AWT Safety Violation Notice

• Job No.

• Audit Title

• Client / Site / Project Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Project Supervision:

Field Discipline Report

• Is this an AWT Employee?

  Yes

  No

  N/A

• Employee Name:

• Date of behavior issue or policy violation

  Date

• Violation Description:

• Photo of Violation

  Media

• Summary:

• Level Of Discipline

  Select Verbal Warning Written Warning Second Written Warning Suspension Immediate Termination Safety Violation Immediate Termination

  • Verbal Warning
  • Written Warning
  • Second Written Warning
  • Suspension
  • Immediate Termination
  • Safety Violation Immediate Termination

• Does employee accept disciplinary action?

  YES

  NO

• Employee has been made to understand that any failure to immediately correct behavior and or policy violation will result in possible immediate termination.

  Yes

  No

  N/A

• Employee Signature

  Sign

• Foreman or Superintendent Signature:

  Sign

• Report Sent To Regional Safety Director?

  Yes

  No

  N/A

Sub-Contractor Field Discipline Report

• Is this a Sub-Contractor Employee?

  Yes

  No

  N/A

• Sub-Contractor Name:

• Employee Name:

• Date & Time of Violation

  Date

• Violation Description:

• Photo of Violation

  Media

• Summary:

• Level of Discipline

  Select Verbal Warning Written Warning Second Written Warning Suspension Immediate Termination Safety Violation Immediate Termination

  • Verbal Warning
  • Written Warning
  • Second Written Warning
  • Suspension
  • Immediate Termination
  • Safety Violation Immediate Termination

• Does employee accept disciplinary action?

  Yes

  No

  N/A

• Employee has been made to understand that any failure to immediately correct behavior and or policy violation will result in possible immediate termination.

  Yes

  No

  N/A

• Employee Signature:

  Sign

• Foreman or Superintendent Signature:

  Sign

• Report Sent To Regional Safety Director?

  Yes

  No

  N/A