Template

Safety Violation Write-up Template

by Stan Gray, from the Community

30+

This Safety Violation Write-up template helps supervisors document workplace safety incidents consistently. Record employee details, date and time, type of warning, unsafe acts, PPE or housekeeping issues, and failure to follow procedures. Attach a photo of the violation, add notes, and capture agreement or disagreement statements from the employee. Include required signatures to formalize the report and guide corrective actions. Suitable for industrial and field environments seeking a clear, repeatable process for safety compliance.

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About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

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Safety Violation Write-up Template

With SafetyCulture you can

Digitize team workflows

Reduce manual errors

Create and share inspection reports

About author

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Disciplinary Write-up Template

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