Information
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Audit Title
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Conducted on
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Prepared by
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Which division do you work for?
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Which contract are you working on?
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Type of incident
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Date and time of incident
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Who has been injured?
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Are they:
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Where did the incident take place?
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What task was being done at the time?
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Describe the incident:
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What actions were taken after the incident?
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What injuries were caused?
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Who witnessed the incident?