SIBI EN

Observation Grap
UNSAFE ACT 2 RISK POTENTIAL

UNSAFE CONDITION 1 LOW 1

NEAR MISS 1 MEDIUM 2

GOOD OBSERVATION 1 HIGH 1

TOTAL OBSERVATION 5 VERY HIGH 1

WORK AT ACCESS
CONFINED SPACES ELECTRICAL HOTWORK
HEIGHT BLOCKS
3 2 1 2 2

Observation Status for the Month

Categ
OPEN 0

CLOSED 0
 SIBI ENGINEERING.
bservation Graph for the Month of ...........

UNSAFE ACT
UNSAFE LOW
CONDITION MEDIUM
NEAR MISS HIGH
GOOD OB- VERY HIGH
SERVATION

MATERIAL PROCEDURE
HOUSEKEEPING OTHERS PPE
HANDLING VIOLATION
1 1 1 1 1

Category-wise Observation Graph

CONFINED SPACES
ELECTRICAL
WORK AT HEIGHT
ACCESS BLOCKS
HOTWORK
HOUSEKEEPING
MATERIAL HANDLING
OTHERS
PPE
PROCEDURE VIOLATION
SCAFFOLDING
GOOD OBSERVATION
.......

LOW
MEDIUM
HIGH
VERY HIGH

GOOD
SCAFFOLDING TOTAL
OBSERVATION
1 1 17

raph

CONFINED SPACES
ELECTRICAL
WORK AT HEIGHT
ACCESS BLOCKS
HOTWORK
HOUSEKEEPING
MATERIAL HANDLING
OTHERS
PPE
PROCEDURE VIOLATION
SCAFFOLDING
GOOD OBSERVATION
 HSE Obs
Sr No Date Time Division Location Permit Details
 SIBI ENGINEERING
HSE Observation Register for the month of ............
Recommendatio
Observation UA/UC Category
n
UNSAFE ACT CONFINED SPACES
UNSAFE CONDITION ELECTRICAL
NEAR MISS WORK AT HEIGHT
GOOD OBSERVATION GOOD OBSERVATION
UNSAFE ACT HOTWORK
HOUSEKEEPING
MATERIAL HANDLING
CONFINED SPACES
ELECTRICAL
PROCEDURE VIOLATION
ACCESS BLOCKS
HOTWORK
PPE
OTHERS
SCAFFOLDING
CONFINED SPACES
ACCESS BLOCKS
nth of ............
Associated
Potential Target Date Status Observed By AIL in Charge
Contractor
LOW
MEDIUM
MEDIUM
HIGH
VERY HIGH
Remarks
 Contractor-wise observation matrix
No of Open No of Closed
Sr No Name of the Contractor
Observations Observations
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
atrix
Total No of
Remarks
Observations
 AIL In Charge-wise observation matrix
No of Open
Sr No Name of the In Charge Department
Observations
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
servation matrix
No of Closed Total No of
Remarks
Observations Observations