SAFETY DISCIPLINARY WARNING NOTICE

  • Employee's Name:

  • Select date

  • Department:

  • Job Classification:

  • Contract Labor Name: (Jag, Smith, Regal etc.)

  • REASON FOR NOTICE:

  • Add media

  • PPE

  • Welding

  • LOTO

  • Forklift

  • Crane

  • Proper use of Tools

  • Failure to report Accident/ Incident.

  • ACTION TAKEN ON THIS NOTICE:

  • Step 1, Written Warning

  • Step II, Final Written Warning

  • Step III, Termination

  • Decision:

  • ISSUE:

  • SUPERVISOR'S COMMENTS:

  • EMPLOYEE'S COMMENTS:

  • EMPLOYEE'S SIGNATURE

  • Select date

  • SUPERVISOR'S SIGNATURE

  • Select date

NOTE: If, in the opinion of the Company, an infraction is serious enough, any and all steps may be bypassed and discharge may occur at any time. A copy of this notice will be offered to the employee and a copy placed in the employee's personnel file.

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