Audit

1) Access, Egress & Housekeeping

- Access and egress to work area is clear of obstruction and easily defined
- Work areas are orderly and free from trip hazards (e.g. tools and rubbish)
- Materials are stored in a neat and orderly state
- General work area is clear of trip hazards and any rubbish or off-cuts
- Waste bins are available for use and not overflowing, correctly used
- Entry signs (if required) are located at appropriate locations to work area

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed
2) Behaviour & Work Habits

- Workers and assisting persons are wearing mandatory PPE
- Workers are wearing task specific PPE as required
- Worker are not taking any obvious risks
- Workers are using the right tools for the task at hand

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

3) SQE Risk Management

- All workers have been inducted
- Take 5 assessment has been appropriately completed
- SWMS documentation available for high risk tasks

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

4) Excavation & Trenching

- The CSD Contact Officer has approved any Excavation/ Trenching/ Ground breaking / Penetrating work activities
- Trench walls are appropriate battered, benched or shored
- Spoil Stock piles are placed appropriate distance from edge
- Barricades, fencing securing excavation adequate to prevent people from entering the immediate work area
-Underground services identified, positively marked and isolated where possible
-Safe means of access and egress maintained (ladders, stairs or ramps for excavations greater than 1.5m in depth.
-Daily inspections carried out for all excavations over 1.5 metres in depth

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

5) Mobile Powered Plant

- Daily Inspection completed and any faults recorded
- SWMS documentation completed and available
- Beacons and motion alarms are operational
- Plant operations are appropriately isolated or separated from adjacent work activities
- Spotter is in place for plant operations where plant operation can not be controlled by barricades or fencing
- Plant operators are not operating when using a mobile phone
- Operator holds applicable license / competency andcompetency has been verified
- Plant has fire extinguisher
- Appropriate traffic control signage in place
-Overhead services and structures identified with appropriate control measures implemented to prevent collision by plant and vehicles
-Pedestrian / vehicle crossing points clearly identified and controlled
-Loading/unloading zones clearly delineated with controls to prevent unauthorised access
-Effective communication between plant operators and ground controllers
-Keys removed from plant when not in use

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Corrective / Remedial Action

6) Tools & Equipment

- Tools and Equipment are appropriate for the task being undertaken and free from obvious damage
- Oxy / acetylene sets have flash back arresters fitted
- Fixed / retractable blade knives are not being used (Stanley Knives)
- Plant Fire Extinguishers have been tested tested in previous 6 months

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

7) Lifting Equipment & Operations

- Lifting Equipment is appropriate to the task and ready to use
- Lifting device is tagged / identified with SWL / WLL
- Dogman / Rigger holds the relevant competency and has been verified
-Cranes/lifting appliances regularly inspected, certified, tested and maintained.
-Pre-start inspection and/or function test completed
-Physical barriers and/or other suitable controls in place to exclude unauthorised persons from lifting operations.
-No loads lifted or suspended over people or walkways
-Ground conditions assessed with controls in place to stabilise equipment
-Tag lines used on loads which are liable to swing whilst being hoisted
-All rigging equipment kept in good order and condition and defective gear replaced or tagged and marked for repair.

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

8) Electrical & Lighting

- Equipment is tagged and in test date
- RCD is fitted to mains supply or portable generators in use
- Leads are run out correctly off the ground and supported on insulated stands or hooks
- No lead extends > 35 meters and are fitted with clear shrouded plugs with LED indicator
- Access and / or task lighting is adequate and work lights have protective cage or diffuser
-Electrical supply panels fixed and secured to prevent unauthorised access. RCD and circuit breakers locked
-No piggybacking or double adapters

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

9) Hot Works & Welding

- Hot Works Permit is current and available
- Suitable fuel reduction and fire fighting provisions in place
- Oxy and other bottles stored up right and secured
- Oxy / Act bottles on trolley with flash back arrestors at bottle & torch + extinguisher
- Welding signs are set out in appropriate locations

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

10) Working Platforms & Fall Protection

-Incomplete scaffold sign posted
-Scaffold tied in at regular intervals or mobile assembled correctly using check sheet
-Toe boards fitted when > 2m high
-Scaffold have base-plate or screw jacks
-Scaffolds adequately braced
- No gaps > 225mm between perimeter edge and scaffold. <6m metres from rail (fibre glass)
- Edges are appropriately delineated and barricaded
- Edge protection in place is appropriate for the protection required
- Penetrations are covered, secured and handrailed with applicable signage
- Platform ladders in good condition, Industrial rated (120kg) and set up correctly

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

11) Work at Heights

- Personnel working at height are using the correct fall prevention equipment
- Fall restraint / arrest equipment is certified and in date
- Method of working at height follows the Hierarchy of Controls for working at height
- Work at Height Permit has been issued and is in date
- Work at Height / EWP Rescue Plan has been developed for the works
- Personnel conducting work at height have been trained (within previous 2 years)
-Penetrations, shafts and risers protected to prevent the fall of people and material. Covers must be robust, securely fastened and identified (signage)
-Grid mesh or flooring material installed as per design requirements, secured at all stages of installation, and regularly inspected.
-Roof mesh is not used as a primary means of fall protection.

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

12) Chemical & Dangerous Goods

- MSDS documentation available on site
- Hazardous Substances are stored correctly
- Flammable substances stored in bundled area
- Spill Kit is available at the work location
- No evidence of spills

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

13) Environmental Management

- Controls in place where there is a risk of pollution of waterways
- Erosion and sedimentation controls in good working order
- No evidence of polluted water or other substances leaving the work area

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

13) Emergency Procedures

- Workers aware of evacuation procedures
- Workers aware of First Aid Kit locations
- First aid kits accessible and checked and re- stocked regularly
-First aid posters displayed and contact details listed
-First aid areas kept clean and tidy
-Eye wash facilities available if required

Are there issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Discipline (SQE)

Observation / Hazard / Issue

Corrective / Remedial Action

Contractor Responsible

Close-out Time Frame

Signature once item fixed / closed

Are there further issues with this category

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.