Description Of Identified Aspect

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Remedial Action

Required to be completed

Action Taken

Reported By:
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Remedial Action Completed By:
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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.