Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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When was the hazard detected?
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John Holland or Subcontractor?
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Subcontractor Name?
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Type of Report
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Details of report
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Take a photo?
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Has the hazard been fixed?
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How was the hazard fixed? Or what is required to fix the hazard?
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ALL HAZARDS MUST BE IMMEDIATELY REPORTED TO YOUR SUPERVISOR IN ADDITION TO SUBMITTING THIS FORM
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Has your supervisor been advised?
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Name of Supervisor
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ALL HAZARDS THAT REQUIRE ATTENTION IN LESS THAN 1 DAY MUST BE FIXED IMMEDIATELY OR YOUR SUPERVISOR NOTIFIED IMMEDIATELY.
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Draw a sketch here if appropriate.
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Signature of Person Reporting Hazard