Information
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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
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Observer (s)
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Add signature
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Area
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Select date
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Rank Between L-VH ( L = Low, M = Moderate, H = High, VH = Very High)
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Task Observed
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Classification
- safe act
- safe condition
- unsafe act
- unsafe condition
- safe rule violation
- environmental issue
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Category
- personal protective equipment
- positions of people
- tools & equipment
- procedures
- housekeeping
- driving
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Immediate Action
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Risk potential
-
Task Observed
-
Classification
- safe act
- safe condition
- unsafe act
- unsafe condition
- safe rule violation
- environmental issue
-
Category
- personal protective equipment
- positions of people
- tools & equipment
- procedures
- housekeeping
- driving
-
Immediate Action
-
Risk Potential
-
Task Observed
-
Classification
- safe act
- safe condition
- unsafe act
- unsafe condition
- safe rule violation
- environmental issue
-
Category
- personal protective equipment
- positions of people
- tools & equipment
- procedures
- housekeeping
- driving
-
Immediate Action
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Risk Potential
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Follow up action
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Person (s) responsible
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Date due
