| Observer Name | Dennis Pawlitz |
|---|---|
| Date | 05/22/2026 |
| Location | Fraser |
| Department | Quality |
| Shift | First |
| Before Picture |  |
| PERSONAL PROTECTIVE EQUIPMENT | |
| PPE is adequate and worn correctly | Not Applicable |
| ERGONOMICS | |
| Loading, bending over & twisting | Not Applicable |
| Overstretching, pulling & pushing | Not Applicable |
| SAFETY PROCEDURES | |
| They are known and respected | Safe |
| FLOOR, AISLES & WORK AREAS | |
| Floor free of spills and without tripping hazards | Unsafe |
| SAFETY IN MACHINERY | |
| Safety guards installed | Not Applicable |
| Interlocks are present, light curtains, emergency stops are working | Not Applicable |
| POWERTOOLS AND HANDTOOLS | |
| They are in good conditions and they are adequate for the type of job | Not Applicable |
| AT THE FIRE LINE | |
| Trapping - pinching points & being hit by an object | Not Applicable |
| OTHER QUESTIONS | |
| Task or work area observed | B16 secondary |
| Describe the unsafe act or unsafe condition observed as well as the behavior observed, including the immediate countermeasures taken | Matt rolled up, uneven, hosed stored in an unsafe way which is a tripping hazard. |
| If a follow up is required, describe the actions to be taken | Cleaned floor, properly stored hoses, reinstall ergo Matt correctly |
