HSE/SQ Observation Card

Observation submitted successfully!

*For Subcontractor Employees or Visitors Only

Identification

Observation:

HSE SQ Both

Select at least one option.

Type:

Behavior Hazard

Select a type.

Personnel Area:

Location: Date: No. of Employees:

Observer Name:

PSL: Sub PSL:

Sales Order: Cost Center:

Behavior or Hazard Observed: *

This field is required.

0/1000

Action Taken: *

This field is required.

0/1000

Was Stop Work Authority Used?

Yes No

What is the Risk Priority Code (Severity)?

Low Medium High

Select a risk priority.

Checklist

Life Rules

Confined Space Driving Safe Mechanical Lifting Energy Isolation Working at Height Work Authorization Hot Work Bypassing Safety Controls Line of Fire

Critical Focus Areas

Well Barriers Hydrocarbons to Surface Radiation and Explosives Pressure Control Well Proximity

Possible Personal Injury

Arms Foot and Toes Body Hand and Fingers Back Head Legs Eyes and Face Ears Respiratory System

Possible Incident Type

Service Quality (SQ) Property Personal Injury Environment Vehicle

Hazards

Pressure Equipment Radiation Chemical Storage Explosives Tools Filed Service Equipment Lifting and Hoisting Maintenance Equipment Tool Racks Real State Equipment Scaffolding Laboratory Equipment Ladders Manufacturing Equipment Machine Guarding Work Environment Vehicles Emergency Equipment Electrical Equipment Office – Workstation design

Behavior

Desk Body Position Body Use/Ergonomics Office Body Mechanics Tools and Equipment Office Environment Procedures Hand and Finger Position PPE Body Position Working Environment Smith Driving Keys

Environmental

Materials Utilization Standards and Procedures Waste Material Handling Environmental Responsibilities Equipment Utilization Environmentally Friendly Practice