Académique Documents
Professionnel Documents
Culture Documents
Name (Print)
Steven Dsouza
Signature
_______________________________
Date
_______________________________
Name (Print)
_______________________________
Signature
_______________________________
Date
_______________________________
Name (Print)
_______________________________
Signature
_______________________________
Date
_______________________________
NB: This declaration must be completed in full submitted and retained with the
candidates script. If this declaration is not submitted the candidates result may be
declared void.
Course provider
number
Course provider
name
Student number
Student name
Steven Dsouza
Maximum
marks
available
Criteria
1
1.1
15
1.2
15
2.1
2.2
Executive summary
3.1
3.2
3.3
4.1
15
4.2
15
TOTAL MARKS
Grades:
15
5
10
100
Assessors
marks awarded
NEBOSH
moderated
marks
(if different)
Candidates observation
sheet
Sheet number
of _____
Timescale
3-5 days.
1. Electrocution: Can be caused
due to non-standard electric
connections
and
improper
insulation from electric cables
coming from the mail lines.
2. Excavation
work
exposes
equipment operators to whole
body
vibration
from
earthmoving equipment and
ergonomic problems from poor
seat and cabin design.
5-7 days.
2 days.
Fuel
to
be
moved
immediately and
with
high
priority.
6. Trash
from
materials
packaging,
employee
lunch/meal breaks, etc. Has
been properly maintained,
Recycle bins and garbage bins
have been provided at the site.
To
Continued.
Good Practice.
3 days.
be
Candidates observation
sheet
Sheet number
of _____
Observations
Control measures
Timescale
7.
Candidates observation
sheet
Sheet number
of _____
Observations
Hazards and Consequences
Control measures
Timescale
Candidates observation
sheet
Sheet number
of _____
Observations
Control measures
Timescale
Candidates observation
sheet
Sheet number
of _____
Observations
Control measures
Timescale
Candidates observation
sheet
Sheet number
of _____
Observations
Hazards and Consequences
Control measures
Timescale
Candidates observation
sheet
Sheet number
of _____
Observations
Hazards and Consequences
Control measures
Timescale
Candidates observation
sheet
Sheet number
of _____
Observations
Hazards and Consequences
Control measures
Timescale
Candidates observation
sheet
Sheet number
of _____
Observations
Hazards and Consequences
Control measures
Timescale
Candidates observation
sheet
Sheet number
of _____
Control measures
Timescale
Location ______________________________________
Date of review
Executive Summary
Conclusions
Candidate Name__________________
Priority
Target date
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________
Candidate Name__________________
Candidate Number______________