Scribd
Upload
317 views3 pages

Planned Task Observation Form

This document is a task observation form used to record inspections of tasks and activities. It collects details of the date, time, location, people involved, equipment used, risks identified, safety procedures followed, and any issues or actions needed. The form is used to ensure tasks are performed safely according to procedures and identifies areas for improvement.

Uploaded by

Prakash Sharma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
317 views3 pages

Planned Task Observation Form

This document is a task observation form used to record inspections of tasks and activities. It collects details of the date, time, location, people involved, equipment used, risks identified, safety procedures followed, and any issues or actions needed. The form is used to ensure tasks are performed safely according to procedures and identifies areas for improvement.

Uploaded by

Prakash Sharma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Task Observation form

Main Form Details

Date: Time:

Task or activity:

Location:

Inspection team leader:


(Person conducting the PTO) Signature:

Inspection team member:


(Person being observed) Signature:

Contract company (if applicable):

Equipment involved (include plant number if applicable):

Risk management method used prior to starting this task:

o None o RA/FLRA o Work Permit o Safe Work Procedure


Hazard Targeted:

o None o Scaffolding
o Energy Isolation o Lifting and Rigging
o Working at Height o Excavation
o Confined Space Entry o Hot Work
o Mobile Equipment o Other:
o Electrical Safety
Planned Task Observation

Name of SOP, plan or procedure reviewed:

Critical controls checked (e.g. Correct tools used, correct work posture used, LOTOTO done, risk assessment done, Correct use of
PPE…what was done to make work safe?)

Is the latest RA/FLRA, procedure available for task?  YES  NO

Observation classification (tick box below):

 Safe behaviour  At risk behaviour  Safe condition  Unsafe condition


Task Observation form

Observation summary & immediate actions taken (if applicable)::

Issue

Issue relates to:

o Competency o Health and hygiene o Position of person(s) o Procedures


o Environment o Housekeeping o Tools and equipment o Other:
o Fitness for work o Work procedure o Work condition
Issue details:

Is this issue related to a Fatal Hazard? If YES, please choose below!

o None o Scaffolding
o Energy Isolation o Lifting and Rigging
o Working at Height o Excavation
o Confined Space Entry o Hot Work
o Mobile Equipment o Other:
o Electrical Safety
Planned Task Observation

Action assignment

Action required Assigned to Signature Due date Action approved Approver ( Min level HOD)

No pending actions o YES o NO


o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO
o YES o NO

Task Observation form Main Form Details Date: Time: Task or activity: Location: Inspection team leader: (Person conducti
Task Observation form Observation summary & immediate actions taken (if applicable):: Issue Issue relates to: o Competency o
Planned Task Observation Action assignment Action required Assigned to Signature Due date Action approved Approver ( Min leve

You might also like