AL-FANARY EST.

Unsafe Act Form

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

Worker Name: Abdullah Designation: Labor

Description of Unsafe Act:

On 02-10-2018 round about @15:30 he was found involved in fighting where 2 workers fight and he hit the other
worker with hand shovel, which does not make any injury to him. As he already received a orientation in which
he was informed about the safe behavior at the site. Safety manager already warn them about their behavior’s
many times.

Action Taken:
A warning letter has been issued to him for his offensive behavior.
Removed from the site permanently.

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

FINAL REPORT PREPARED BY: DATE:

SIGNED BY: DATE:

Worker

SIGNED BY: DATE:

Safety Manager