Title Page
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Conducted on
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Prepared by
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Location
SITE PARTICULARS
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Safety Observation Number
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Safety Observation Title
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Date Performed
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Team Member Observed
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Safety Observation Location
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Add location
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Observer
JOB SPECIFIC INFORMATION AND DOCUMENTATION
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Was a Risk Assessment/Method Statement created and submitted to the client prior to today's arrival?
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Has a Point of Work Risk Assessment (POWRA) been completed and precautions put in place for identified risks?
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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 ?
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Does the S&C Team member have access to all electrical drawings of the system?
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Have all the working party signed onto all relevant permits provided by the client SAP?
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Does S&C Team Member have access to EMEA IQES System?
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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.
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Is the PPE in good condition?
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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?
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Is the S&C Team Member complying with the customer's PPE requirements, if applicable?
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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?
ELECTRICAL SAFETY
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Has the S&C Team Member removed all jewelry before starting any electrical work?
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Has the S&C Team Member erected barricades or used barrier tape to establish work safe zones, if needed?
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Has the S&C Team Member communicated isolation requirements to the customer, if required?
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Has electrical equipment that is about to be worked on been proven dead using a calibrated proving unit?
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Is all testing equipment being used or in the possession of the S&C Team Member calibrated, labeled and has a acceptable calibration date?
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Are extension leads in good condition?
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Are all insulated tools present in good condition, clean and free of damage? If not, note each item individually in the corrective actions section.
FALL PROTECTION
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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?
ERGONOMICS
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Have all S&C Team Members demonstrated good manual handling techniques? <br>
SUMMARY OF OBSERVATION
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MAJOR NON CONFORMANCE - The S&C Team Member was stopped from working and or removed from the job site. Immediate corrective actions are required.
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MINOR NON CONFORMANCE- Critical requirements are being met in order to work safely. Minor issue that require follow up are noted.
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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.
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SIGNATURES
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S&C Team Member Signature
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S&C Service Manager Signature
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Observer Signature