Job Safety Observation For Employees Recognition 2023Suggestion Form Product ReviewsSafety Observation Your ProfilePassword ResetLogout Driver Audits / Surveys Asset Audit 2023 7-11 Model # SurveyPetro Mart MO SurveyAlpine Asset Audit 2024 Employee DirectoryLogout Job Safety Observation Form 2023 Please enable JavaScript in your browser to complete this form.Date / TimeDateTimeObservation Type *Peer 2 PeerSupervisor / ManagementPlease check one.Observers Name: *Person Observed:Department of Person Observed:Location of Observation:Observation Type *SafeAt RiskAction observed (Briefly describe action witnessed):Observation Conversation (Explain what was discussssed and how both parties agree to improve)Check here if immediate attention is needed. (if an at-risk physical condition requires immediate attention contact supervisor or Safety Manager).Immediate attention is neededSelect the appropriate behavior category. No more than two concerns that relate best with the action observed.Body Mechanics:Lifting, bending, twistingRepetitive motionRushingAwkward positionsFatigue or inattentionImproper use of ladders or stairsReaching, pulling, pushing, carryingIn Harms Way:Struck by or against potentialExtreme temperature exposureElectrical hazard exposurePotential to be pinched or caught between objects Fatigue or inattentionUnprotected from sharp objects or cutting towards selfFall potential from same or different levelVehicles:Failed to yield or stopInspections incomplete or improper Failure to use turn signalsNot using 3 points of contactSpeed limit exceeded Improperly secured loadFailure to use required safety equipmentProcedures:Procedure not up up to dateProcedure not understoodTraining wasn't understoodProcedures not followedTools and Equipment:Not the Right JobImproper material handlingImproper fork lift usedImproper use of pallet jackIn poor conditionNot used properlyWork Area:Poor housekeepingWeather hazards not addressedimproper stacking of palletsSlip/trip/fall hazardsProducts not stored or staged properlySubmit
