Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Signal Identification
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Date and Time Notified of Accident
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Date and Time Arrived on Site
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Has the Duty Officer being Notified?
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Is CCTV Present on Site?
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Photo's of Initial incident
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TNS Site Risk Assessment Completed
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Are Police details available?
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Officer 1 - Name, Badge, Station and QPS
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Officer 2 - Name, Badge, Station and QPS
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Are Vehicle / Driver Details Available?
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Vehicle 1 - Registration, Vehicle Type, Driver Details/Address
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Vehicle 2 - Registration, Vehicle Type, Driver Details/Address
Signal Action
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What work was done to rectify
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Earth Continuity Completed? Result Recorded?
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Further Action Required
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Bell Joint Used
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Materials Damaged
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Materials to be Re-used
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Is any other BCC Infrastructure damaged as a result of Accident. i.e street signs, bus shelter
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Has the Call Centre been notified of the damage? Note reference number.
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Photo of how the site was left
Site Resource Utilisation
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Site Diary Completed?
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Staff on Site - Payroll, Name, Hours
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Fleet on Site - Fleet Number, Fleet Type, Hours
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Supplier/Hire Company on site
Sign Off
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Date and Time Finished on Site
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Add signature
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Add signature
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Add signature
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Add signature
Further Works Completion
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Action taken to complete job 1
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Technician
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Date / Time Restored
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Supervisor