Decide Report ObLenT AUDIT DONE IN AREA: Date Time ObLenT Observer's Name Visit Ask Employee No Level Observe Department Mark if OBSERVATION CHECKLIST JOB OBSERVED: unsafe Safe Acts Observed / A REACTIONS OF PEOPLE Number at risk Out of No observed Adjusting Personal Protective Equipment Changing Position Rearranging Job Stopping Job Attaching Earthing cables Performing Lockouts PERSONAL PROTECTIVE EQUIPMENT Safety Helmet Safety Goggles & Face Shield / Screen Ear Plug / Ear Muff Dust / Fume protection Mask Gloves, Hand Sleeves Apron for Welder / Grinder Safety Shoes & Leg Guard POSITIONS OF PEOPLE (Injury Causes) Striking Against Objects Struck By Objects Caught In, On or Between Objects Falling At Risk Behaviours Ob Contacting Hot Surface Contacting Electric Current Inhaling of Hazardous Chemical & Gases Body extension Repetitive Motions Awkward Positions/Static Postures MATERIAL HANDLING (MECHANICAL) Improper Material Handling Attention while Handling Compliance with Procedure & Work Permit TOOLS AND EQUIPMENT Inapprdopriate for the job Used Incorrectly In Unsafe Condition PROCEDURE AND WMS Procedures Inadequate Procedures Not Known / Understood Procedures Not Followed WMS Standards Inadequate WMS Standards Not Known / understood WMS Standards Not Followed Observer's signature: L&T At Risk Behaviour Observation Card Commit Decide Report ObLenT Visit Ask Observe
Safe Acts Observed / Actions taken to encourage continued safe behaviour
At Risk Behaviours Observed; Immediate Corrections; Corrective Actions