Information

  • Document No.

  • Conducted on

Citation 1

  • Citation No.

  • Inspector

  • Condition or Practice

  • Part/Section of Title 30 CFR:

  • Gravity: Injury or Illness (has) (is):

  • Severity: Injury/Illness could reasonably be expected to be:

  • Significant and Substantial:

  • Persons Potentially Affected:

  • Negligence

  • Termination Due Date

  • Picture of Findings

  • Additional Notes

Citation 2

  • Citation No.

  • Inspector

  • Condition or Practice

  • Part/Section of Title 30 CFR:

  • Gravity: Injury or Illness (has) (is):

  • Severity: Injury/Illness could reasonably be expected to be:

  • Significant and Substantial:

  • Persons Potentially Affected:

  • Negligence

  • Termination Due Date

  • Picture of Findings

  • Additional Notes

Citation 3

  • Citation No.

  • Inspector

  • Condition or Practice

  • Part/Section of Title 30 CFR:

  • Gravity: Injury or Illness (has) (is):

  • Severity: Injury/Illness could reasonably be expected to be:

  • Significant and Substantial:

  • Persons Potentially Affected:

  • Negligence

  • Termination Due Date

  • Picture of Findings

  • Additional Notes

Citation 4

  • Citation No.

  • Inspector

  • Condition or Practice

  • Part/Section of Title 30 CFR:

  • Gravity: Injury or Illness (has) (is):

  • Severity: Injury/Illness could reasonably be expected to be:

  • Significant and Substantial:

  • Persons Potentially Affected:

  • Negligence

  • Termination Due Date

  • Picture of Findings

  • Additional Notes

Citation 5

  • Citation No.

  • Inspector

  • Condition or Practice

  • Part/Section of Title 30 CFR:

  • Gravity: Injury or Illness (has) (is):

  • Severity: Injury/Illness could reasonably be expected to be:

  • Significant and Substantial:

  • Persons Potentially Affected:

  • Negligence

  • Termination Due Date

  • Picture of Findings

  • Additional Notes

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