Information
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Conducted on
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Prepared by
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Audit Title
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Employees that were observed to be working safely and reviewed safety checklists or safety quick check (list employees):
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Areas that have been evaluated for unsafe conditions and are deemed to be acceptable:
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I have checked on the following safety issue resolutions and feel that the action taken was appropriate:
I have specifically looked at these focal points
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Eliminate hand injury potential
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Ways to reduce lifting where possible
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Identify and eliminate RSI risk factors
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Ways to reduce Noise levels
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Ways to improve dust collection
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Other
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I have personally found and fixed the following safety concern which has been causing frequent problems or has the potential to cause a serious incident:
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I have given a Safety Stroke today to:
The following employee will be asked to attend a Safety Sit Down meeting:
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Employee:
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Topic:
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Select date
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