Information
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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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NOTE: This card should be handed to your supervisor or put in the box provided
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HAZARD
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NEAR MISS
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IMPROVEMENT
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POSITIVE EVENT
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PPE
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SAFETY BREACH
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FATIGUE
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NON CONFORMANCE
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NATURAL EVENT
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ENVIRONMENTAL CONDITIONS
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ZERO HARM
All accidents are preventable
