Title Page
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STOP Observation Checklist
General Information
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Safe acts observed
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Unsafe acts observed
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Name
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Date/Time
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Site
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Area
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Shift
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Time spent on observatiom
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# of People Contacted
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# of People Observed
Conditions
Tools and Equipment
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Right for the Job
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In Safe Condition
Structures and Work Area
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Are They Clean
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Are They Orderly
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Are They Right For the Job
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Are They In Safe Condition
Environment
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Is It Clean
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Is It Orderly
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Is It In Safe Condition
Orderliness
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Standards Available
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Standards Adequate
Actions
Reactions of People
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Adjusting Personal Protective Equipment
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Changing Position
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Rearranging Job
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Stopping Job
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Attaching Grounds
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Performing Lockouts
Personal Protective Equipment
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Head
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Eyes and Face
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Ears<br>
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Respiratory System
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Arms and Hands
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Trunk
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Legs and Feet
Positions of People
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Striking Against or being Struck by Objects
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Caught In, On, or Between Objects
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Falling
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Contacting Temperature Extremes
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Contacting Electrical Current
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Inhaling, Absorbing, or Swallowing a Hazardous Substance
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Repetitive Motions
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Awkward Positions/Static Postures
Tools and Equipment
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Right for the Job
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Used Correctly
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In Safe Condition
Procedures
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Available
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Adequate
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Known
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Understood
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Followed
Orderliness
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Known
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Understood
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Followed
