AL-FANARY EST.

Unsafe Act Form

Unsafe Acts require a written warning and re-training before the Employee resumes work

Worker Name: Mubarak Fathi Designation: Carpenter

Description of Unsafe Act:

On 18-09-2018 safety manager found a worker named Mubarak fathi throwing wood from top floor to downside
and he is not aware that downside is someone or not. Safety manager already stopped him a day before for this
activity. He violated again.

ACCIDENT/INCIDETN/NEARMISS DIAGRAM/PHOTOGRAPHS ATTACHED:__________YES ___________NO

FINAL REPORT PREPARED BY: Faisal Shodari DATE: 18-09-2018

SIGNED BY: DATE:

Worker

SIGNED BY: DATE:

Safety Manager