Aircraft Maintenance Safety Observation Form
Document and report safety observations during aircraft maintenance activities to promote a safer work environment.
Observer Name
*
First Name
Last Name
Observer Email Address
*
example@example.com
Date and Time of Observation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location (Hangar, Bay, or Site)
*
Type of Maintenance Activity Observed
*
Please Select
Routine Inspection
Repair
Component Replacement
Testing/Calibration
Cleaning
Other
Describe the Situation or Activity Observed
*
Was the act or condition safe or unsafe?
*
Safe
Unsafe
Categories of Observed Safety Issue (Select all that apply)
Personal Protective Equipment (PPE)
Tools/Equipment Usage
Procedures/Compliance
Housekeeping/Cleanliness
Hazardous Materials
Other
Potential Consequence if Not Addressed
*
Please Select
Minor (No injury or damage)
Moderate (First aid required, minor damage)
Major (Medical treatment, significant damage)
Critical (Serious injury/fatality, major damage)
Immediate Corrective Action Taken
*
Yes
No
Describe Corrective Action Taken or Recommended
Additional Comments or Recommendations
Signature (Confirming accuracy of this observation)
*
Submit Observation
Submit Observation
Should be Empty: