Title Page
-
Project
-
Date and Time
-
Nome do responsável pelo registo:
-
Employee:
-
Worker N.º
-
Name of responsible on the area:
REASON FOR REGISTRATION
-
REASON FOR REGISTRATION
- Disrespect of health and safety order by the hierarchical superior.
- No use of PPE required for the the task being performed.
- Inappropriate use of PPE.
- Damage / change of a Collective protection equipment without authorization.
- Apparently under the influence of alcohol.
- Playing in the Workplace.
- Adoption of unsafe positions.
- Another
-
What:
Description:
-
Description:
ADOPTED MEASURE:
-
ADOPTED MEASURE:
-
What?
-
Witnesses:
SIGNATURES _ ASSINATURAS
-
FILLING RESPONSIBLE
-
EMPLOYEE
-
RESPONSIBLE ON THE AREA
-
Safety representative