Title Page
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Site conducted
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Conducted on
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Prepared by
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Zone Observed
- Observations
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Location of Observation
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Photo Log of Observation
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Observation Category
- House Keeping / Orderliness (Not Maintained)
- Personnel Protective Equipment (Unavailable / Not Used)
- Procedures (Not following the requirement)
- Tools and Equipment Defect
- Position of people (Not in safe position)
- Reactions of people
- Safety Violation
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Description of Observation
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Recommended corrective action
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Responsible Department
- Operation Department
- Mechanical Department
- Electrical Department
- Control & Instrumentation Department
- Stores Department
- Chemical Department
- Admin Department
- Safety Department
- Performance Department
- Fuel Department
- Civil Department
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Target Date
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Any violation to TAQA Essential Safety Rules
- Rule 1 – Permit to Work
- Rule 2 – Energy Isolation
- Rule 3 – Ground Disturbance
- Rule 4 – Confined Space Entry
- Rule 5 – Working at Height
- Rule 6 – Lifting Operations]
- Rule 7 – Personal Protective Equipment
- Rule 8 – Driving Safety
- Rule 9 – Management of Change
- Rule 10 – Restricted Area Entry
- Rule 11 – System Override
- Rule 12 – Overhead Electric Power Lines
- Not Applicable
