Information
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Job No.
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Audit Title
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Client / Site / Project Name
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Conducted on
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Prepared by
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Location
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Project Supervision:
Field Discipline Report
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Is this a JMCC Employee?
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Employee Name:
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Date and Time of policy violation
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Violation Description:
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Summary:
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Level Of Discipline
- Verbal Warning
- Written Warning
- Second Written Warning
- Suspension
- Immediate Termination
- Safety Violation Immediate Termination
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Does employee accept disciplinary action?
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Employee has been made to understand that any failure to immediately correct behavior and or policy violation will result in possible immediate termination.
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Will employee require training / re-training? (If yes describe training and list expected completion date)<br>
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Employee Signature
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Foreman or Superintendent Signature:
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SSHO (Site Safety & Health Officer) Signature
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Report sent to RIsk Management, copied to Corporate Safety Director and Employee File?
Sub-Contractor Field Discipline Report
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Is this a Sub-Contractor Employee?
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Sub-Contractor Name:
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Employee Name:
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Date & Time of Violation
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Violation Description:
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Summary:
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Level of Discipline
- Verbal Warning
- Written Warning
- Second Written Warning
- Suspension
- Immediate Termination
- Safety Violation Immediate Termination
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Does employee accept disciplinary action?
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Employee has been made to understand that any failure to immediately correct behavior and or policy violation will result in possible immediate termination.
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Will Employee require training / re-training to prevent future disciplinary actions? (If yes, please describe and list expected date of completion)
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Employee Signature:
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Foreman or Superintendent Signature:
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SSHO (Site Safety & Health Officer) Signature:
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Report Sent to Employer, Risk Management, Corporate Safety Director and Company Job File?
