安全隱患觀察卡范本

SafetyObservationandcommunicationReportNo:(No.Year/Site)___________Part1:plannedobservers.(AllSMOEandPTTEPemployeesandcontractors)OBSERVEDBY:_______________________________COMPANY:________________POSITION:_______________________DATE:__________________TIME:______________________________LOCATION:_______________________________________________________________Pleasecheckandmark()inBLOCKSPersonalprotectiveequipmentSafeAtriskN/APositionsofpeopleSafeAtriskN/AHeadprotection(helmet)Eyesandfaceprotection(Goggles,faceshield,glasses)Hearingprotection(earplugs,earmuffs)Respiratoryprotection(mask,filter)Handprotection(gloves)Fallprotection(harness)CoverallLegsandfeetprotection(safetyshoes)Freefromstrikingagainst/beingstruckbyobjectsWorkinginareaofpotentialfallSafetyfromelectriccurrentFreefromhazardoussubstancesWorkingunderloadProceduresSafeAtriskN/AKnowtheprocedureofthejobUnderstandcontentoftheprocedureProcedureisadequateFollowtheprocedurecorrectlyComplywithpermitsComplywithlockout/tagoutReactionsofpeopleduringobservationSafeAtriskN/AIsheadjustingpersonalprotectiveequipmentIshechangingpositionsuddenly?Isherearrangingjob?Ishechangingtools?ToolsandequipmentSafeAtriskN/ARightforthejobInsafeconditionandreadytouseUsedcorrectlyRemovingmachinesafetyguardsFeedbackSafetyObservationandcommunicationDecideStopReportAct/discussObservationFeedbackSafetyObservationandcommunicationDecideStopReportAct/discussObservationSafepractices:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Unsafeactsobserved:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Correctiveactiontaken:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________Observer’ssignature_______________________Date:______________________________Part2:Supervisor/SitesafetyActiontopreventreoccurrenceforsupervisor:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Supervisor’ssignature______________________Date:______________________________Note:PleasereturntoHSEdepartmentforkeeprecordsandstatistics. XXX項目安全隱患觀察卡ReportNo:(No.Year/Site)___________1:計劃觀察人員（SMOE，PTTEPI及CSE方）觀察者:_______________________________公司:________________職位:_______________________日期:__________________時間:______________________________地點:_______________________________________________________________Pleasecheckandmark()inBLOCKSPPE安全不安全N/A工作區(qū)域安全不安全N/A頭部保護（安全帽）臉部面部保護（安全眼鏡、面罩）耳朵保護（耳塞）呼吸保護（呼吸器、過濾器）手部保護(手套)墜落保護(安全帶)工作服腿腳保護(安全鞋)是否不易受打擊是否有有墜落隱患是否會觸電是否遠離危險物10）是否是重負荷程序安全不安全N/A是否知道有工作程序是否了解工作程序程序是否完全是否正確執(zhí)行程序是否執(zhí)行作業(yè)許可是否執(zhí)行危險/停工觀察中人們的反應(yīng)安全不安全N/A是否調(diào)整了PPE是否突然移動了位置是否重新安排了工作是否有更換工具工具設(shè)備安全不安全N/A適合用于工作設(shè)備工具條件狀況是否正確使用是否移除了機器安全保護裝置反饋安全隱患觀察交流程序決定停止報告行動/討論觀察反饋安全隱患觀察交流程序決定停止報告行動/討論觀察安全措施:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________觀察到的不安全行為描述:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________采取的整改措施:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________觀察者簽名_______________________日期:______________________________2:監(jiān)督或主管/現(xiàn)場安全采取的防范措施:_____________________________________________________________________________________________________________________________________________