Information
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Document No.
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Audit Title
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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
Positive concern
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Safe Actions
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Good Practice
Area to improvement/concern
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Unsafe Actions; eg. Position, Handling, Unsafe Operation, etc.
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Unsafe Conditions; eg. Machine, Equipment, Portable tools, etc. (fix and mobile type)
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Unsafe Material; eg. Chemical, Electricity, Radiation, etc.
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Unsafe Environment; Temperature, Biological, Noise, Dust, etc.
Agreement and Signature
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Area Owner
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SOT Leader
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SOT Member
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SOT Member
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SOT Member