Title Page

  • Site conducted

  • Job Number

  • Project Manager Name

  • Prepared by

  • Created on

  • Location

Information

  • Zero Tolerance Policy Rules:

    Red Card Rule Examples.

    Personnel will be removed from site pending investigation of allegations involving
    (i) breaches of health and safety standards,
    (ii) the site rules and/or
    (iii) any criminal activities.

    Examples of behaviour which may give rise to such investigations are listed
    below. The list should not be regarded as being exhaustive.

    > Threatening or violent behaviour
    > Unauthorised use of mobile plant and equipment
    > Climbing external scaffold or tower
    > Alterations of scaffolding / mobile towers by untrained unauthorised persons
    > Removing or climbing on handrails
    > Using scaffolding when tagged “not in use”
    > Pulling or pushing podiums / towers with personnel on the platform
    > Bombing materials
    > Working at height without appropriate edge protection
    > The use of stepladders is forbidden without a risk assessment & a permit
    > Working without permit (hot work, confined space entry, excavation etc.)
    > Having alcohol or unprescribed drugs in the body and/or being under the influence of drink/drugs during working hours
    > Working outside of method statement and significant unsafe practice
    > Acts which are hazardous to persons or property
    > Acts of gross negligence
    > Repeat yellow card offenders

    Yellow Card Rule Examples

    > Housekeeping - not maintaining a clean and safe working area
    > Not using eye and ear protection when using abrasive wheels
    > Not wearing appropriate PPE at all times
    > Using radios on site
    > Smoking on site (inside) – other than in designated areas
    > Using mobile phones in site working areas – other than areas provided for safe use
    > Use of incorrectly assembled mobile scaffold

  • Green Card Rule Examples.

    Personnel can be given a green observation card for going above & beyond with regards to working safely on site.

    Examples of instances which may lead to a green observation card are below. The list should not be regarded as being exhaustive.

    > Removing H&S hazards without being asked to do so
    > Re-routing cabling overhead to avoid trip hazards
    > Planning works to ensure that work is carried out safely
    > Stopping any tasks which may be unsafe
    > Constant safe working on site

Card Report

  • Name of Person Observed

  • Name of Organisation

  • Please provide a full description of observation

  • Image of Safety Observation

  • Type of card being issued

  • Advise the operative that they are not permitted to work on any ADT Workplace site until further notice.

  • I declare that I understand and accept the comments on the ADT Workplace H&S Observation Card issued.

  • Issuer

  • Advise the operative that they should they be issued with a second Yellow card they will be escalated to a RED and potential removal from site.

  • I declare that I understand and accept the comments on the ADT Workplace H&S Observation Card issued.

  • Issuer

  • Issuer

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.