Title Page
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Conducted on
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Prepared by
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Address of Site Visited
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Enter Date and Time of Visit
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Employee on Duty
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Employee’s SIA License Number
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Expiry Date of License
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Has the Employee a Mainstay ID Card?
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Expiry Date of ID Card?
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Has the employee a valid NIACS Card?
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Is the Employee in Correct Uniform?
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Does the Employee Have Good Site Knowledge?
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Has the employee a valid NIACS Card?
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Has the Employee Read and Signed the AI’s?
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Any Uniform Requests?
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Are there any Questions?
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Employees Signature
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Managers Signature
