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PAKAT
WHAT WHY
(CODE)
PLAN * ASSESS * KEEP LOOKING * AGREE ACTION * TAKE NOTE
ACTION / REMARKS
FINDINGS Date
Follow-up required
DISCUSSION AND AGREED ACTION TARGET DATE
Yes No
WHAT WHY
What hazardous act / condition did you see? Why did the hazardous act / condition occur?
PPE HOUSEKEEPING
A) Head protection not worn Z) Access block by construction NOT AWARE
B) Eye protection not worn AA) Tools / materials disorganised
C) Face protection not worn BB) Poor / Improper roping off 1) Not informed
D) Ear protection not worn CC) Accumulation of rubbish 2) Language problem
E) Protective clothing not worn 3) Not reading permit
F) Safety shoes not worn ENVIRONMENT 4) Wrong interpretation of risk
G) Hand protection not worn DD) Water is being polluted 5) Wrong instruction
H) PPE in bad condition EE) Air being polluted 6) No procedure
I) Wrong PPE for the job FF) Too much noise 7) Forgotten
J) Substandard PPE NN) Soil being polluted 8) Behaviour & Attitude (intentionally)
N.B. If there is no unsafe act / condition during a visit, congratulate the person involve and put your remarks in the card. Revision: February 2004