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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Company/Employer:
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Visionstream Manager Responsible:
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Visionstream Safety Officer:
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Reason for Cease:
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Relevant Project Manager Informed
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Worksite made safe while work has ceases
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Reason for cease work explained to contractor
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Signature of issuer:
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Alternate Delegate who may lift cease work:
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Issue Resolved and work recommenced
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Date of recommencement:
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Responsible manager sign off: