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Dole/Bwc/Ohsd/Ip-5: ST ST ST

This document is a report on the health and safety organization of an unnamed establishment. It provides information on the establishment's policy and program on safety and health, the composition of its safety and health committee including names and positions, and a brief description of its process operations and equipment. The report also includes data on the number of employees broken down by gender and work shift.

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Jamil Dilig
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81 views1 page

Dole/Bwc/Ohsd/Ip-5: ST ST ST

This document is a report on the health and safety organization of an unnamed establishment. It provides information on the establishment's policy and program on safety and health, the composition of its safety and health committee including names and positions, and a brief description of its process operations and equipment. The report also includes data on the number of employees broken down by gender and work shift.

Uploaded by

Jamil Dilig
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DOLE/BWC/OHSD/IP-5

Republic of the Philippines


Department of Labor and Employment
BUREAU OF WORKING CONDITIONS
Manila

REPORT ON HEALTH AND SAFETY ORGANIZATION

Date______________
Regional Labor Office No. ____
File Number _______________

Name of Establishment: _____________________________________________________________________


Address: _________________________________________________________________________________
Nature of Business: ________________________________________________________________________
Number of Persons Employed (Including Management) _______________________

1st Shift: Male: _______________ Female: _______________


2st Shift: Male: _______________ Female: _______________
3st Shift: Male: _______________ Female: _______________
TOTAL: Male: _______________ Female: _______________

A. POLICY AND PROGRAM ON SAFETY AND HEALTH:

B. COMPOSITION OF SAFETY AND HEALTH COMMITTEE: TYPE: ________________


CENTRAL SAFETY COMMITTEE

NAME POSITION IN ESTABLISHMENT

Chairman: ______________________________ _________________________

Members: ______________________________ _________________________

______________________________ _________________________

______________________________ _________________________

Secretary: ______________________________ _________________________

B. TECHNICAL INFORMATION:

A. Brief description of process operation and number and kind of equipment.

Submitted by:

______________________________
General Manager

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