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Module 6 Inspection Summary Report - Example

1. An inspection was conducted on November 2, 2020 at 10:00am in zone 7 by John Doe. 2. There were 2 pending items and 4 new items identified during the inspection for a total of 6 items. 3. The items ranged from priority issues like a missing guard on a guillotine and a frayed cable on a jib crane to lower priority issues like a cracked window pane and worker complaints about fume exposure levels.

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Godfrey Tamane
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83 views1 page

Module 6 Inspection Summary Report - Example

1. An inspection was conducted on November 2, 2020 at 10:00am in zone 7 by John Doe. 2. There were 2 pending items and 4 new items identified during the inspection for a total of 6 items. 3. The items ranged from priority issues like a missing guard on a guillotine and a frayed cable on a jib crane to lower priority issues like a cracked window pane and worker complaints about fume exposure levels.

Uploaded by

Godfrey Tamane
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EXAMPLE: INSPECTION SUMMARY REPORT

Area: zone 7
Date/time of inspection: 11/02/2020 - 10:00am
HSE representative/Inspector: John Doe, Control Specialist
Distribution list: See attached memo

Pending items (*): 2 New items: 4 Total items: 6


IMMEDIATE RESPONSIBLE
ITEM/ DESCRIPTION RECOMMENDE CORRECTIVE
PRIORITY LOCATION ACTION BY HSE PERSON/
ELEMENT OF HAZARD D COMP DATE ACTION TAKEN/TO
H/M/L REP (WHERE SUPERVISOR/
BE TAKEN
POSSIBLE) DEPARTMENT
1 H Guard missing Paper Stop process Immediate J Hendriks Supervisor notified
on guillotine cutting bay

2* L Window pane Supervisor’s Contact 20/02/2020 M Albano Order issued to


cracked office maintenance to maintenance for
replace window replacement of
window
13/02/2020
3 H Worker at Print works Supervisor to 16/02/2020 B Pieterse Eye protection re-
cleaning tank evaluate issued at time of
not wearing training inspection. Mr
eye Pieterse will hold
protection meeting on
15/02/2020

4 H Cable on jib Goods yard Replace cable 13/02/2020 A Mahlangu Withdraw from use
crane badly until cable can be
frayed replaced
on12/02/2020

5* H Handrail Stairway Issue work order 27/02/2020 J Bloggs Order issued


damaged on south-west for repair 13/02/2020
stairway to 1st corner
floor

6 L Complaints Spray- Ventilation 16/02/2020 HSE Committee Awaiting results of


from workers painting study from AIA ventilation study to
regarding booth be done 15/02/2020
fume
exposure
level

Comments and recommendations

Signature: Designation:

Handed to: ....................................... of 20x committee .........................................on................./................/...........

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