VSZ-HS-FRM-038

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Project:

  UFB

  M&P

  Build Services

• Activity Observed:

Observations

• Body Position (BP)

  MRO

  ARB

  ARS

• Personal Protective Equipment (PPE)

  MRO

  ARB

  ARS

• Housekeeping (HK)

  MRO

  ARB

  ARS

• Work Methods (WM)

  MRO

  ARB

  ARS

• Job Focus (JF)

  MRO

  ARB

  ARS

Telecommunications Safety Essentials (identify those relevant to work)

• TSE

  Select Electrical Work Working at Height Driver Alertness Working with Utility Services Excavation Works Working in the Vicinity of Vehicular Traffic Working in/around Mobile Plant Working in Remote & Isolated Locations Heavy Lifting Exposure to Asbestos

  • Electrical Work
  • Working at Height
  • Driver Alertness
  • Working with Utility Services
  • Excavation Works
  • Working in the Vicinity of Vehicular Traffic
  • Working in/around Mobile Plant
  • Working in Remote & Isolated Locations
  • Heavy Lifting
  • Exposure to Asbestos

• TSE

  Select Electrical Work Working at Height Driver Alertness Working with Utility Services Excavation Works Working in the Vicinity of Vehicular Traffic Working in/around Mobile Plant Working in Remote & Isolated Locations Heavy Lifting Exposure to Asbestos

  • Electrical Work
  • Working at Height
  • Driver Alertness
  • Working with Utility Services
  • Excavation Works
  • Working in the Vicinity of Vehicular Traffic
  • Working in/around Mobile Plant
  • Working in Remote & Isolated Locations
  • Heavy Lifting
  • Exposure to Asbestos

• TSE

  Select Electrical Work Working at Height Driver Alertness Working with Utility Services Excavation Works Working in the Vicinity of Vehicular Traffic Working in/around Mobile Plant Working in Remote & Isolated Locations Heavy Lifting Exposure to Asbestos

  • Electrical Work
  • Working at Height
  • Driver Alertness
  • Working with Utility Services
  • Excavation Works
  • Working in the Vicinity of Vehicular Traffic
  • Working in/around Mobile Plant
  • Working in Remote & Isolated Locations
  • Heavy Lifting
  • Exposure to Asbestos

• TSE

  Select Electrical Work Working at Height Driver Alertness Working with Utility Services Excavation Works Working in the Vicinity of Vehicular Traffic Working in/around Mobile Plant Working in Remote & Isolated Locations Heavy Lifting Exposure to Asbestos

  • Electrical Work
  • Working at Height
  • Driver Alertness
  • Working with Utility Services
  • Excavation Works
  • Working in the Vicinity of Vehicular Traffic
  • Working in/around Mobile Plant
  • Working in Remote & Isolated Locations
  • Heavy Lifting
  • Exposure to Asbestos

• TSE

  Select Electrical Work Working at Height Driver Alertness Working with Utility Services Excavation Works Working in the Vicinity of Vehicular Traffic Working in/around Mobile Plant Working in Remote & Isolated Locations Heavy Lifting Exposure to Asbestos

  • Electrical Work
  • Working at Height
  • Driver Alertness
  • Working with Utility Services
  • Excavation Works
  • Working in the Vicinity of Vehicular Traffic
  • Working in/around Mobile Plant
  • Working in Remote & Isolated Locations
  • Heavy Lifting
  • Exposure to Asbestos

Corrective Actions (include details of "by who" and "by when"

• Observers signature:

  Sign

• Cintellate IOA#

• Managers signature:

  Sign