MM/YYYY

Emami Infrastructure
SAFETY INSPECTION REPORT
Limited

From: Inspector to Head Safety

HIGHLIGHTS:
1.
2.
3.
4.
5.

STOCK OF PPEs:

S PPE Stock held S No PPE Stock held

No
1 Safety Helmets 2 Safety Boots size 9
3 Safety Boots size 8 4 Safety Boots size 7
5 Safety Belts 6 Reflective Jackets

PENALTIES:
A penalty of Rs. Has been imposed vide voucher no.. dated

Name of Contractor: - Date:-

S No Photograph Observation Inferenc Action NCR Action

e required / taken
Penal by
ties

Signed by:
(Inspector)
Name:
Date & Time:

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