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HSE Violation Fine Summary

This document appears to be a health, safety, and environment violation fine form for a construction company. It lists fines for both staff and laborers for various safety violations like not wearing proper safety equipment. It then provides details on 6 workers who were fined for violations like not wearing steel-toed boots or helmets. The form includes spaces to describe the violations and note any actions taken against the violators. It is signed by the HSE and civil departments.

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Gatot Edi Susanto
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6K views1 page

HSE Violation Fine Summary

This document appears to be a health, safety, and environment violation fine form for a construction company. It lists fines for both staff and laborers for various safety violations like not wearing proper safety equipment. It then provides details on 6 workers who were fined for violations like not wearing steel-toed boots or helmets. The form includes spaces to describe the violations and note any actions taken against the violators. It is signed by the HSE and civil departments.

Uploaded by

Gatot Edi Susanto
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Health, Safety & Environment

HSE Violation Fine Form


Date:________
Fine for Staff: Safety shoes/Helmet/Uniform /FBH/Smoking 500 Rs/violation

Fine for Labour: 200/Violation

Name of violator: ________ ______

Fine Violater Signature

01: usman scaffolder 500 Mild Steel

02: javed Scaffolder 200 Mild Steel

03: imran Scaffolder 200 IKAN

04: Zafer Scaffolder 200 IKAN

05: Amanullah Driver 200 IKAN

06: Faisal Painter 200 Sohna Khan

07:

Detail of Violation:

______________________________________________________________________________
_____________________________________________________________________________

Action against Violator:

______________________________________________________________________________
__________________________

HSE Department: Civil Department:

Note: In case of any asset loss of IKAN than Person will be pay the total amount of those item.

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