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MMC | NAC Safety Observation
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Company Observed
MMC
NAC
Other:
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Craft Observed
*
Pipefitting
Plumbing
Sheet Metal
Service
Electrical
Controls
Fab Shop
Other
Type of Observation
Kudos - Witnessed an employee go above and beyond to improve safety
Good Catch - Corrected a hazard to prevent a near miss or incident
Near Miss - An event occurred with no injuries or damage, but had potential for injury or loss.
Stop Work Authority - Major hazard identified, stopped work to correct hazard.
Suggestion or Comment
Other:
Description
Your answer
Job Site
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Your answer
Observer
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Please type first and last name
Your answer
Your Job Category
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Construction
Controls
Electrical
Fab Shop
Service
APM/PM/Safety/Exec. Leader/Other Office Staff
Other:
Unsafe Items
Personal Protective Equipment (PPE)
Dust Mask/Respirator
No Face Shield - while griniding, etc.
Fall Protection NOT Being Used (for work above 6 feet)
Gloves NOT Appropriate for Task
No Hard Hat
Hearing Protection not used when needed
No High Visibility Vest
Inappropriate Footwear
No Safety Glasses
All Safe
Body Position
Mark any unsafe body positions or mark "all safe"
At Risk of Falling
Bending/Twisting (muscle strains)
Caught In/On/Between Objects
Electrical Hazard: Contact with Electrical Current
Lifting (muscle strains)
Inhaling, Absorbing Or Swallowing Hazardous Substance
Pinch Points
Under Suspended Load/ crushing hazards
All Safe
General Conditions/Misc.
Mark any unsafe conditions or mark "all safe"
Barricades not
Electrical Cords - damaged
Fall protection systems
Fire Extinguishers not present
Floor openings - not covered, labeled and secured
GFCI - not used
Jobsite not clean/organized
Unsafe Ladders
Lighting
Lock Out/Tag Out
Rigging
Scaffolding
Excavation
All Safe
Tools/Equipment
Mark any unsafe tools/equipment or mark "all safe"
Aerial lifts - not inspected daily or not documented
Chain fall certification not current (within one year)
Defective tools not taken out of service or tagged “Do Not Use”
Guards are missing or removed
Wrong Tool for the Job
Tools used incorrectly
All Safe
Other:
Safe Conditions Observed
Your answer
Unsafe Conditions Observed
Your answer
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