SAFETY VIOLATION NOTICE

Project Name : Project # :

Date : Location:

Time : Notice # :
Details of Defaulter

Name : Emp ID & Designation:

Previous default if any [Yes / No] Default Notice No. :

Signature: Immediate Supervisor :

Brief description of default :

Recommended Action : (highlight if applicable )

4 Counsel / Warn the defaulter & deduct half a day salary

4 Cut a days salary of defaulter / staff concerned
4 Suspend / Terminate
4 Others

Action taken:

Job Title Name Signature Date

HSE Manager

Project Manager / Site Supervisor

HSE Officer
CC : OM, HRO / Personal File ABE-HSE-F-007, Rev.02