General Comments

• Technician signature

  Sign

• Supervisor signature

  Sign

• Photos attached

  Media