Information
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Branch/ Location:
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Inspected by:
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Sub Contractor:
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Job Number:
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Job Name:
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Conducted on
Revision Information
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This record is compliant with the requirements of HSF14.4 issue 0. This is electronic issue 1.0 issued on 08/11/2016
Sub standard condition
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If sub standards exist please use the following codes:
A = Issue to be attended to immediately
B = To be attended to by the indicated date
C = Investigation meeting required
T = Training required
Site / Vehicle / Resource
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Punctual (checking signing in / out)
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Parked in a designated area?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Reverse parked?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Number of operative(s) on site satisfactory
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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All operatives hold ECS or equivalent
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Waste material and storage of kit?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Work standard (current progress)
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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General quality of workmanship
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
Personal protective equipment / uniform
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Correct PPE for the task?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Correct plant for the task?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Plant tagged and valid?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Appropriate Attire (Tyco T Shirt)?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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All 230v devices PAT Tested?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Valid relevant license for plant e.g. IPAF ?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
Documentation / General
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Job spec / method statement?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Copy of RAM's / Zero Harm Form.
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Company Identity Card?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Drawings?
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Please provide any comments
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Please select the follow up category:<br>
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Please indicate the follow up date.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please record your actions.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please indicate the time and date of the investigation meeting.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
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Please provide details of the training requirements.
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Please provide any comments
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Is manager escalation required?
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Please provide names and issues
Site Operatives
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List all names of operatives on site working for the contractor / vendor
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Please record any relevant notes regarding the operatives on site
Audit completion
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Any comments / Actions:
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Managers Signature
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Contractors Signature
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Are any further actions required?
Corrective Action
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Removal of plant
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Please provide your comments
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Removal of operative(s)
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Please provide your comments
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Report to procurement / management
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Please provide your comments
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Suspend works
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Please provide your comments
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Training / TBT
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Please provide your comments
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Investigation meeting required
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Date carried out
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Yellow / Red card issued
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Please provide your comments
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Additional details from corrective action(s): (detail any supporting documents)
Closed out / confirmation of Corrective Actions Complete
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All corrective actions are complete and this spot check is now closed.
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Name