OBSERVATION ON SAFETY ASPECTS (OSA) FORMAT (Rev1)

BPCL ENGG & PROJECTS (E&P)

Name of work: --------

Location of work: ----

Issued to: M/s --------

Date & Time of issue : -
DETAILS OF LAPSES/SHORTFALLS/HAZARDS RECOMMENDED COURSE OF ACTION
IDENTIFIED
Appropriate category box be ticked:
i) PPE
ii) Lock out & Tag out
iii) Working at Height
iv) Work Permit System
v) Confined Space Entry Safety
vi) System Over-ride
vii) Follow JSP/ SOP
viii) Management of Change
ix) Wear Safety Belt Suspension of work required till
x) Intervene
xi) Authorized Person only
resolution
xii) Alcohol & Drugs (Yes/No) :

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Copy of photos attached, if any.

Time allowed for correction:

Issued by: BPCL Site Engineer/Project Leader Received by : M/s --------

Name: Name:
Designation: Signature:
Signature: Date & Time:
Corrective Action Report By Contractor:

Name: Signature: Date:

Verification of Resolution by Issuer: SE/PL

Name: Signature: Date:

Distribution before Resolution: Project Leader

Distribution after Resolution : Project Leader