Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

To be actioned

  • Hazard, Incident or near miss

  • Type of Hazard, Location
  • Name of Issue

  • Was this a near miss, incident or hazard.

  • What time do this happen

  • What was the issue

  • Media of the issue

  • Rate the risk 0 Nothing 10 Extream threat

  • Suggested solution.

  • Select date

  • Sign Off By

  • Notes

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.