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Near Miss
Near-misses are an unplanned event that did not result in injury, illness, or damage—but had the potential to do so. Somewhere in the chain of events leading to the near miss, we caught a lucky break.
Good Catch
A “good-catch” is when an employee recognizes an unsafe condition, action, or defect and actively takes measures to prevent an event from occurring.
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Observations-Field
Observations-Office
Near Miss
Good Catch
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Observation-Field
Observer Name (not required)
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District
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NE
NW
KC
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CD
STL
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Date
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Observing Dept. or Org
7DCA
7DCB
7DCC
7DCD
7DCN
7DTS
6DRE
6DRW
7DDE
7DMA
6DDO
6DAC
7DBG
7DGS
7DJA
6DHR
6DIS
7D06
7D11
7D12
7D16
7D17
7D20
7D22
7D23
7D24
7D25
7D28
7D31
7D33
7D34
7D38
7D43
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7D50
7D51
7D55
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7D71
7D79
7D95
7DB1
7DB2
7DEA
7DEE
7DEF
7DLN
7DLS
7DSN
7DSS
6DRB
6DRP
6DTP
7D75
7D76
7DTR
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Observing Dept. or Org
6M10
6M11
6M14
6M15
6M16
6N10
7NI1
7NI2
7NI3
7NI4
6CX8
6DX8
6FX8
6GX8
6HX8
6M20
6M21
6M22
6N20
6N21
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6N25
6N26
6N27
6N28
6N29
6M40
6M42
6M43
6M30
6M31
6NDE
7N21
7N22
7N42
7N43
7N44
7N45
6M50
6N40
6P10
6M70
6P20
6M60
6P30
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6P38
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6P50
6P51
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6P54
6P90
6P91
6P60
7I05
7I06
7I18
7I19
7I22
7I30
7I40
7I51
7I60
7I70
6P70
6P72
6P73
6T10
6T11
6T12
6T13
6T14
6T15
6K41
6K42
6K43
6K49
6P80
6P82
6P83
2XRB
6P80
6K60
6K61
6N50
6N51
6N52
6N54
6N55
6ND2
6ND4
7K60
7K70
7K71
Invalid Input
Observing Dept. or Org
6CCN
6CMA
7CCB
7CCD
7CCE
7CCK
7CCL
7CCN
6CRE
7CDE
7CRW
6CDO
6CAC
7CBG
7CJA
7CPP
6CHR
6CIS
6CEA
7C01
7C03
7C06
7C10
7C15
7C16
7C18
7C21
7C24
7C25
7C26
7C27
7C29
7C31
7C32
7C34
7C36
7C71
7C95
7CB1
6CRB
6CTP
7C75
7C76
7C79
7CTA
7CTM
7CTR
Invalid Input
Observing Dept. or Org
7BCA
7BCB
7BCD
7BCN
7BTS
6BRE
6BDE
6BRW
6BDO
7BEA
7BEB
7BEC
7BAC
7BBG
7BGS
7BJA
6BHR
7BIS
7B01
7B02
7B03
7B04
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7B09
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7B15
7B25
7B30
7B32
7B33
7B35
7B74
7B78
7B79
7BBM
7BMT
7BSS
6BRB
Invalid Input
Observing Dept. or Org
7ACA
7ACB
7ACE
7ACN
7ATS
7AR1
7ARE
7ADE
7ARW
7ATP
7ADO
7AAC
7ABG
7AGS
7AJA
7AJB
7APP
7AHR
7AIS
7A01
7A02
7A03
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7A06
7A11
7A12
7A13
7A15
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7A33
7A35
7A36
7A37
7A38
7A71
7A72
7ABM
7AEA
7AEB
7AMT
7ATR
7ARB
Invalid Input
Observing Dept. or Org
6HCN
6HTS
7HCA
7HCC
7HCD
7HCG
6HRE
6HRW
7HDE
7HMA
6HDO
6HAC
7HPP
6HGS
7HGS
7HJA
6HHR
6HIS
6HEB
6HEC
6HED
6HEE
6HEG
6HEH
6HEI
7H01
7H02
