Title Page
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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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Supervisor name
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Location
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Personnel
Hazards
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Slips, trips or falls
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Falls from height/Roof work
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Chemicals
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Falling objects
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Asphyxiation
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Heat/Fire/Explosion/Hot works
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Asbestos
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Stationary objects
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Overturn/Collapse
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Manual handling<br>
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Insecure load<br>
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Vehicles<br>
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Confined spaces (Permit Req’d)<br>
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Noise<br><br>
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Temperature<br>
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Vibration<br><br>
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Electricity<br><br>
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Contamination<br><br>
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Radiation<br><br>
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Poor lighting<br><br>
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Adverse weather<br>
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Uncertified equipment<br>
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Dust/Fumes<br>
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Additional notes
Completion
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Supervisor signature