Title Page

  • Report Number

  • Observation Category

  • Observation History

  • Date / Time

  • Photolog of Observation

  • Owner Department

  • Location of Observation (Line / Stage / Machine)

  • Description of Observation

  • Hazard / Environmental Impact

  • Recommended Corrective Action

  • Responsible Department

  • Responsible Person

  • Target completion date

  • Date of Completion

  • Mail to

  • CC to

  • Inspector Sign

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.