Title Page
-
CAR #:
-
Corrective Action Report
-
Person and Company being issued the CAR:
-
Add signature
-
Person and Company issuing the CAR:
-
Add signature
-
Location CAR is being issued (e.g: FLL Worksite, Log 6, Huanui Forest)
-
Date of Finding/Incident/Breach:
-
Finding/Incident/Breach Details:
-
Attach a photo as evidence (if applicable and available)
-
Please select the type of Finding, Incident or Breach:
- Safety
- Company Policy
- Company Procedure
- Legislation
-
Were there any Immediate Action/s? - (If “Yes” then actions require what, when, why, and who Details)
Remedial Action/s
-
Action Detail
-
Person Responsible
-
Action Due Date
-
Sign when Action is complete
-
Will this CAR require a Disciplinary Action?
-
Select the type of Disciplinary Action Required:
-
Who is responsible for issuing Disciplinary Action?
-
Due Date to issue Disciplinary Action
-
Sign when Action has been issued
