RLX HSE CONVERSATION RECORD
Name
*
Site:
*
Please Select
CQLX
CRLX
CTLX
CVLX
HRLX
IRLX
NVLX
TRLX
SELX
WVLX
Corporate
Work Area
Date
*
/
Day
/
Month
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
What did you observe:
*
Please Select
Safe Act
Safe Condition
Safe Behaviour
Unsafe Act
Unsafe Condition
Unsafe Behaviour
Environmental Risk
Health Risk
Was High Risk Work involved?
*
Yes
No
Type of Worker:
*
RLX Employee
Contractor
Agent
Transporter
Visitor
How many people did you speak to:
*
What was the person doing?
*
Please Select
Working
Cleaning
Stacking
Lifting
Driving
On a break
Other
What did you discuss:
*
What were the positives:
*
What were the negatives:
*
How would you rate the persons/groups understanding of RLX HSE requirements:
Excellent
Good
Fair
Poor
Are there any agreed actions to be taken. If so, raise a Hazard / Incident Report
*
Yes
No
Submit
Should be Empty: