SAFETY DEPARTMENT

OBSERVATION CARD
Document N°: HSE-F-0600 Rev 01
Name: People
Department: Date and Time: Planning / Communication Positions / Handling / Lifting
Procedure not enforced Other
Location of Observation:
Work Environment
Nature of     Near Noise / Heat / Ventilation
Observation: Health Safety Environment Miss Ergonomics
Lighting / No barriers & signs
Work Surfaces / Area
Description of Observation: Hygiene / Health
Other
Housekeeping
Tools and Equipment
Selection / Use
Other
Condition / Maintenance
PPE
Head / Face / Eyes / Ears
Hands / Arms
Reflector
Immediate actions taken: Trunk / Feet / Legs
Fall protection
Other
Respiratory System
Environment
Trash not disposed Material incorrectly stored or
Energy / Water Waste labeled
Air Emissions / Spills Other
Procedure and training
Further Actions Suggested: Unsuitable procedure
Other
Procedure not known
Positive Comment
Positive Comment

Document N°: BLX-AFR-HSE-F-0600 Rev 01

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