Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Untitled Page
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Photo of Near Miss
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Brief description of Near Miss Reported
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Is the Podium Supervisor Notified?
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Is the Client Supervisor Notified?
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Does the area need to be evacuated or controlled?
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Do emergency service need to be contacted?
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Does security need to be contacted?
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Equipment to be tagged out of service?
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Actions required?
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Clients instructions?
