Title Page
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Conducted on
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Conducted by
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Site
Executive Summary
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Housekeeping
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Housekeeping Standards
Slips & Trip Hazards
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Slips and Trips Hazards
Machinery Safety
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Machine Safety Hazards
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Lock Out Tag Out
Electrical & Hazardous Energy Safety
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Electrical Hazards
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Hazardous Energy Hazards
Height & Lifting Safety
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Height & Lifting Hazards
Fire Safety
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Fire Hazards
Transport Safety
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Transport Hazards
Manual Handling Safety
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Manual Handling Hazards
Chemical Hazards
PPE
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PPE
Other Hazards
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Details of Good Practice Observed
Summary of Any Positive Safety Conversations or Safety Observations
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Type of Observation & Conversation
- Positive Observation with Positive Conversation
- Negative Observation with Positive Conversation
- No Observation or Conversation Made
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Notes
- Positive Observation with Positive Conversation
- Negative Observation with Positive Conversation
- No Observation or Conversation Made