Title Page

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Kesalahan Keselamatan dan Kesihatan Tapak Bina

Kesalahan yang dilakukan.

Sila sertakan gambar.

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Individu atau Kumpulan.

Sila sertakan gambar.

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Nama Penyelia yang bertanggungjawap.

Adakah kesalahan berulang?

Jumlah denda yang dikenakan.

Tandatangan penerimaan

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