NEBOSH International General Certificate

in Occupational Health and Safety

UNIT IGC3: HEALTH AN SA!ET" #$ACTICAL
A##LICATION
Student Name:
Student Number:
Date of Submission:
IGC3 % The Health and Safety #ractical Application
Candidate and cour&e pro'ider declaration&:
!or co(pletion )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 N!"S# $alpractice policy.
Name %&rint' (((((((((((((((((((((((((((((((((
Signature (((((((((((((((((((((((((((((((((
Date (((((((((((((((((((((((((((((((((
!or co(pletion )y a cour&e pro'ider repre&entati'e *e+,+ internal practical a&&e&&or-:
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 N!"S#
$alpractice policy.
Name %&rint' (((((((((((((((((((((((((((((((((
Signature (((((((((((((((((((((((((((((((((
Date (((((((((((((((((((((((((((((((((
!or co(pletion )y the cour&e pro'ider.& internal practical a&&e&&or:
I declare that I have marked this work and am both )ualified and approved by N!"S# 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 N!"S# $alpractice policy.
Name %&rint' (((((((((((((((((((((((((((((((((
Signature (((((((((((((((((((((((((((((((((
Date (((((((((((((((((((((((((((((((((
NB: Thi& declaration (u&t )e co(pleted in full &u)(itted and retained /ith the
candidate.& &cript+ If thi& declaration i& not &u)(itted the candidate.& re&ult (ay )e
declared 'oid+
INTE$NATIONAL GENE$AL
CE$TI!ICATE A&&e&&or.& (ar0in, &heet
*1233 &pecification-
IGC3 % THE HEALTH AN
SA!ET" #$ACTICAL A##LICATION
Date of practical application Name of assessor
*ourse provider
number
*ourse provider
name
Student number Student name
*riteria
4a5i(u(
(ar0&
a'aila)le
A&&e&&or.&
(ar0& a/arded
NEBOSH
(oderated
(ar0&
%if different'
3 Co(pletion of o)&er'ation &heet&
+.+ ,ange and outline of ha-ards and conse)uences 36
+..
Identification of suitable control measures and
timescales
36
1 $eport 7 Introduction and E5ecuti'e Su((ary
..+
Introduction providing an overview of the chosen
area
6
... /ecutive summary 6
3 $eport 7 4ain findin,& of the in&pection
0.+ 1uality of interpretation of findings 36
0..
Identification of possible breaches of international
standards
6
0.0 &ersuasiveness 2 conciseness 2 technical content 32
8 $eport 7 Conclu&ion& and $eco((endation&
3.+
*lear and concise conclusions which are clearly
related to report findings and are effective in
convincing management to take action
36
3..
,ecommendations which present realistic actions to
improve health and safety in the chosen area
36
TOTAL 4A$9S
322
Outcome: PASS (60% or more) REFER (less than 60%)
Date assessed (((( 2 (((( 2 ((((
4ssessor5s signature ((((((((((((((((((((((
Date received by course provider (((( 2 (((( 2 ((((
Date received by N!"S#
(if applicable) ((((( 2 ((((( 2 (((((
A&&e&&or.& additional co((ent& on the practical application:
ASSESSE B" *na(e in )loc0 letter&- (((((((((((((((((((((((((((((((((((((((((((((((((
The (ar0 &heet (u&t )e retained )y the Cour&e #ro'ider and &ent to NEBOSH only if re:ue&ted+
NEBOSH USE ONL"
NEBOSH 4oderator.& co((ent&:
INTE$NATIONAL GENE$AL
CE$TI!ICATE Candidate.& o)&er'ation
*1233 &pecification- &heet
IGC3 % THE HEALTH AN
SA!ET" #$ACTICAL A##LICATION
Sheet nu()er of ;;;;;
Student na(e ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; Student nu()er ;;;;;;;;;;;;;;;;;;
#lace in&pected ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ate of in&pection ;;; < ;;;;; < ;;;;;
O)&er'ation& Control (ea&ure& Ti(e&cale
#a-ards and conse)uences Immediate and longer term actions
INTE$NATIONAL GENE$AL
CE$TI!ICATE
*1233 &pecification- Candidate report te(plate
UNIT IGC3 % THE HEALTH AN
SA!ET" #$ACTICAL A##LICAITON
Student nu()er;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Location;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ate of re'ie/ < <
Introduction includin, o'er'ie/ of area in&pected and acti'itie& ta0in, place
INTE$NATIONAL GENE$AL
CE$TI!ICATE
*1233 &pecification- Candidate report te(plate
UNIT IGC3 % THE HEALTH AN
SA!ET" #$ACTICAL A##LICAITON
Student nu()er;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Location;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ate of re'ie/ < <
E5ecuti'e Su((ary
/ecutive Summary 6pon completion of the inspection, the inspector found there
were several areas of concern which lead to breaches to the following #ealth and
Safety legislations: $anagement of #ealth and Safety at 7ork ,egulations +888,
,egulatory ,eform %9ire Safety' "rder .::;, *ontrol of Substances #a-ardous to
#ealth ,egulations .::. %*"S##', lectricity at 7ork ,egulations +8<8, &rovision
and 6se of 7ork )uipment ,egulations +88< =he health and safety of the
employees, clients, subcontractors and visitor working on the 9acility may be at risk
if these concerns will not be looked into or treated with high importance. 9ailure to...
INTE$NATIONAL GENE$AL
CE$TI!ICATE
*1233 &pecification- Candidate report te(plate
UNIT IGC3 % THE HEALTH AN
SA!ET" #$ACTICAL A##LICAITON
Student nu()er;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Location;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ate of re'ie/ < <
4ain findin,& of the in&pection
INTE$NATIONAL GENE$AL
CE$TI!ICATE
*1233 &pecification- Candidate report te(plate
UNIT IGC3 % THE HEALTH AN
SA!ET" #$ACTICAL A##LICAITON
Student nu()er;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Location;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ate of re'ie/ < <
Conclu&ion&
INTE$NATIONAL GENE$AL
CE$TI!ICATE
*1233 &pecification- Candidate report te(plate
UNIT IGC3 % THE HEALTH AN
SA!ET" #$ACTICAL A##LICAITON
Student nu()er;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Location;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ate of re'ie/ < <
$eco((endation&:
$eco((endation Li0ely re&ource i(plication& #riority Tar,et date