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Sample STARRT Card <br /> Back <br /> Safety Task Assignment Wiisk Reduction Talk <br /> TASK DESCRIPTION ist Ste HAZARDS PLANS TO ELIMMATE <br /> Are you trained I competent to perform the above tasks? LjYes No <br /> Lowining Opporturdfim Identified During Shiest l ° &Thiriic <br /> Near Mss❑ I Hazard ❑ I Safety Tip ❑ Location_ <br /> Describe Learning Opportunity <br /> Corrective Actions Taken <br /> Follow ue actions Em uired? Yes No <br /> Post Job Questions.Complete at the end of your shift <br /> he weed space eiMm red dbbo ed dP YES[:1 NO❑ WA❑ Hastte aiav t darned up? YES ❑ NO ❑ NIA ❑ <br /> i1MftandhwWtadspn /shed? YES[:] NO❑ WA❑ Amtl..Yhizadsiernaitig?YES® NO ❑ WA ❑ <br /> seed en: YES❑ NOD WAD Wevetheaa inclinW ?YEs No❑ Nor ❑ <br /> Ensure you have reAamed this STARRT card before signing. <br /> Crew STARRT Card Quality Audit{Circle} Audit Rating <br /> Fotiaw up actionsrequired?Yes I ND <br /> is srAwr card caientaid vaid far task?YES I NO wak Sbpped: ❑ <br /> Ate a®hazads ;cnniab it plane?YIS IND Impmuamants needed I 1 - ❑ <br /> Has Rrenansgnedcad?YESINO EXa3-Lw: ❑ <br /> Comm Supei 6-Soaiae: <br /> Tore cfAudit <br /> •15w j"SeM wopaeat3WMffena Yes ❑ ❑ S8MYDepartnwtIS I9%ieW <br /> Fasnan must sign palm ia first calfs tweak. Faremn(Flit) Fenn(ygieire) <br />