Information
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Audit Title
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Conducted on
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Employee Name
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Department:
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Ship or Location:
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Violation Type:
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Specific Action:
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Supervisor Name:
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Witness:
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Witness Signature
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Corrective Action Taken/Req:
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Penalty:
- Verbal
- Written
- Suspension/Termination
- Other
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Penalty- Other:
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Employee Signature
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Select date
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Supervisor Signature
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Select date
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Safety Manager Signature
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Select date
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Comments:
