Title Page

  • Client / Site

  • Conducted on

  • Prepared by

Safety Share and Health Check

  • Performance reveiw

Safety. Safe Home Every Day

  • Was the day minor incident or near miss free

  • Was the day major incident free?

Quality. In Spec.

  • Was grain quality to weighted average?

Cost

  • Was daily tonnage target achieved?

Today's Activities and Required Jobs.

  • Provide details of the days planned activities and any controls put in place to mitigate risk.

  • Has a risk assessment been done for the days tasks?

  • Were any new or high risk activities identified. If Yes please give details. Provide photograph of JSA or Take 5

Breakdowns and calls for Help.

  • Enter photo of any damage here.

Recognition

Signatures

  • Shane Massam

  • Eric Smith

  • PAUL OREILY

  • Matt Thornton

  • Add signature

  • Add signature

  • Add signature

  • Add signature

  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.