PENALTY NORMS
SECOND THIRD
SL NO NATURE OF VIOLATION FIRST VIOLATION Action Taken
VIOLATION VIOLATION
Without Verbally warning &
1 500 1000 1500Rs/Warning Letter
safetyHelmet/Shoes correction
Without dust mask in
Verbally warning &
3 inside the plant and dusty 100 200 300Rs/Warning Letter
correction
area
Gas cylinders safety:For
Verbally warning &
4 each violation (e.g cap, 500 1000 1500/Warning Letter
correction
regulator condition etc)
Without Ear plug/Ear Verbally warning &
5 100 200 300Rs/Warning Letter
Muff at high noise area correction
Not use of safety harness
Verbally warning &
6 and anchor while working 500 1000 1500Rs/Warning Letter
correction
at height ( Above 1.8mtr )
Working without hand Verbally warning &
7 200 300 400Rs/Warning Letter
gloves correction
Without goggles inside Verbally warning &
8 500 1000 1500Rs/Warning Letter
the unit/work area correction
Verbally warning &
9 Helmet without chin strip 500 1000 1500Rs/Warning Letter
correction
Verbally warning &
10 work permit violation 500 1000 1500/Warning letter
correction
Confined space entry/Exit Verbally warning &
11 500 1000 1500Rs/Warning Letter
Procedure Violation correction
Verbally warning &
14 Poor housekeeping 500 1000 1500/Warning Letter
correction
Verbally warning &
15 Without Barication 500 1000 1500/Warning Letter
correction
Violating road safety
rules(driving without seat
belt,overspeeding,withou
Verbally warning &
16 t insurance, without 500 1000 1500/Warning Letter
correction
brake,horns,light,Flag
man etc.).Penalty per
violation
Welding machines safety
for each violation(e.g
cable,joints,no lug, poor
conditions of lugs, Verbally warning &
17 500 1000 1500/Warning letter
without ELCB,holder correction
condition and proper
welding/Grinding booth
preparation etc).
Verbally warning &
19 Others 500 1000 1500Rs/Warning Letter
correction
F-SP-HSE-05 A Rev : 00 Issue Date : 19/04/2023
PENALTY LETTER
INCIDENT VIOLATER NAME
DESIGNATION
CONCORD ENVIRO ENGINEER (RESPONSIBLE)
INCIDENT VIOLATER COMPANY
REPORTED BY
INCIDENT DATE
INCIDENT CATEGORY
INCIDENT TIME
INCIDENT LOCATION
INCIDENT SUMMARY
PENALTY IMPOSED
YOU MIGHT NOT HAVE BEEN AWARE THAT YOU WERE BREAKING THE SAFETY LAWS OR BEST
PRACTICES, OR YOU MIGHT NOT HAVE DONE IT ON PURPOSE. IN ORDER TO PROTECT OUR SAFETY
AND TO PREVENT A SAFETY VIOLATION INSIDE THE PLANT PREMISES, WE ARE BRINGING THIS TO
YOUR ATTENTION.
WE ARE GLAD THAT YOU AGREE TO BE CONCERNED ABOUT YOURSELF AND YOU’RE COWORKERS.
ECONOMY OR CONVENIENCE OF EITHER MANAGEMENT OR OUR EMPLOYEES SHALL NOT TAKE
PRECEDENCE OVER SAFETY IN OUR OPERATION.
CONCORD ENVIRO MANAGEMENT IS IMPOSING A PENALTY OF __________ IN LIGHT OF THE
VIOLATION. UPON FURTHER VIOLATION, YOU MAY BE REMOVED FROM THE SITE IMMEDIATELY
WITHOUT ANY EXCUSES.
AREA HSE SIGNATURE
I HAVE READ AND UNDERSTAND THE ABOVE WARNING NOTICE, YOU AGREE THAT WILL NOT
COMMIT THIS VIOLATION AGAIN AND THAT I WILL TRY TO INCREASE THE SAFETY WITH WHICH I
WORK.
