Title Page
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Document No.
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PROJECT SAFETY AND HEALTH SURVEY
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Conducted on
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Prepared by
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Location
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Personnel
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Project Name/Job # .....
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Date and Time
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Description
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Project Manager
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Supervisor
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McCarl's employees (Trade/#)
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Subcontractors (by Trade #)
Requirements (Check if verified)
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McCarl's Safety & Health Program onsite/ online
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Safety & Health Posting Requirements
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First Aid Kit
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OSHA 300 Log
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Emergency Procedures/Phone Numbers
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Orientation performed for all employees
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Physician Panel (if required)
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Fire Extinguisher in office
Overview
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PPE
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Housekeeping
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Confined Space Entry
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Assure Grounding of Tools/Cords
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Scaffolding
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Trenching/Excavation
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Ladders/Stairways
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Wall & Floor Openings
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Perimeter/Fall Openings
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Fire Protection
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Mechanical Lock-out/Tag-out
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Welding/Cutting
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Gas Cylinders
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Cranes/JLG's/Manlifts
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Rigging-Slings/Cables
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Material Storage
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
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Subcontractor Safety
- Not Applicable
- Acceptable Compliance
- Improvement Needed
- See comments & Observations
Safety Preplanning (2 week look ahead)
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Please enter response below.
Hazard Corrections
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials
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Hazard #
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Check if hazard is created by others
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Observations/Location
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Immediately Abated?
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Steps taken to correct condition
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Goal Date
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Responsible Person
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Date Completed
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Initials