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To:
Job Cycle Check Coordinator
Date: ____________________
From:
__________________________ Shift Area:________________
( Shift Supervisor/ Team Leader)
Job Title:________________________________________
Job Procedures:___________________________________
Technician’s Name:_______________
DSPC Pass (ID) Number:_______
Date of Audit:_______________
Time of Audit:________________
Type of Check Made: Actually Did Job ( ) Dry Run ( )
Unsafe Acts, Practices or conditions Observed:
Yes ( ) No. ( )
If yes, explain: _______________________________________________________
Tools Readily Available? _______ Good Condition? _____ Replaced? __________
Other Hazards Notes: __________________________________________________
____________________________________________________________________
Safety Rules: KNOWN ( ) FOLLOWED ( ) UP-TO-DATE ( )
Can Job be done by Present Procedure?_____________________________________________
_____________________________________________________________________________
If minor revision is needed, make a copy of procedure, note CHANGES required, attach it to this form and send to the Job Cycle Coordinator.
If major revision is required, describe below briefly WHAT is needed and send this form to the Job Cycle Check Coordinator.
What is needed to make this operation safer, more efficient, to improve quality; or to change changes standard practice or Safety Rules?
Technician/Operator’s Comment:_________________________________________________
Job Cycle Check Auditor’s Comment:______________________ |
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