* Tumutukoy sa kinakailangang tanong
Daily Safety Report
| Safety Officer Name *
H
| Job/Project Number *
I
| p23-017
Job/Project Description
, 1 are i
Main condenser cleaning and tube replacement
lew August 22, 2023
Violator Fullname *
Write “none” ifthere is no safety violator
lyong sagot
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Time caught violating safety rule
ras
AM y
PPE Use Violations
Safety Shoes
Hard Hat
Safety Hames
Safety Eye Wear
Ear Muft/Plug
Working Gloves
Dust
Mask/Respirator
Uniform
Safety
Vest/Jacket
Protective Suit
Lacking/none/not Notin_ Improper
wearing
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PISAS Jobsite Stary Daly Report
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Use
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Defective
PPE
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26PISAS Jobsite Safety Daly Report
Time caught violating safety rule
Oras
AM
PPE Use Violations
Not Defect r t '
App d Toy ee anneal unsafe
for Use
Safety Shoes o oodoadou og
Hard Hat Oo O 0 0 0 0 0
Safety Harness o ood ao,nd
Safety Eye Wear ood o o
Ear Muff/Plug im] oOo Oo oO oO
Working Gloves oO oOo oO oO og
Dust
mavrepitr O OF OF O O 0 0
Uniform Oo Oo oO Oo oO
Safety
VestiJacket o O00 0 0 0
Protective Suit Oo oop oO oO oD
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Violator Unsafe Acts
No Mid Moderate Severe
Horse Playing Oo oO
mincowenees, o Oo
Mindeess 0 Oo 0
Unruly Behaviour a a a o
Uncooperative o Oo oO
Tardiness o o o o
Tool Box Meeting Oo Qa
-Inattentiveness
Actions taken against the violator
List actions taken
yong sagot
Jobsite safety hazards found *
List down observation of safety hazards found and action taken. Write "none" if you did not
find.
WAH - Use FBH 100% tie off
Caught in between - Use proper ppe
Poor illumination - Provide proper illumination
Manual hauling - Proper manual hauling procedure
Recommended Safety Tools/Equipment Needed *
Write none” if you don't have any recommendation.
lyong sagot
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Overall Safety Assessment *
ste OO @ O OO Batremety Unsafe
Bumalik it eel
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Google Forms
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