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IUotification ®f unsafe Act or Condition <br />Subcontractor: <br />Employee Name: <br />lobsite <br />lobsite Address: <br />You are in VIOLATION of the following regulations or policies: <br />❑ Hard Hats <br />❑ Personal Clothing <br />❑ Housekeeping <br />❑ Fall Protection <br />❑ Horseplay <br />❑ Ladders <br />❑ Hand Tools <br />❑ Railings/Barricades <br />❑ Ramps, Walkways, Stairs <br />❑ Other: <br />Date: <br />❑ Safety Glasses <br />❑ Work Boots <br />❑ Electrical — Extension Cords <br />❑ Electrical - Other <br />❑ Welding/Cutting <br />❑ Scaffolding <br />❑ Power Tools <br />❑ Cranes / Hoists <br />a Trenching / Excavation <br />Superior Landscaping and Lawn Service Management Signature: <br />Copy to Subcontractor Office and Job File <br />