Work Unsafe Observations

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Unsafe Observations

• In this section, the HSE Representative shall do the following:
  1- Take photos of live unsafe acts
  2- Write comments with regards to the unsafe act
  3- Note down the individual's Name, Time of unsafe act, Date of unsafe act and Location

• Photo Snap

  Media

• A brief description to the Unsafe Observation

• Name of Violator

• Name of Direct Supervisor

• Please enter Date and Time

  Date

• Location

• State the Corrective Action that need to be taken

• Status of Corrective Action

  Closed on Spot

  Open

  Violator Non-Compliant

• Violator's Name and Signature

  Sign