VIOLATOR SIGNATURE RCM SIGNATURE / SHIFT -INCHARGE
F-SP-HSE-05 C Rev.00 Issue Date: 19/04/2023
INCENTIVE & DISINCENTIVE ISSUE RECORD
Month : Project/Site : Dated: __/__/__ To __/__/__ Prepared By :
Remarks
[Link] Date Time [Link] Name Designation Immediate Supervisor Company/Contract Reported By Issue Record Category Area/Location Description Penalty Imposed
(incentive Given)
1
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Incentives Issued 0 Disincentives Issued 0 Penalty Issued 0 Total Penalty 0
F-SP-HSE-05 D Rev : 00 Issue Date : 19/04/2023
SUSPENSION/TERMINATION LETTER
INCIDENT VIOLATER NAME
DESIGNATION
CONCORD ENVIRO ENGINEER (RESPONSIBLE)
INCIDENT VIOLATER COMPANY
REPORTED BY
INCIDENT DATE
INCIDENT CATEGORY
INCIDENT TIME
INCIDENT LOCATION
INCIDENT SUMMARY
YOU MAY NOT HAVE REALISED THAT YOU WERE VIOLATING A SAFETY RULE OR A SAFE PRACTISE, OR
YOUR VIOLATION MAY NOT HAVE BEEN INTENTIONAL. WE ARE BRINGING THIS TO YOUR ATTENTION
FOR BOTH OUR OWN SAFETY AND YOURS.
ECONOMY OR CONVENIENCE OF EITHER MANAGEMENT OR OUR EMPLOYEE'S SHALL NOT TAKE
PRECEDENCE OVER SAFETY IN OUR OPERATION, AND WE HOPE THAT YOU SHARE THIS CONCERN
FOR YOURSELF AND YOU’RE COWORKERS.
SUSPENSION
CONSIDERING THE SEVERITY OF THE VIOLATION OR THE REPETITIVE VIOLATION CONCORD ENVIRO
MANAGEMENT POLICY INCURS TO SUSPEND THE CANDIDATE FOR A PERIOD OF _____ DAYS.
TERMINATION
CONSIDERING THE SEVERE VIOLATION AND MULTIPLE INSTANCES UPON OBSERVATION BY OUR
SAFETY PROFESSIONALS CONCORD ENVIRO MANAGEMENT POLICY INCURS TO TERMINATE THE
CANDIDATE FOR THE TENURE OF THE PROJECT.
AREA HSE SIGNATURE
I HAVE READ AND UNDERSTAND THE ABOVE WARNING NOTICE, YOU AGREE THAT WILL NOT
COMMIT THIS VIOLATION AGAIN AND THAT I WILL TRY TO INCREASE THE SAFETY WITH WHICH I
WORK.
VIOLATOR SIGNATURE PROJECT HEAD / SHIFT -INCHARGE
F-SP-HSE-05 E Rev.00 Issue Date: 19/04/2023
WARNING LETTER
INCIDENT VIOLATER NAME
DESIGNATION
CONCORD ENVIRO ENGINEER (RESPONSIBLE)
INCIDENT VIOLATER COMPANY
REPORTED BY
INCIDENT DATE
INCIDENT CATEGORY
INCIDENT TIME
INCIDENT LOCATION
INCIDENT SUMMARY
YOU MAY NOT HAVE REALISED THAT YOU WERE VIOLATING A SAFETY RULE OR A SAFE PRACTISE, OR
YOUR VIOLATION MAY NOT HAVE BEEN INTENTIONAL. WE ARE BRINGING THIS TO YOUR ATTENTION
FOR BOTH OUR OWN SAFETY AND YOURS.
ECONOMY OR CONVENIENCE OF EITHER MANAGEMENT OR OUR EMPLOYEE'S SHALL NOT TAKE
PRECEDENCE OVER SAFETY IN OUR OPERATION, AND WE HOPE THAT YOU SHARE THIS CONCERN
FOR YOURSELF AND YOU’RE COWORKERS.
IF YOU VIOLATE THE TERMS OF SERVICE ONCE MORE IN THE FUTURE, CONCORD ENVIRO
MANAGEMENT WILL TAKE DISCIPLINARY ACTION AGAINST YOU, AND YOU RISK BEING IMMEDIATELY
AND WITHOUT CAUSE REMOVED FROM THE SITE.
AREA HSE SIGNATURE
I HAVE READ AND UNDERSTAND THE ABOVE WARNING NOTICE, YOU AGREE THAT WILL NOT
COMMIT THIS VIOLATION AGAIN AND THAT I WILL TRY TO INCREASE THE SAFETY WITH WHICH I
WORK.
VIOLATOR SIGNATURE PROJECT HEAD / SHIFT -INCHARGE
F-SP-HSE-05 B Rev.00 Issue Date: 19/04/2023
