Whsmp · OPW16/0021

                                                                                       Corrective Action Report (C.A.R.)
                                                                                                                          HB-HSEQ-F-029-A
                                                                                                                                Version: 9


Job Name:                                                               Job #
Employer:                                                               CAR No:
Date:                                                                   Time:
Select one of the following:
Health & Safety Issue                         Environmental Issue                             Quality Issue
unsafe work practices , breach of             Public/client compliant , sediment              administration systems failure ,
policy or procedures , Work at Heights        control ,waste control , pollution of           inadequate resources , Defective
  , Plant/equipment operations ,              water ways , flora & fauna , dust/air           product upon delivery , substandard
Role & responsibilities                       quality , oil/fuel/chemical spills ,            workmanship
other __________________________              other __________________________                other _________________________
Brief description of identified issue or hazard:




What was the system breach / root cause that has resulted in the identified issue or hazard?
(E.g. Breaches to any of the following: SWMS, PRA, Site Rules, PRA, Scope of Works, WHSMP / QMP / EMP, Codes or standards etc.)




The location in the workplace where the identified issue or hazard occurred.




Identified Corrective Action to fix identified issue or hazard? (Fix the immediate issue)




Recommended completion date ………/………./……….
Identified Preventative Action to prevent the identified issue or hazard recurring? (Stop it happening again)




Recommended completion date:……..…/………./………..
Will there be any additional monitoring required? (E.g. Task observations)             Yes      No
Monitoring Type                               Frequency                                       Person Responsible




What evidence has been provided to support the close out of the CAR?
Photographs:                                  Documentation amended:                           Completed Task Observations:
                                              SWMS, PRA etc.
Training Materials (Toolbox Talk)             Other:                                           Other:

Hutchinson Builders Team Member (Issuing & Closing)                   Received by the Employer Representative

Name:                                                                 Name:

Signature:                                                            Signature:
Date Issued :          /      /     Date Closed:          /      /    Date:        /      /


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