HaBIT Card

Observation

Location Date Shift

Day Night

Type

Safe At Risk

STOP WORK AGREEMENT: Immediately intervene if the condition or behavior is immediately dangerous to life or health (IDLH).

What did you see or find? What did you say or do? Additional action required?

Yes No N/A

Ideas for improvement

Check the identified condition(s) or scenario(s):

Completed by the HSE specialist. Leave blank when filing from the field.

HSE specialist Date received Tracking no.