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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Prepared by
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Location
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Personnel
SAFETY SHARE & HEALTH CHECK
SAFETY -Safe Home Everyday
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Was the day minor incident or near miss free?
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Was the day major incident free?
COST
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Was daily tonnage target achieved?
QUALITY - Specs
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Was grain quality to average?
TODAYS ACTIVITIES & JOB REQUIREMENTS
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Provide details of the day's planned activities and any controls put in place to mitigate risk
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Has a risk assessment been done for the day's task?
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Were any new or high risk activities identified? If yes please give details & provide image of JSA or TAKE 5
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BREAKDOWNS & CALLS FOR HELP
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Enter photo of any damage here:
RECOGNITION
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Name & Reason
SIGNATURES
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