Template

Unsafe Action/Condition Notification

by Werner De Klerk, from the Community

This unsafe action or condition notification template helps teams document breaches of health, safety, or environmental rules on site. Record worker and subcontractor details, induction number, activity, location, date and time observed, and whether the incident warrants a yellow or red card. Describe the unsafe act or condition, note previous offences, and specify corrective actions to prevent recurrence. Capture acknowledgements and signatures from the issuer, subcontractor, and management close-out, with optional comments and distribution to project and HSE stakeholders.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Unsafe Condition Notification Form
This unsafe condition notification template helps construction teams quickly document hazards on site, capture photos, note locations, and outline recommended corrective actions. Use it to record key details such as job number, project name, general contractor, safety representative, and foreman. Notify the project and contractor teams by email or verbally, track follow up actions, and collect sign off with name and date. Streamline reporting to reduce risk and improve safety communication across the job site.
by Jay Rodman, from the Community
Downloads: 0
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Template
KGM Unsafe Act, Condition and Equipment Report
Use this KGM safety checklist to report unsafe acts, unsafe conditions, and substandard or unsafe use of equipment on site. Capture date and time, location, department or company, people involved, detailed description, immediate corrective actions, and who the issue was reported to, including supervisor, foreman, superintendent, manager, safety, or control room. Designed for mining operations to improve hazard awareness and prevent incidents.
by Gerald Visagie, from the Community
Downloads: 0
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Template
Near Miss Report Template
This Near Miss Report template helps construction teams quickly capture and investigate near-miss events before they cause harm. Record key details such as document number, client or site, date and time, location, personnel, and department. Identify factors including unsafe acts, unsafe conditions, unsafe equipment, or improper equipment use. Describe the incident or hazard, attach photos, and capture employee signatures and dates. The investigation section guides users to document the near-miss condition, identify primary and contributing causes, and define corrective actions such as removing hazards, replacing or repairing equipment, or retraining staff. Includes management sign-off to close the loop and improve site safety and HSE compliance.
by Chris Graydon, from the Community
Downloads: 0
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Template
Yellow Card
Document and manage site safety non-compliance with this Yellow Card template. Capture the issuer, recipient, employer, incident location and date, contraventions of site rules or legislation, and recommendations to prevent recurrence. Use it to notify subcontractors or employees, record acknowledgements and witnesses, and track corrective actions over a 12 months period. Intended as a starting point for construction teams; seek professional advice to ensure it suits your jurisdiction and company policies.
by Jon Sharrock, from the Community
Downloads: 20+
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Unsafe Condition Notification Form

This unsafe condition notification template helps construction teams quickly document hazards on site, capture photos, note locations, and outline recommended corrective actions. Use it to record key details such as job number, project name, general contractor, safety representative, and foreman. Notify the project and contractor teams by email or verbally, track follow up actions, and collect sign off with name and date. Streamline reporting to reduce risk and improve safety communication across the job site.

by Jay Rodman, from the Community

Get

Template

KGM Unsafe Act, Condition and Equipment Report

Use this KGM safety checklist to report unsafe acts, unsafe conditions, and substandard or unsafe use of equipment on site. Capture date and time, location, department or company, people involved, detailed description, immediate corrective actions, and who the issue was reported to, including supervisor, foreman, superintendent, manager, safety, or control room. Designed for mining operations to improve hazard awareness and prevent incidents.

by Gerald Visagie, from the Community

Get

Template

Near Miss Report Template

This Near Miss Report template helps construction teams quickly capture and investigate near-miss events before they cause harm. Record key details such as document number, client or site, date and time, location, personnel, and department. Identify factors including unsafe acts, unsafe conditions, unsafe equipment, or improper equipment use. Describe the incident or hazard, attach photos, and capture employee signatures and dates. The investigation section guides users to document the near-miss condition, identify primary and contributing causes, and define corrective actions such as removing hazards, replacing or repairing equipment, or retraining staff. Includes management sign-off to close the loop and improve site safety and HSE compliance.

by Chris Graydon, from the Community

Get

Template

Yellow Card

Document and manage site safety non-compliance with this Yellow Card template. Capture the issuer, recipient, employer, incident location and date, contraventions of site rules or legislation, and recommendations to prevent recurrence. Use it to notify subcontractors or employees, record acknowledgements and witnesses, and track corrective actions over a 12 months period. Intended as a starting point for construction teams; seek professional advice to ensure it suits your jurisdiction and company policies.

by Jon Sharrock, from the Community

20+

Get

Unsafe Action/Condition Notification

About author

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Unsafe Condition Notification Form

KGM Unsafe Act, Condition and Equipment Report

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Unsafe Condition Notification Form

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