PENALTY FORM PENALTY FORM

THIS PENALTY WILL BE EXECUTE TO WORKERS ARE NON COMPLY WITH SAFETY THIS PENALTY WILL BE EXECUTE TO WORKERS ARE NON COMPLY WITH SAFETY
& HEALTH AT SITE. & HEALTH AT SITE.

OFFENSE: OFFENSE:

1. NOT WEARING HELMET/CHEEK STRAP 1. NOT WEARING HELMET/CHEEK STRAP

2. NOT WEARING REFLECTOR VEST 2. NOT WEARING REFLECTOR VEST
3. NOT WEARING SAFETY SHOES 3. NOT WEARING SAFETY SHOES
4. NOT WEAR PROPER DRESS CODE 4. NOT WEAR PROPER DRESS CODE
5. NOT WEARING SAFETY HARNESS FOR W.A.H. 5. NOT WEARING SAFETY HARNESS FOR W.A.H.
6. ABSENT TOOLBOX MEETING 6. ABSENT TOOLBOX MEETING
7. SMOKING 7. SMOKING
8. URINATE 8. URINATE
9. HOUSEKEEPING 9. HOUSEKEEPING
10. LITTERING 10. LITTERING
11. UNSAFE ACT/CONDITION 11. UNSAFE ACT/CONDITION
12. SLEEPING AT SITE 12. SLEEPING AT SITE

OTHERS :....................................... FINE RM :................. OTHERS :....................................... FINE RM :.................

*all amount of non compliance will be charge by safety supervisor/officer *all amount of non compliance will be charge by safety supervisor/officer
*refer the attachment *refer the attachment

OFFENDER:........................ OFFICER:........................ OFFENDER:........................ OFFICER:........................

NAME : NAME :
PASSPORT NO: DATE:............................. PASSPORT NO: DATE:.............................