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Date: ___________

To,

Subject: Warning Letter for not wearing PPE

Dear Mr. _______________________

You were seen not wearing personal protection equipment provided by Company during factory
premises. Following are the details:

Sr. No. Particulars Remarks

1 Date

2 Time

3 Location/Place

4 Activity/Work Carrying Out

5 Nos. of Time Violation

Witness 1 ______________________________
6
Witness 2 ______________________________

You are warned to use the PPE’s regularly failing which, you are liable to be removed from the site
and a disciplinary action will be initiated. I agree being non wearing of PPE’s a sum of Rs. 500/- will
be deducted from my salary which I am agree to pay as part of penalty.

Safety Officer Signature Production Manager Signature Employee Signature

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