PBS Observation Checklist

Observer:	Jake	Vessel	Area:	Office
Date		Time	Task Observed	Sitting at desk
Number of people observed?		1 2 3	Contractor:	TSA

Categories/Behaviours	Safe	At Risk	N/A	Observation-include exactly what you saw	Employee Response / Action Taken
1.0 Body Mechanics
1.1 Keeping eyes on Job/Path				Test	Test
1.2 Lift/Pulling/Pushing/Heaving				Test	Test
1.3 Line of fire/Danger				Test	Test
1.4 Use of handrails				Test	Test
1.5 Three Points of contact - Ladders				Test	Test
1.6 Body position/Stretching/Straining				Test	Test
2.0 PPE
2.1 Basic PPE (Long Pant, Long Sleeves)				Test	Test
2.2 UV Protection				Test	Test
2.3 Wearing Eye Face Protection				Test	Test
2.4 Using Foot Protection				Test	Test
2.5 Wearing Hand Protection				Test	Test
2.6 Using Hearing Protection				Test	Test
2.7 Using Task Specific Body Protection				Test	Test
2.8 Wearing Head Protection				Test	Test
2.9 Using Respiratory Protection				Test	Test
2.10 Wearing PFD's				Test	Test
3.0 Job Factors
3.1 Effictive Communication (Radio's Horns Bells)				Test	Test
3.2 Shortcuts Haste				Test	Test
3.3 Adherence to procedures				Test	Test
3.4 PreStart/Restart meetings conducted as required				Test	Test
3.5 Seamanship Practices				Test	Test
3.6 Situational Awareness				Test	Test
3.7 Access and Egress				Test	Test
4.0 Tools and Equipment
4.1 Effictive Communication (Radio's Horns Bells)				Test	Test
4.2 Shortcuts Haste				Test	Test
4.3 Adherence to procedures				Test	Test
5.0 Housekeeping
5.1 Material Storage					Test
5.2 Storage of Hazardous Materials				Test	Test
5.3 Waste Management				test	Test
5.4 Vessel Cleanliness				Test	Test
6.0 Health Awareness
6.1 Insect Vectors				Test	Test
6.2 Hydration Provisions				Test	Test
6.3 Sun Protection				Test
6.4 Fitness for Work				Test	Test
6.5 Personnel Hygiene				Test	Test
7.0 Environment
7.1 Effuent Removal				Test	Test
7.2 Rubbish Disposal				Test	Test
7.3 Oil Chemical Spills				Test	Test
7.4 Marine Species in Vessel Vacinity				Test	Test

Behaviour Number	Additional Information
1	Test
2	Test
3	Test
4	Test
5	Test
Comments	Test
Authorisationn Code