Title Page
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Conducted on
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Prepared by
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Location
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Name of Op
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Agency / Employed
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Sentinel Number
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Primary Sponsor
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Travel Time to work
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Second Sponsor
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4LM Induction
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Asbestos Awareness
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Manual Handling
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Face Fit Type
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Working at Height
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Date of Inspection
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Reason for Inspection (New Starter / Post Incident / Random)
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Sentinel ICI LU – EXP DATE
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BTA – EXP DATE
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PTS AC/DC – EXP DATE
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Area A – EXP DATE
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LUL Medical – EXP DATE
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PHOTO REQUIRED IF YES
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LUL DAMSP
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PHOTO REQUIRED IF YES
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First Aider (Training Provider) – EXP DATE
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PHOTO REQUIRED
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Cat / Genny (Training Provider) – EXP DATE
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PHOTO REQUIRED – Signed off by employing manager as competent?
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PASMA – EXP DATE
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Track Trolley Controller – EXP DATE
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Fire Watchmen – EXP DATE
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QUAF 54 – EXP DATE
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Confined Space – EXP DATE
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Small Tools – EXP DATE
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Cembre Drill – EXP DATE
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TSW035 (If an SPC or acts as an SPC) – EXP DATE
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Lanyard Training – EXP DATE
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Other
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Other
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PPE
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Minimum Standard
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Standard / Carried on site?
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Gloves
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Glasses
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Face Mask
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Ear Defenders
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Orange Trousers
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Hi Vis
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Boots
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Hard Hat
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Exp date
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Reviewed By:
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Signature:
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Date:
