DUTY OF CARE CARD (DOC Card)

DUTY OF CARE CARD(DOC)

This card shall be used by AGC employees, Unsafe act: Unsafe condition: Safe act: Suggestion:
contractors or visitors to report the following:
SiteVessel:
Date/time:*
Unsafe act: Project number:
An act that could lead to an injury to
Responsible dept:*
personnel, equipment or the environment. (your department)

DOC coordinator:
(your direct supervisor)
Unsafe condition:
Observers name: (optional)
A physical situation or condition of equipment
Location of observation:
that could lead to an injury to personnel, (e.g. drill deck, gun deck, car park, open field, construction site, etc.)

equipment or the environment. Observation:*

Safe act:
An act beyond normal expectations that
displays exceptional awareness or
commitment.

Suggestion: Task stopped by: co-worker supervisor other

Immediate action taken:
A suggestion for improvement to a condition
or a process that has the potential to improve
health and safety of personnel, environment or
equipment.

Safety Suggested further action:

Starts with
Me IMPACT Nr:
* Required Field Issue number: 3 Date: 20June 2018

Initiated By Asif Khan (Ops manager), Reviewed By: Mr. Haythem (COO) & Mr. Marzio (BDM)