Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • When was the hazard detected?

  • John Holland or Subcontractor?

  • Subcontractor Name?

  • Details of report

  • Take a photo?

  • Has the hazard been fixed?

  • How was the hazard fixed? Or what is required to fix the hazard?

  • ALL HAZARDS MUST BE IMMEDIATELY REPORTED TO YOUR SUPERVISOR IN ADDITION TO SUBMITTING THIS FORM

  • Within how many days should the hazard be attended to?

  • Has your supervisor been advised?

  • Name of Supervisor

  • ALL HAZARDS THAT REQUIRE ATTENTION IN LESS THAN 1 DAY MUST BE FIXED IMMEDIATELY OR YOUR SUPERVISOR NOTIFIED IMMEDIATELY.

  • Draw a sketch here if appropriate.

  • Signature of Person Reporting Hazard

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.