SAFETY CORRECTIVE ACTION REPORT

Project Name: Company Name: Observation Date:

Responsible Person: SCAR NO.
Project Location: Specific Location: Revison Date:

Activity:
SAFETY CONCERN/ISSUE
Unsafe Condition
Unsafe Act/Unsafe Practices
Non Compliance / Non Conformance
Others (Specify): ____________________________
Item No. Hazard / deficiency description Recommended Corrective Actions:

References/Attachment: (ATTACH PHOTO)

CORRESPONDING CORRECTIVE ACTION

Item No. Action Taken

References/Attachment: (ATTACH PHOTO)

Action Taken by: Accepted by:

Designation: Senior Safety Officer

Date: Date:
Inspected by:

ESTII-SHEQ PERSONEL

Date:
Noted by:

Department Head/Manager/Director Corporate Services Director

Date: Date:
ECO-OP-CSD-26F2
Revision: 0