1. ACTIONS I. Following Procedures a. Violation by Individual b. Violation by group c. Violation by supervisor d. Operation of Equipment without authority e. Improper position or posture for the task f. Overexertion of physical capability g. Work or motion at improper speed h. Improper lifting techniques i. Improper loading j. Shortcuts II. Use of Tools or Equipment a. Improper use of equipment b. Improper use of tools c. Use of defective equipment (Aware) d. Use of defective tools (Aware) e. Improper placement of tool, equipment, or materials f. Operation of equipment at improper speed g. Servicing of equipment in operation III. Use of Protective Methods a. Lack of knowledge of hazard present b. PPE not used c. Improper use of PPE d. Servicing of energized equipment e. Equipment or materials not secured f. Disabled guards, warning systems or safety devices g. Removal of guards, warning systems or safety devices h. PPE not available IV. Inattention / Lack of Awareness a. Improper decision making or lack of sound judgement b. Distracted by other concerns c. Inattention to footing and surroundings d. Horseplay e. Acts of violence f. Failure to warn g. Use of drugs or alcohol h. Routine activity without thought
2. CONDITIONS I. Protective System a. Inadequate guards or protective devices b. Defective guards or protective devices c. Inadequate PPE d. Defective PPE e. Inadequate warning systems f. Defective warning systems g. Inadequate isolation of process or equipment h. Inadequate safety devices i. Defective safety devices II. Tools, Equipment, and Vehicles a. Defective Equipment b. Inadequate equipment c. Improperly prepared equipment d. Defective Tools e. Inadequate Tools f. Improperly prepared tools g. Defective Vehicle h. Inadequate vehicle for the purpose III. Work Exposures to: a. Fire or Explosion b. Noise c. Energized electrical systems d. Energized systems, other than electrical e. Radiation f. Temperature extremes g. Hazardous Chemicals h. Clutter or debris i. Storms or acts of nature j. Slippery floors or walkways IV. Work Place Environment / Layout a. Congestion or restricted motion b. Inadequate or excessive illumination c. Inadequate ventilation d. Unprotected height e. Inadequate workplace layout Controls less than adequate Displays less than adequate Labels less than adequate Locations out of reach or sight Conflicting information is presented
POSSIBLE IMMEDIATE CAUSES 1. PERSONAL FACTORS I. Physical Capability a. Vision deficiency b. Hearing deficiency c. Other sensory deficiency d. Reduced respiratory capacity e. Other permanent physical disabilities f. Temporary disabilities g. Inability to sustain body positions h. Restricted range of body movement i. Substance sensitivities or allergies j. Inadequate size or strength k. Diminished capacity/capability due to medication II. Physical Condition a. Previous injury or illness b. Fatigue due to: Workload Lack of rest Sensory overload c. Diminished performance Temperature extremes Oxygen deficiency Atmospheric pressure variation d. Blood sugar insufficiency e. Impairment due to drug or alcohol use III. Mental Status a. Poor Judgement b. Memory Failure c. Poor Coordination or reaction time d. Emotional disturbance e. Fears or Phobias f. Low mechanical aptitude g. Low learning aptitude h. Influenced by medication IV. Mental Stress a. Preoccupation with problems b. Frustration c. Confusing directions/demands d. Conflicting directions/demands e. Meaningless or degrading activities f. Emotional overload g. Extreme judgement / decision demands h. Extreme concentration / perception demands i. Extreme boredom
V. Behavior a. Improper performance is rewarded Saves time or effort Avoids discomfort Gains attention b. Improper supervisory example c. Inadequate identification of critical safe behaviors d. Inadequate reinforcement of critical safe behaviors Proper performance is criticized Inappropriate peer pressure Inappropriate performance feedback Inadequate disciplinary process e. Inappropriate aggression f. Improper use production incentives g. Supervisor implied haste h. Employee perceived haste VI. Skill Level a. Inadequate assessment of required skills b. Inadequate practice of skills c. Infrequent performance of skill d. Lack of coaching on skill e. Insufficient review of instruction to establish skill VII. Training / Knowledge Transfer
Hi Mr. Vans, I was informed that Mr. Jeff already prepared a vehicle gate pass for a certain Toyota Hilux but they have decided to switch that vehicle with another one so I prepared another request for Temporary Vehicle gate pass for such. Please find the attached documentation for this request.