Projects and Engineering Form SHE.PPD.

001
Author CK
Personal Profile Dossier 25.08.22
To be completed for each employee
Page 1

Dossier Number PPD-CD11

Project Number and Name HEINEKEN TAIWAN – KAG - PIPING

Company Name Cao Duong Company

Employee Details
Surname TRINH XUAN
First Names HOANG
ID / Passport / Work Permit No C6145854
Mobile No +84 961115547
Work email Address
Date engaged by present employer 2016
Job Title Fitter
Brief description of role and key responsibilities whilst on the project :

- Responsible for Piping work activities.

Employee’s Next of Kin

Name DANG THI MAI
Relationship Sister
Contact No (+84) 973562394

EMPLOYEE DECLARATION

 I hereby declare that the information provided is true and correct.

 I agree to commit myself to the ultimate goal of “Zero Harm” by personally ensuring that :
 I will endeavour not to suffer, or be the cause of, any injury or incident.
 I will tackle every task safely and see to it that my colleagues work safely at all times.
 I will attend Toolbox Talks and/or safety meetings, as required.
 I will wear appropriate personal protective equipment where required.
 I will report any unsafe behaviour or condition I might observe.

TRINH XUAN HOANG

Name: ________________________________ Signature: ___________________________

FITTER
Job Title: ______________________________ Date: _______25/08/2023 ____

 Page 1 of 2
 Projects and Engineering Form SHE.PPD.001
Author CK
Personal Profile Dossier 25.08.22
To be completed for each employee
Page 2

Company (Employer) Details

Company Name CAO DUONG
Key Contact Safety Person + No NGUYEN TRONG LAM (+84) 395305273
On-site Supervisor + Contact No TO HUU KHOI (+84) 913918619

Proof
Qualification and Competence Yes No NA Attached
Does the employee have the required competence and/or qualifications for the

role?
Is the employee required to drive / operate any mobile equipment or vehicle(s)

and proof of certification / licence verified?
Is the employee required to perform any work in confined spaces and proof of

training and competence verified?
Is the employee required to work at heights and proof of training and

competence verified?
Is the employee required to work with power/energy tools or equipment and

proof of training and competence verified?
Is the employee required to work with hazardous chemicals/biological agents

and proof of training and competence verified?
Other Hazardous Exposures: 

Medically Qualified for designated tasks, Medical Fitness Certificate attached

Certification / Licence # License Code Description Expiry Date
FERROUS AND NON -
CD-CER-PF1-264/ENG PIPE FITTER I N/A
FERROUS PIPE ASSEMBLY
SPECIALIZED PIPING SISTEMS CD-CER-PF2-264/ENG PIPE FITTER II N/A

EMPLOYER DECLARATION

For, and on behalf of, the abovementioned company, I hereby declare that:
Fitter – Trinh Xuan Hoang
 The aforementioned employee’s position is stated as ________________________________________
 The employee is competent to perform his/her assigned duties in a safe and responsible manner.
 The employee will be provided with the correct equipment, knowledge and training to perform their duties in a
safe and responsible manner.
 The Company will take all reasonable steps and precautions to ensure the health and wellbeing of the
employee.
 The information provided above is true and correct.

Name: ________________________________
CAO NGOC DUY Signature: ___________________________

CHAIRMAN
Designation: ___________________________ Date: 25/08/2023_________________

Page 2 of 2