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Safety Audit Report Form
TRACK OR AREA:_________
TERMINAL: ______________________________
DATE: ____________________
AUDITOR(S):______________________________
START TIME: _____________
__________________________________________
DURATION: _______________
NO. EMPLOYEES OBSERVED: _____________
SAFETY RULE VIOLATION
(Actual observation, or the evidence that a rule has been
violated.)
SRV _______
Unsafe Act
(An act, obviously unsafe, not covered by a written
rule or practice.)
UA _______
Unsafe Condition
(A condition, obviously unsafe.)
UC ________
Safe Act
(An act or maneuver performed within safety guidelines.)
SA ________
OBSERVATIONS
CLASS