SOT & Hazard report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Positive Concern

• Good Practice

  Yes

  No

  N/A

• PPE

  Yes

  No

  N/A

• Environment & housekeeping

  Yes

  No

  N/A

Hazard Report - Source of hazard

• People (eg. Position, posture, gravitation and etc.)

  Safe

  At Risk

  N/A

• Equipment (fix, mobile and portable tool/equipment)

  Safe

  At Risk

  N/A

• Material (hazardous substance, electricity and etc.)

  Safe

  At Risk

  N/A

• Environment (eg. Heat, dust, noise, biological and etc.)

  Safe

  At Risk

  N/A

Risk level

• Risk level = Likelyhood x Consequence

  Hight

  Medium

  Low

Recommendation for control

• Eliminate

  Yes

  No

  N/A

• Substitution

  Yes

  No

  N/A

• Emgineering

  Yes

  No

  N/A

• Administration

  Yes

  No

  N/A

• PPE

  Yes

  No

  N/A

Approval

• Agreement

  Agree

  Try another way

• Owner area

  Sign

• Manager

  Sign

• Reporter

  Sign