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    Stop Work Authority Reporting Form

    Uploaded by

    engineering Indopile
    This Stop Work Authority Reporting Form documents an incident where an employee issued a stop work order due to an unsafe work activity or safety hazard. It records the date, time, location of the incident, the employee and manager involved, the work being performed, and a description of the unsafe activity. It notes whether the receiving party stopped working and complied. Immediate corrective actions were taken to address the hazard, and the form is used to track any long-term corrective actions needed to prevent future incidents.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Stop Work Authority Reporting Form

    Uploaded by

    engineering Indopile
    48 views2 pages
    This Stop Work Authority Reporting Form documents an incident where an employee issued a stop work order due to an unsafe work activity or safety hazard. It records the date, time, location of the incident, the employee and manager involved, the work being performed, and a description of the unsafe activity. It notes whether the receiving party stopped working and complied. Immediate corrective actions were taken to address the hazard, and the form is used to track any long-term corrective actions needed to prevent future incidents.

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    This Stop Work Authority Reporting Form documents an incident where an employee issued a stop work order due to an unsafe work activity or safety hazard. It records the date, time, location of the incident, the employee and manager involved, the work being performed, and a description of the unsafe activity. It notes whether the receiving party stopped working and complied. Immediate corrective actions were taken to address the hazard, and the form is used to track any long-term corrective actions needed to prevent future incidents.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    48 views2 pages

    Stop Work Authority Reporting Form

    Uploaded by

    engineering Indopile
    This Stop Work Authority Reporting Form documents an incident where an employee issued a stop work order due to an unsafe work activity or safety hazard. It records the date, time, location of the incident, the employee and manager involved, the work being performed, and a description of the unsafe activity. It notes whether the receiving party stopped working and complied. Immediate corrective actions were taken to address the hazard, and the form is used to track any long-term corrective actions needed to prevent future incidents.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Stop Work Authority Reporting Form

    Stop Work Initiation Details

    Date: Time

    Employee’s Name Depot:

    Stop Work Authority issued to? (Name & Position)

    Line manager’s name: Line manager informed Yes or No?

    Location

    Description of work
    being performed:

    Description of the
    unsafe work activity or
    safety hazard(s)?

    Did they stop and followed your instructions? Yes or No?

    Immediate Corrective
    Action(s) Taken:

    ----------------------------------------------------------------------

    For Safety department use only:

    Form Received on: Date: Time:


    Stop Work Authority Resolution Form

    Section 1: Stop Work Initiation (Background)


    Date: Time
    Reported by: Depot:
    Stop Work Authority issued to? (Name & Position)
    Line manager’s name: Line manager informed Yes or No?

    Location

    Description of work
    being performed:

    Description of the
    unsafe work activity or
    safety hazard(s)?
    Did they stop and followed the instructions? Yes or No?

    Section 2: Stop Work Issue Resolution

    Immediate Corrective
    Action(s):

    Any other relevant


    information or
    observations related
    to the unsafe work
    activity or safety
    hazard?

    Section 3: Long-Term Corrective Actions

    Resolution Date and Time: Signed off by:

    ----------------------------------------------------------------------
    For Safety department use only:
    Reviewed by:
    Further investigations required? Yes or No? Date: Time:

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