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HSE ANNUAL GOALS

EMPLOYEE: Joe Doe

SUPERVISOR: John Smith

DATE OF REVIEW: January 15th, 2014

Completion
Item # Tasks to be Completed Verified by Additional Comments
Date

1. Lead one safety meeting March 3rd John Smith Discussed hazards of roads during
break-up

2. Participation in one Facility July 7th Mary Smith

Inspection

3. Submit completed vehicle Ongoing Fleet Inspection booklet is always handed on

inspections as required
each month Foreman Friday and is always done right.
Bob

4. Submit one Hazard Report Jan 3rd John Smith Joe submitted others but these were the
each quarter
April 7th first of each quarter
Sept 10th
Nov 12th

5. Etc.

HSE Annual Goals

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