JRC Mechanical Field Discipline Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Field Discipline Report

• Crew Member:

• Date of behavior issue or policy violation

  Date

• Summery

• Response

• 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

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

• Does crew member accept disciplinary action?

  YES

  NO

• Crew Member Signature

  Sign

• DOFO Signature

  Sign

• Report Sent To Susan Hedges HR Department

  Yes

  No

  N/A