Jacobs - safety observation report (sor) checklist
Safety observation report (sor)
What does this form include?
This form contains 9 sections:
Select date Date
Observation
IMMINENT DANGER
What immediate corrective action was taken?
Action(s) to prevent recurrence
Direct cause (check those that apply)
- Unsafe act
- Safe act
- Unsafe condition
- Safe condition
Basic cause due to organizational failure to:
- Plan
- Direct
- Organize
- Control Human and material resources
Indirect cause(s) due to lack of:
Signature
Use this template