• Prepared by

  • Conducted on

Business Units

  • BS

  • Engineering

  • Drilling Tech

  • Maintenance

  • M&LO

  • PS

  • Subsea

  • WIS

  • Umbilicals


Body Position

  • Avoids walking/working under loads

  • Excessive lifting/pushing/pulling/bending

  • In harm's way

  • Pinch points

  • Office ergonomics

  • Walking/climbing


  • Authorization/permits to work

  • Barricades/barriers

  • Communication between workers

  • Distracted driving

  • JSA/operating procedure

  • Worker fatigue

Personal Protective Equipment

  • Eye/face protection

  • Fall protection

  • Foot/leg protection

  • Hand/arm protection

  • Hearing protection

Tools & Equipment Use

  • Condition of hoses/connections/gauges

  • Equipment selection/condition/use

  • Hand tool selection/condition/use

HSE Condition

  • HSE At-Risk Condition

  • Explain HSE impact

Description of Observation

Action Taken for At-Risk Behavior

  • Intervened and stopped act

  • Coached and corrected at-risk behavior

  • Eliminated/mitigated the hazard(s)

  • Stop Work Used

  • Requested action from HSE

Safe Behavior(s)

  • Feedback given to reinforce safe behavior(s)

  • Nominated for recognition

  • Other comments

Improvement Opportunities

Follow-up Process

  • Feedback Requested

  • Observation Closed

Sign Off

  • Auditor's signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.