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HODGE CONSTRUCTION, LLC EMPLOYEE REPRIMAND / NOTIFICATION SHEET

EMPLOYEE NAME:
NOTIFICATION

DATE: 9/28/2012
NON - SERIOUS OFFENSE
X

REPRIMAND

SERIOUS OFFENSE

OFFENSES:
LATE TO WORK DESTRUCTION OF HCI PROPERTY
X

VIOLATION OF SAFETY GUIDELINES

CALLED OFF WORK

INSUBORDINATION

IMPROPER WORK ATTITUDE

DIDN'T SHOW UP FOR WORK

IMPROPER DRESS / BOOTS

OTHER

DESCRIPTION OF OFFENSE:

CONSOL MAJORSVILLE-LACK OF PROPER FACE SHIELD/ GLASSES WHILE USING PAINT THINNER TO CLEAN PAINT GUN RESULTING IN AMBULANCE-EMERGENCY ROOM VISIT. CONSOL RYERSON-IMPROPER USE OF NAIL GUN CAUSING IT TO DISCHARGE INTO LEG, RESULTING IN EMERGENCY ROOM VISIT

MAJORSVILLE-AS DISCUSSED, ANY CHANCE WHERE SPLASH HAZARD WE SHOULD BE WEARING FACE SHIELD. ON RYERSON, BE AWARE OF ANY LOOSE ITEMS THAT MAY SNAG TRIGGER AND OR DEPRESS SAFETY. BE COMING DOWN LADDER CORRECTLY, AND KEEP HAND OFF OF TRIGGER UNTIL READY TO USE. LOSS OF PROFIT-BONUS FOR ONE MONTH

ACTION TO BE TAKEN:

EMPLOYEE COMMENTS:

BY SIGNING THIS FORM I UNDERSTAND THAT THIS OFFENSE AND ALL OTHER OFFENSES WILL BECOME A PART OF MY PERMANENT RECORD OF EMPLOYMENT AT HC. I ALSO ACKNOWLEDGE THE NATURE OF THE REPRIMAND AND ACTIONS THAT ARE TO BE TAKEN AS LISTED ABOVE.
EMPLOYEE SIGNATURE: SUPERVISOR SIGNATURE: DATE:

R. Allen Hodge

DATE: 10/15/2012

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KOVACH, MICHAEL REPRIMAND CONSOL 20121015 OPEN

10/15/2012

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