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EHS Field Evaluation

Comprehensive Environment, Health & Safety Assessment

📋 Evaluation Information

Evaluator Name *

Role *

Date *

District / Base *

Operation *

Site Supervisor

✅ EHS Evaluation Categories

Click each category to expand. Rate items as Satisfactory (S), Unsatisfactory (U), or Not Applicable (N/A).

▼Safety Management

▼Hazard Communication

▼PPE Compliance

▼Walking/Working Surfaces

▼Fall Protection

▼Electrical Safety

▼Fire Prevention

▼Pressure Safety

▼Lifting Operations

▼Lockout/Tagout

▼Confined Space

▼Environmental

▼Health & Hygiene

▼Emergency Preparedness

📊 Overall Score

--%

Overall EHS Compliance Score

📝 Findings & Observations

Critical Findings (Immediate Attention Required)

Positive Observations *

Recommendations

Immediate Actions Required

Follow-Up Items

✍️ Acknowledgment

Site Supervisor Signature Obtained? *

Yes

N/A

Photos (take a picture or pick from your library, as many as you need)

Photos and PDFs, 15MB max each. Attachments lock when the form is submitted.

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