Sheet No. 1 of 37
IGC3 – The Health and Safety Practical Application Candidate and course provider declarations: For completion y the candidate: I declare that the work submitted for this practical application assessment ie. the completed observation sheets and the report to management, is my own work. I recognise that contravention of this statement constitutes malpractice and may result in my being subject to the penalties set out in the NEBO! "alpractice policy.
Name #$rint%
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ignature
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'ate
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For completion y a course provider representative representative !e"#" internal practical assessor$: I declare that the work marked is identical to that received from the candidate. I recognise that contravention of this statement constitutes malpractice and may result in my being subject to the penalties set out in the NEBO! "alpractice policy.
Name #$rint% &&&&&&&&&&&&&&&&&&&&&&&& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&&& ig ignatu nature re
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'ate
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For completion y the t he course provider%s internal practical assessor: I declare that I have marked this work and am both (ualifi ed and approved by NEBO! to do so. I recognise that contravention of this statement constitutes malpractice and may result in my being subject to the penalties set out in the NEBO! "alpractice policy. policy.
Name #$rint% &&&&&&&&&&&&&&&&&&&&&&&& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&&& ig ignatu nature re
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'ate
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&': This declaration must e completed in full( sumitted and retained )ith the candidate%s script" If this declaration is not sumitted the candidate%s result may e declared void"
APP*&+I, Prepared By:
Dated //
Sheet No. 2 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard Haard 0is4: *+
•
Conse5uences Conse5uences .ocation:
Haard Haard 0is4: *-
•
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APP*&+I, Prepared By:
Dated //
Sheet No. 2 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard Haard 0is4: *+
•
Conse5uences Conse5uences .ocation:
Haard Haard 0is4: *-
•
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Haard Haard 0is4: *
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Conse5uences Conse5uences .ocation:
APP*&+I, Prepared By:
Dated //
Sheet No. 3 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard Haard 0is4: */
•
Conse5uences Conse5uences .ocation:
Haard Haard 0is4: *0
•
Conse5uences Conse5uences .ocation:
Haard Haard 0is4: *1
•
Conse5uences Conse5uences .ocation:
APP*&+I, Prepared By:
Dated //
Sheet No. 4 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard 0is4: *2
•
Conse5uences .ocation:
Haard 0is4: *3
•
Conse5uences .ocation:
Haard 0is4: *4
•
Conse5uences .ocation:
APP*&+I, Prepared By:
Dated //
Sheet No. 5 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard 0is4: +*
•
Conse5uences .ocation:
Haard 0is4: ++
•
Conse5uences .ocation:
Haard 0is4: +-
•
Conse5uences .ocation:
APP*&+I, Prepared By:
Dated //
Sheet No. 6 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard 0is4: +
•
Conse5uences .ocation:
Haard 0is4: +/
•
Conse5uences .ocation:
Haard 0is4: +0
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Conse5uences .ocation:
APP*&+I, Prepared By:
Dated //
Sheet No. 7 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard 0is4: +1
•
Conse5uences .ocation:
Haard 0is4: +2
•
Conse5uences .ocation:
Haard 0is4: +3
•
Conse5uences .ocation:
APP*&+I, Prepared By:
Dated //
Sheet No. 8 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard 0is4: +4
•
Conse5uences .ocation:
Haard 0is4: -*
•
Conse5uences .ocation:
Haard 0is4: -+
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Conse5uences .ocation:
APP*&+I, Prepared By:
Dated //
Sheet No. 9 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard --
0is4:
•
Conse5uences
Haard -
0is4:
•
Conse5uences
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•
Conse5uences
APP*&+I, Prepared By:
Dated //
Sheet No. 10 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -0
0is4:
•
Conse5uences
Haard -1
0is4:
•
Conse5uences
Haard -2
0is4:
•
Conse5uences
APP*&+I, Prepared By:
Dated //
Sheet No. 11 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
•
Conse5uences
Haard -4
0is4:
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APP*&+I, Prepared By:
Dated //
Sheet No. 12 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
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Conse5uences
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APP*&+I, Prepared By:
Dated //
Sheet No. 13 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
•
Conse5uences
Haard -4
0is4:
•
Conse5uences
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APP*&+I, Prepared By:
Dated //
Sheet No. 14 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
•
Conse5uences
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0is4:
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APP*&+I, Prepared By:
Dated //
Sheet No. 15 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
•
Conse5uences
Haard -4
0is4:
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APP*&+I, Prepared By:
Dated //
Sheet No. 16 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
•
Conse5uences
Haard -4
0is4:
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APP*&+I, Prepared By:
Dated //
Sheet No. 17 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
•
Conse5uences
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APP*&+I, Prepared By:
Dated //
Sheet No. 18 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
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APP*&+I, Prepared By:
Dated //
Sheet No. 19 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
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APP*&+I, Prepared By:
Dated //
Sheet No. 20 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
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APP*&+I, Prepared By:
Dated //
Sheet No. 21 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
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APP*&+I, Prepared By:
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Sheet No. 22 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
0is4:
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Dated //
Sheet No. 23 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
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APP*&+I, Prepared By:
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Sheet No. 24 of 37
GC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICATI1&
Candidate%s oservation sheet
Student name :
Student no:
Place inspected: +ate of inspection 2
S" &
2 Control measures Immediate and longer term actions
1servations #!a)ards and conse(uences%
Timescale
Haard -3
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Sheet No. 25 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
+ate of revie): 2 2
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Sheet No. 26 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
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Sheet No. 27 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: 7767;6< .ocation: =uail Commercial port !Construction Site$ +ate of revie):7;2732678>
*?ecutive Summary:
Prepared By:
Dated //
Sheet No. 28 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
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Sheet No. 29 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
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Sheet No. 30 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
Prepared By:
+ate of revie): 2 2
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Sheet No. 31 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
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Sheet No. 32 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
Prepared By:
+ate of revie): 2 2
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Sheet No. 33 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
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Sheet No. 34 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
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Sheet No. 35 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: .ocation:
Prepared By:
+ate of revie):
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Sheet No. 36 of 37
I&T*0&ATI1&A. G*&*0A. C*0TIFICAT* Candidate report template !6788 specification$ 9&IT IGC3 – TH* H*A.TH A&+ SAF*T/ P0ACTICA. APP.ICAIT1& Student numer: 7767;6< .ocation: =uail Commercial port !Construction Site$ +ate of revie):7;2732678>
0ecommendation
.i4ely resource implications
Priority
*lectrical Safety" •
•
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Prepared By:
Dated //
Tar#et date