Planned Task Observation

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PLANNED TASK OBSERVATION (PTO) REPORT

CONTRACT NAME: ____________________________


NAME OF CONTRACTOR: _____________________
TASK OBSERVED: _____________________
REASON FOR OBSERVATION: _____________________
DATE OBSERVED: _____________________

REFERENCE TO RA AND SWP NO: _____________________

YES NO
Is the correct Personal Protective Equipment used?
Are the employees physically fit for the task performed?
Was related training given?
Is the task performed to standard?
Are the correct tools being used?

General comments and comments on revision required to Risk Assessment and / or WSWP:

Person conducting observation: _____________________ _____________________


Name Signature

Reviewed with the employee: _____________________ _____________________


Name Signature

Discussed with: _____________________ _____________________


Name Signature

Final comments and recommendations:

Follow up date for review _____________________

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