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7H05
7H07
7H08
7H09
7H11
7H12
7H13
7H15
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7H21
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7H25
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7H52
7H5F
7H5K
7H64
7H78
7H91
7HB1
7HBM
7HEA
7HEB
7HEC
6HRB
6HTP
6HTR
7H73
7H74
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Observing Dept. or Org
7FB1
7FBM
6FCN
6FTS
7FCA
7FCB
7FCD
7FCE
7FCG
7FCJ
7FCN
6FR1
6FRE
6FNC
6FRW
7FDE
7FV1
7FV2
7FV3
6FDO
7FAC
7FBG
7FJA
7FPP
6FHR
6FIS
7F01
7F21
7F22
7F23
7F25
7F32
7F33
7F34
7F35
7F36
7F41
7F52
7F54
7F61
7F62
7F63
7F6A
7F91
7F95
7FEA
7FEC
7FED
7FEE
7FEF
6FRB
6FTP
6FTE
7F72
7F73
7F76
7F77
7F78
7FTA
7FTM
Invalid Input
Observing Dept. or Org
6GSV
7GCA
7GCD
7GCE
7GCG
7GCJ
7GCN
6GRE
6GDE
6GPA
6GRW
6GDO
7GBG
6GAC
6GGS
7GJA
6GHR
6GIS
6GEA
6GEB
6GEC
6GMT
7G01
7G03
7G04
7G05
7G06
7G07
7G08
7G09
7G11
7G12
7G16
7G19
7G21
7G26
7G27
7G32
7G33
7G35
7G36
7G37
7G38
7G39
7G42
7G43
7G48
7G51
7G52
7G56
7G71
7G72
7G79
7G80
7G91
7G92
7G93
7G94
7G95
7G96
7G97
7G98
7GBM
7GMT
6GRB
6GTP
6GTM
7G76
7G7A
7G81
7GTM
Invalid Input
Task/Job Observed
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Location of Observation
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Please skip the item or section if it is not applicable to the task/job that is included in the observation. A skipped question is considered NA.
Next >
PPE
Hi-Visibility Clothing
Safe
At-Risk
Invalid Input
Eyes/Face
Safe
At-Risk
Invalid Input
Hardhat
Safe
At-Risk
Invalid Input
Hand (gloves adequate)
Safe
At-Risk
Invalid Input
Footwear
Safe
At-Risk
Invalid Input
Hearing Protection
Safe
At-Risk
Invalid Input
Respiratory
Safe
At-Risk
Invalid Input
Fall Protection
Safe
At-Risk
Invalid Input
Comments
Invalid Input
< Prev
Next >
Body Position
Lifting/Pushing/Pulling
Safe
At-Risk
Invalid Input
Awkward/Twisting/Bending
Safe
At-Risk
Invalid Input
Paying Attention
Safe
At-Risk
Invalid Input
Pinch Point
Safe
At-Risk
Invalid Input
3 Points of Contact
Safe
At-Risk
Invalid Input
Struck by Potential
Safe
At-Risk
Invalid Input
Pace
Safe
At-Risk
Invalid Input
Comments
Invalid Input
< Prev
Next >
Tools & Equipment
Correct Tool/Equipment
Safe
At-Risk
Invalid Input
Used Correctly
Safe
At-Risk
Invalid Input
Condition of Tool/Equipment
Safe
At-Risk
Invalid Input
Comments
Invalid Input
< Prev
Next >
Housekeeping
Slip/Trip/Fall Hazards
Safe
At-Risk
Invalid Input
Clear Floor/Exits
Safe
At-Risk
Invalid Input
Lighting
Safe
At-Risk
Invalid Input
Comments
Invalid Input
< Prev
Next >
Vehicular Operations
Walk Around/Circle Check
Safe
At-Risk
Invalid Input
Seatbelt
Safe
At-Risk
Invalid Input
Stability & Terrain (rollover hazard)
Safe
At-Risk
Invalid Input
Attachments
Safe
At-Risk
Invalid Input
Overhead Hazards
Safe
At-Risk
Invalid Input
Backing/Spotting
Safe
At-Risk
Invalid Input
Vehicle Visibility/Parking Location
Safe
At-Risk
Invalid Input
Comments
Invalid Input
< Prev
Next >
Noted Safe Behaviors
Invalid Input
Reasons Behind At-Risk Behaviors
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Solutions Proposed/Implemented
Invalid Input
Attach a photo or video. (not required)
Invalid Input
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