Sfc Hse

Behavior Based Safety Observation
Item - Sfc Hse Image-1 0
Result of Observation
GREEN - All Safe
Submitted By:
Test McTester
Date
6/12/2024
Time
11:24 AM
Type of Observation
Learning Moment
Name of person being observed
John Doe
Position?
OFAIII
How long have they been in this position?
Less than 1 year
Division
MEDICAL
Location
Field
Client
Ovintiv
Weather
Sunny
Windy
Please describe observation in detail
This would be the observation description in detail.
Please provide your feedback on the observation
This would be the feedback of the observation description.
What else would you like to add?
This is additional information on the observation.
Photo Taken (if applic
able)
Item - Sfc Hse Image-2 1
Drawing Board
Item - Sfc Hse Image-3 2
Action Items (If Applicable)
Action Item
Follow up action item #1
Responsible
Boss Man
HSE Coordinator Name
Katie Funk
HSE Coordinator Signature
Item - signature 3
HSE/HR Manager Name
Darren Steinke
HSE/HR Manager Signature
Item - signature 4
About this template

Hazard ID / Near Miss / BBS Observation / Incident Report

Categories
Details
1 Clone
Created by
Darren_Steinke
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