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    Screening of Worker

    Uploaded by

    Brijgopal Yadav
    The document screens workers for a contractor by collecting personal information, having them and the contractor declare safety compliance, and provides for logging safety violations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Screening of Worker

    Uploaded by

    Brijgopal Yadav
    9 views1 page
    The document screens workers for a contractor by collecting personal information, having them and the contractor declare safety compliance, and provides for logging safety violations.

    Original Title

    Screening of worker (1)

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    The document screens workers for a contractor by collecting personal information, having them and the contractor declare safety compliance, and provides for logging safety violations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    9 views1 page

    Screening of Worker

    Uploaded by

    Brijgopal Yadav
    The document screens workers for a contractor by collecting personal information, having them and the contractor declare safety compliance, and provides for logging safety violations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    SPACE INTERRIOZ

    Screening Of Worker
    Worker ID No:- Date:-

    Name of the Contractor :

    Full Name of the workmen: PHOTO


    Mobile Number:

    Father Name:

    Address:

    Date of birth Age Sex

    Marital status:- Married / Single

    Mother Tongue Other Languages Known

    In case of emergency person to be contacted Contact Number

    Declaration by the Worker


    The above information given by me is correct to be best of my knowledge

    Signature / Left Hand Thumb impression of the Worker :-

    Declaration by the Subcontractor / Contractor


    We declare that this employee will be working for us in this side He / She shall follow the entire site safety requirement We take responsibility for his/her safety in
    the site

    Signature of the Contractor:-

    Name & Signuture

    Comments by the Company Representative


    Screened by me & Certificates / Details verified / Not verified

    Name & Signuture

    Suitable for employment as


    Non Compliance Record

    1. First HSE violation discription :-

    Date
    HSE Officer (Remarks/Name &Signature)

    2. Second HSE violation discription :-

    Date
    HSE Officer (Remarks/Name &Signature)

    3. Third HSE violation discription :-


    Date
    Due to no positive behavioural change, this ID card has been revoked & the worker has
    HSE Officer (Remarks/Name &Signature) been asked to reattend the induction briefing.

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