DESCRIPTION

The version control will be maintained by the SHEQ team and is controlled via the Safety Equipment Inspections Document 2073838157-15.

Description of Hazard or Unsafe Condition:

Images of Hazard / Unsafe condition

Immediate action taken

What do you recommend to improve the situation:

Contact Name (optional) :

Contact Number (optional) :

DTL / Supervisor Name (Required) :

THANK YOU FOR TAKING TIME TO REPORT SO WE CAN KEEP YOU SAFE AT WORK

OFFICE USE

Name of SHEQ Advisor managing follow up:

Action Taken:

Date:

Date Entered into VenSafe:

VenSafe ###:

Date Entered into SWIRL:

SWIRL ###:

Communication Back to DTL / Supervisor:

Signature of DTL / Supervisor agreement of work completed:

everyone safe everyday