• Prepared by

  • Personnel

  • Inspection Area/s
  • Conducted on

    Please Select Add To Input Citation


  • Issued to:

  • Area of Citation

  • Equipment Involved/Location/Area of Violation

  • Condition or Practice

  • 30 CFR Standard

  • Gravity

  • Severity

  • Significant & Substantial

  • Number of persons potentially affected

  • Negligence

  • Citation Photo

  • Termination Due Date

  • Action to terminate

  • Termination Photo

  • Inspector

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.