Field Notes Inspection

Field Notes Inspection

This form should be used each time you visit a site to help create content for our quarterly field notes.
Today's Date*

MonthDayYear
Date
Time

Hour Minutes

AM/PM Option
Field Safety Manager Email: *
example@example.com
Employee #1*
first and last name
List additional employees if possible*
List N/A if meeting with only 1 person.
Employee #1 Has All PPE?*
if NO employee cannot work
All other employees have all PPE?
if NO employee cannot work
Location of Job Site*
city and state
Work Being Performed *
Conduct a safety review of your job location and immediate surroundings where you will be working. Check for potential safety hazards and discuss as a team the associated control measures:
Comments, Notes and Observations*
Take Photo
Has this team completed an accurate and active JHA for the day?*

YesNo
Address Map Locator
Should be Empty: