Quality Companies, USA
HSSE Activity Report
Quality Companies Representative
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Please Select
Domenic Floyd
Ken McCann
Jeremy Roper
E-mail
Date of Activity
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Month
-
Day
Year
Date Picker Icon
Activity
*
Please Select
Safety Meeting / Crew Change
Pre Job Meeting
Incident
On-Site Visit
Quality Business Unit
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Please Select
QCP
QPM
Traco
Combined
Customer
Location
*
Employee Name:
First Name
Last Name
Last 4 of SSN:
Discussion / Notes
*
Official Event Report to be Submitted?
Yes
No
Event ID#
Were deficiencies identified?
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Yes
No
Identify deficiencies found
Were corrective actions taken?
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Yes
No
Identify the corrective actions taken
Comment on Observations
Action Taken / Needed
Is follow up required?
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Yes
No
Identify requested follow up
Follow Up Authorization Code
Follow Up
Is follow up complete?
Yes
No
Follow Up Completion Date
-
Month
-
Day
Year
Date Picker Icon
Completed By
First Name
Last Name
Follow Up Notes
Follow Up END
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