Form 6 – Non-conformance Audit Report (complete as per instructions overleaf)

Use this document as a template for your fatigue risk management system.

This form can be replaced with one from your current system if it is equivalent in the key areas and meets the standards and outcomes.

The key areas in this model document are:

-Section 3

Instructions

To be completed by Operations Manager within 24 hours of detection of a non-conformance to report the non-conformance and to notify the non-compliant staff member.

  1. Complete all sections of the form in blue/black ink.
  2. When completing Section 3:
  • a Minor non-conformity is where there is:
  • a failure to conform to a requirement which (based on judgement and experience) is not likely to result in FRMS failure
  • a single observed lapse or isolated incident, or
  • a minimal risk of nonconforming product or service
  • a Major non-conformity is where there is:
  • a total breakdown of system, control, or procedure
  • an absence of an FRMS requirement
  • a number of minors related to the same clause, or
  • a nonconformity that experience and judgement indicate will likely result in FRMS failure or materially reduce its ability to assure controlled processes and products
  1. Attach any supporting information to the report (e.g., staple a copy of the non-compliant daily sheet to this form)
  2. When Section 4 is signed, copy the form and give it to the responsible staff member requesting that they provide a written response within 7 days by completing Section 5.
  3. Place copies of the completed form in [file location 7] and on the responsible staff member’s HR file.

Section 1 – Responsible staff member

Issued to ______

Section 2 – Audit details

An audit of your working hours for the period of: ______to ______

Was conducted on: ______By: ______

Section 3 – Non-conformance details

During this audit a non-conformance was detected, as indicated below:

Not complying with driving hoursMajorMinor

Not completing work diary correctlyMajorMinor

Not having a continuous 10 hour restMajorMinor

Not handing in duplicate pagesMajorMinor

The following observations were made:

______

______

______

______

______

______

______

Section 4 - Notification

You are instructed to adhere to all policies, procedures and regulations in regard to driving hours, completing your work diary, work and rest hours and record keeping.

______Date ______/ ______/ ______
Manager

Section 5 - Response

Following the receipt of this report, I have:

______

______

______

______Date ______/ ______/ ______
Staff member

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