Safety Advise Ticket

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SAT No :

Date : *

Time : *

Location :

Employee Name & ID :

Job Title :

Violation Details :

Employee Acknowledgement** Photo

Photo :

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**Employee/Worker Acknowledgement**

Employee Signature :

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Date :

**Manager/Supervisor/Witness Acknowledgement**

Name *

Signature :

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Date :

Witness Name & Signature (if any) :

Clear Signature

Date :

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