Safety Walk

• Conducted on

  Date

• Prepared by

• Area/Site

  Select

• Company Contractor

  Select

• Supervisor contractor

• General instructions; The items marked with "At risk", must be added an evidence or issue description

• If is observed a relevant unsafe act or condition, it must create an action

01. Work task observed

• Describe of work task observed

02. Acts observed

• The work area is signed with the main risks

  Safe

  At Risk

  N/A

• The workers use the manual tools, and machinery properly

  Safe

  At Risk

  N/A

• The ppe´s are available and the workers are using the ppe´s properly

  Safe

  At Risk

  N/A

• The workers are using the ppe´s in according to the risks involved to this area

  Safe

  At Risk

  N/A

• The work area is keeping a good conditions respect to order and cleaning

  Safe

  At Risk

  N/A

• The chemical product are using in according to the manufacture instructions

  Safe

  At Risk

  N/A

• It is available, and in a proper conditions, the emergency, rescue and evacuation equipments

  Safe

  At Risk

  N/A

• There is a good planning and organization of the tasks

  Safe

  At Risk

  N/A

• The check and safety inspections are implemented on site (previous, during , and after the works)

  Safe

  At Risk

  N/A

• The work equipment has the safety documentation (protocols, instructions, etc.) available to carry out the different tasks

  Safe

  At Risk

  N/A

• Others acts observed

0.3 Concerns Observed

• Describe the concerns observed

Sign Off

• Name of inspector

  Select

• Name & Signature of Reporter

  Sign