NEBOSH International General Certificate

in Occupational Health and Safety

UNIT GC3: HEALTH AND SAFETY PRACTICAL

APPLICATION

Student Name:

Student Number:

Date of Submission:
APPENDIX 1
GC3 – The Health and Safety Practical Application

Candidate and course provider declarations:

For completion by 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 NEBOSH Malpractice policy.

Name (Print) _________________________________

Signature _________________________________

Date _________________________________

For completion by a course provider representative (e.g. 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 NEBOSH
Malpractice policy.

Name (Print) _________________________________

Signature _________________________________

Date _________________________________

For completion by the course provider’s internal practical assessor:

I declare that I have marked this work and am both qualified and approved by NEBOSH 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 NEBOSH Malpractice policy.

Name (Print) _________________________________

Signature _________________________________

Date _________________________________

NB: This declaration must be completed in full submitted and retained with the
candidate’s script. If this declaration is not submitted the candidate’s result may be
declared void.
APPENDIX 2
Assessor’s marking sheet

GC3 – THE HEALTH AND

SAFETY PRACTICAL APPLICATION

Date of practical application Name of assessor

Course provider Course provider

number name

Student number Student name

NEBOSH
Maximum
Assessor’s moderated
marks
Criteria available
marks awarded marks
(if different)

1 Completion of observation sheets

1.1 Range and outline of hazards and consequences 15

Identification of suitable control measures and

1.2 timescales
15

2 Report - Introduction and Executive Summary

Introduction providing an overview of the chosen

2.1 area
5

2.2 Executive summary 5

3 Report - Main findings of the inspection

3.1 Quality of interpretation of findings 15

Identification of possible breaches of international

3.2 standards
5

3.3 Persuasiveness / conciseness / technical content 10

4 Report - Conclusions and Recommendations

Clear and concise conclusions which are clearly

4.1 related to report findings and are effective in 15
convincing management to take action

Recommendations which present realistic actions to

4.2 improve health and safety in the chosen area
15

TOTAL MARKS 100

 Outcome: PASS (60% or more) REFER (less than 60%)

Date assessed ____ / ____ / ____

Assessor’s signature ______________________

Date received by course provider ____ / ____ / ____

Date received by NEBOSH

(if applicable) _____ / _____ / _____

Assessor’s additional comments on the practical application:

ASSESSED BY (name in block letters) _________________________________________________

The mark sheet must be retained by the Course Provider and sent to NEBOSH only if requested.

NEBOSH USE ONLY

NEBOSH Moderator’s comments:

APPENDIX 3

GC3 – THE HEALTH AND Candidate’s observation

SAFETY PRACTICAL APPLICATION sheet

Sheet number of _____

Student name ______________________________________ Student number __________________

Place inspected _____________________________________ Date of inspection ___ / _____ / _____

Observations Control measures Timescale

Hazards and consequences Immediate and longer term actions

(1) Location : Open area near access (1) Stop the vehicle reversing 4 hours
point ( entry point ) no. 1 movements and provide banks men
to direct the vehicles safely at site
Hazard (Mechanical) : Reverse
movement of vehicles transporting (2) Install mandatory hazard beacons 4 hours
building materials to the site without and reversing horns for vehicles
hazard beacon, reversing horns entering the construction site up to
and Banks man the building entrance area

Consequence : (3) Provide a separate walkway for the 3 days

There is a risk of workers pedestrians separated by barriers
(pedestrians) being struck by
reversing vehicles causing serious (4) Provide signboards for vehicle 5 days
injury and even death where there movement area, unloading area for
is no reversing horns to alert designated area
pedestrian.
(5) Provide adequate lights for vehicle 5 days
Vehicle reversing without banks movement area during the night
man guidance can lead to collision work
with other vehicles, properties and
workers/visitors can cause property (6) Prepare Logistic plan which showing 1 week
damages, serious physical injury the vehicle movements, parking
and fatality. area, loading/unloading area for the
site.
APPENDIX 3

GC3 – THE HEALTH AND Candidate’s observation

SAFETY PRACTICAL APPLICATION sheet

Sheet number of _____

Student name ______________________________________ Student number __________________

Place inspected _____________________________________ Date of inspection ___ / _____ / _____

Observations Control measures Timescale

Hazards and consequences Immediate and longer term actions

(2) Location : Access point (entry point) (1) Stop work at areas directly above
no. 1 Zone A the access point on all the floors

Hazard (Workplace) : Workers and (2) Provide a shaded/Covered entrance

staffs were using a uncovered for the under construction buildings
access to enter the under which can withstand to the force of
construction buildings where the falling objects from upper floors
Block work, plastering works etc., in
progress (3) Install safety nets on above floors in
different levels to arrest the falling
Consequence : objects.
There is a risk of workers getting
injured from falling materials from (4) Implement personal protective
upper floors can cause serious equipment like hard hat to be worn
Physical injuries, fracture and by the workers while using the
fatality walkway

(5) Inspect the safety nets and Covered

walk way regularly
APPENDIX 3

GC3 – THE HEALTH AND Candidate’s observation

SAFETY PRACTICAL APPLICATION sheet

Sheet number of _____

Student name ______________________________________ Student number __________________

Place inspected _____________________________________ Date of inspection ___ / _____ / _____

Observations Control measures Timescale

Hazards and consequences Immediate and longer term actions
APPENDIX 4

UNIT GC3 – THE HEALTH AND Candidate report template

SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Introduction including overview of area inspected and activities taking place

Executive Summary

Main findings of the inspection

Conclusions

Recommendations – include as a table in the following format:

Recommendation Likely resource implications Priority Target date

UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Introduction including overview of area inspected and activities taking place

UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Executive Summary
UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Main Findings
UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Main Findings
UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Main Findings
UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Main Findings
UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Main Findings
UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Conclusion
UNIT GC3 – THE HEALTH AND Candidate report template
SAFETY PRACTICAL APPLICATION

Student number_________________________________

Location_______________________________________ Date of review / /

Structure report under the following headings:

Recommendations (should be written in tabular column only)