S&C Electric Company EMEA Team Member Site Safety Observation

• Conducted on

  Date

• Prepared by

• Location
  Address

SITE PARTICULARS

• Safety Observation Number

• Safety Observation Title

• Date Performed

  Date

• Team Member Observed

• Safety Observation Location

• Add location
  Address

• Observer

JOB SPECIFIC INFORMATION AND DOCUMENTATION

• Was a Risk Assessment/Method Statement created and submitted to the client prior to today's arrival?

  Yes

  No

  N/A

• Has a Point of Work Risk Assessment (POWRA) been completed and precautions put in place for identified risks?

  Yes

  No

  N/A

• Do all S&C team members and sub-contractors associated with S&C have valid site inductions or had a site induction prior to commencing ?

  Yes

  No

  N/A

• Does the S&C Team member have access to all electrical drawings of the system?

  Yes

  No

  N/A

• Have S&C signed onto all relevant permits provided by client SAP?

  Yes

  No

  N/A

• Does S&C Team Member have access to EMEA IQES System?

  Yes

  No

  N/A

• Does the S&C Team Member have all personally assigned PPE with them? I.e. All Arc Flash clothing and accessories, hard hat, safety glasses, steel toe capped boots.

  Yes

  No

  N/A

• Is the PPE in good condition?

  Yes

  No

  N/A

• Are hard hats and face shields in good condition, free of cracks or significant scratches, and is stored in a protective bag to prevent damage?

  Yes

  No

  N/A

• Is the S&C Team Member complying with the customer's PPE requirements, if applicable?

  Yes

  No

  N/A

• Has the S&C Team Member confirmed that its associated subcontractor has the correct PPE for the work involved and it is in good order?

  Yes

  No

  N/A

ELECTRICAL SAFETY

• Has the S&C Team Member removed all jewelry before starting any electrical work?

  Yes

  No

  N/A

• Has the S&C Team Member erected barricades or used barrier tape to establish work safe zones, if needed?

  Yes

  No

  N/A

• Has the S&C Team Member communicated ISOLATION requirements to the customer, if required?

  Yes

  No

  N/A

• Has electrical equipment that is about to be worked on been proven dead using a calibrated proving unit?

  Yes

  No

  N/A

• Is all testing equipment being used or in the possession of the S&C Team Member calibrated, labeled and has a acceptable calibration date?

  Yes

  No

  N/A

• Are extension leads in good condition?

  Yes

  No

  N/A

• Are all insulated tools present in good condition, clean and free of damage? If not, note each item individually in the corrective actions section.

  Yes

  No

  N/A

FALL PROTECTION

• If the work being performed requires fall protection, is the equipment available, has it been inspected prior to use, and is it being used correctly?

  Yes

  No

  N/A

ERGONOMICS

• Have all S&C Team Members demonstrated good manual handling techniques? <br>1. Insure path is clear<br>2. Straight back<br>3. Test weight of unknown object before attempting a lift<br>4. No twisting at the waist<br>5. Lift with legs<br>6. Feet staggered and apart to maintain their stability<br>7. Keep load close to body as possible<br>

  Yes

  No

  N/A

SUMMARY OF OBSERVATION

• MAJOR NON CONFORMANCE - The S&C Team Member was stopped from working and or removed from the job site. Immediate corrective actions are required.

• MINOR NON CONFORMANCE- Critical requirements are being met in order to work safely. Minor issue that require follow up are noted.

• CONFORMING - Meets all requirements and expectations. No follow up required.

FOLLOW-UP ACTIONS - STATE ISSUE, FOLLOW-UP ACTIONS, WHO IS RESPONSIBLE TO CORRECT, AND REQUIRED COMPLETION.

• 1.

• 2.

• 3.

SIGNATURES

• S&C Team Member Signature

  Sign

• S&C Service Manager Signature

  Sign

• Observer Signature

  Sign