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8/6/2019 Copy of Blank Activity Audit Log
http://slidepdf.com/reader/full/copy-of-blank-activity-audit-log 1/2
BEHAVIOUR BASED SAFETY - ACTIVITY AUDIT REPORTS
Activity Title Replacement of roof sheets of feeder liquor tank # 1
Area / Department / Section Plant -A (Tank Form Area) 10/3/2011
Observation Round by MSA 17,30 hrs.
Pre - Audit Requirements
Study written work instructions (if available),Longer time activities may be sub-divided into smaller activities
1 Job should be started after getting valid permit. 1 Do not leave combustible material in the area.
2 All PPEs mentioned on the permit to be used. 2 Do not use un inspected welding equipment.
3 Area housekeeping after job to be ensured. 3
Personal Protective Equipment Requirement
HelmitSafety Shoes Activity / Task specific Welder ShieSafety Harness
Observations
Sr. #Description Category
1 There were gaps between tank and scaffolding. Unsafe Condition
2
3
4
Discussion with staff
Feedback to the staff Input provided by the staff
1 1 Staff was already using safety harness while working.
2 Staff was asked about physical isolation. 2 Staff working was aware of job scope and isolations.
Improvement Action Agreed
Sr # Improvement Action Target Date
1 SMz 15-03-11
2
Date of ObservationRound
Time of ObservationRound
3 most important Do(s) of the activity3 most important Don’ts of the activity
Ensure welding / cutting sparks are containedproperly.
Staff was informed about the gaps betweenscaffolding and tank.
ResponsiblePerson
Scaffolding erection technique should be reviewed specially in this area to minimize gaps between tank and
scaffolding.
8/6/2019 Copy of Blank Activity Audit Log
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BEHAVIOUR BASED SAFETY - ACTIVITY AUDIT REPORTS
Activity Title
Area / Department / Section Power Services (Reverse Osmosis) Date of Observation Round 06.05.2011
Observation Round by MSA Time of Observation Round 1500 hrs
Pre - Audit Requirements
Study written work instructions (if available),Longer time activities may be sub-divided into smaller activities
1 Work safely and care about personal safety. 1 Do not touch hot surfaces or any live equipment.
2 Use required PPEs. 2 Avoid slippery floor
3 3
Personal Protective Equipment Requirement
Activity / Task specific
Safety Shoes Dust Mask Hearing protection Same as area specific
Observations
Sr. #
Description Category
1 Staff was using required PPES like dust mask and hearing protection.
2
3
4
5
Discussion with staff
Feedback to the staff Input provided by the staff
1 1
2 2
Improvement Action Agreed
Sr # Improvement Action Target Date
1
2
3
3 most important Do(s) of the activity
3 most important Don’ts of the activity
ResponsiblePerson