PROJECT NAME

DAILY SITE WALK SAFETY INSPECTION REPORT
INSPECTOR: SECTION:
ITEM

Responsible Manager: AREA: (gridlines) Level
HAZ
CODE

S/C Resp. Manager: DATE & TIME :
Closed out Yes / No

/
Actual Completion Date

/10
RESP. MANAGER SIGN

h
RESP FOR AREA

SUBSTANDARD ACT & CONDITIONS / NON CONFORMANCE / CONFORMANCE

REMEDIAL ACTION TAKEN / RECOMMENDED ACTION

HAZARD AA A B C

SEVERITY IMMEDIATELY MAJOR SERIOUS NOT ACCEPTABLE

TIME TO RECTIFY STOP WORK & RECTIFY SAME DAY WITHIN 48 HOURS WITHIN 4 DAYS

MANAGER / Lead Engineer SIGNATURE «««««.«««..............««««««««««««««..DATE........../......../............

1