Information

  • Document No.

  • Prepared by

  • Select date

  • Observers name

  • Area

  • Activity

  • Employment

  • Year Service

  • How many Behaviours can Associate name

  • Pre-job Inspection Warning of Risk

  • Perception Habit Obstacle or Barrier

  • Personal Protective Equipment, ie Gloves, Glasses, Safety Shoes, etc.

  • Perception Habit Obstacle or Barrier

  • Use the tool/equipment properly

  • Perception Habit Obstacle or Barrier

  • Pinch Points (keep body parts out of meeting surfaces)

  • Perception Habit Obstacle or Barrier

  • Select the proper tool/equipment for the job.

  • Perception Habit Obstacle or Barrier

  • Observers comments

  • Workers comments

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