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Contractor Safety Observation Form

The document provides a checklist for observing contractor safety behaviors. It includes categories for personal protective equipment, position of people, rules and procedures, tools and equipment, and housekeeping. The checklist is to be completed weekly by project management personnel and retained in project records.

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thennarasu
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41 views2 pages

Contractor Safety Observation Form

The document provides a checklist for observing contractor safety behaviors. It includes categories for personal protective equipment, position of people, rules and procedures, tools and equipment, and housekeeping. The checklist is to be completed weekly by project management personnel and retained in project records.

Uploaded by

thennarasu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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CONTRACTOR SAFETY CONTRACTOR SAFETY

BEHAVIOR OBSERVATION CHECKLIST BEHAVIOR OBSERVATION REPORT

CSBOR#:
"All field Project Management personnel shal
complete this form weekly, as a minimum, and retain
in the project records".

Observe quitely. Mark each observation item:


N/A if Not Applicable
0 if Non-Compliant
1 if Needs Improvement

Stop Work
2 if Compliant
1. Personal Protective Equipment (PPE)
* Are contractor employees wearing and properly
using approved PPE in good condition for:

Contractor Area Supervisor's Company ID/Badge #:


Head

Record Corrective Actions Taken or Requested:

Organization Code:
Written
Ears
Eyes

Immediate Corrective Action(s) Taken:


Face
Respiratory Protection
Contractor Safety Observation Report

Hands
Contract/BI Number:

Body

Verbal

Title:
Observation Date:

Feet

2. Position of People
* Do contractor employees maintain safe positions
to prevent:

Falls
Overexertion
(If yes, describe below)

Badge #:
Striking Against/Struck By
Caught Between Objects
Intake/Contact With Hazardous Substance
Contact With Hot/Cold Surface
Contact with Electric Current
Where Any Observations Considered Immediately Dangerous to

3. Rules and Procedures


No

Procedures Developed

Procedures Known And Understood


Procedures Followed
Yes

Supervisor at Work Activity

Certified/Competent Work Activity Personnel


Approved Safety Officer on Site
Contractor Area Supervisor:

Describe Key Observations:

4. Tools and Equipment


Life or Health (IDLH)?
Contractor Company:

Correct for the job


Observer's Signature:
Work Location Area:

Used Properly
Observer Name:

Safe Condition

5. Housekeeping
Good Housekeeping Maintained
PQP

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