reconstituire fisa ssm su



SC ……………………………. SRL

              ..............................................  

Nr. ............... / .................

                                                                                                                                            Vizat

                                                                                                                ADMINISTRATOR,

Vizat                                                                                                                    

DIRECTOR 

PC LUCRU,

.............................................                                                                 

   

                                                                                                                         Vizat, 

                                                                                                  SIPP-SU,.......................

                                                          

                                                                 PROCES VERBAL

RECONSTITUIRE FISA INDIVIDUALA DE INSTRUIRE SSM/SU

        Subsemnatul ................................................., salariat al ............................................ in functia de SEF dep ........................ , am constatat pierderea/deteriorarea a doua - Fise de instruire individuala privind Securitatea si Sanatatea in Munca si a doua- Fise de instruire in domeniul situatiilor de urgenta apartinand lucratorilor ............................... si ................................, fapt pentru care am procedat la reconstituirea fiselor de instruire individuala, astfel: 

  • pe coperta s-au inscris datele individuale ale lucratorilor: ...................................................... - cf. Rubricilor; 

  • pe pagina 2 s-a completat traseul  si timpul de deplasare de la domiciliu pana la serviciu si s-a semnat de catre fiecare dintre lucratori;

  • pe pagina 3  s-a inscris  “ RECONSTITUIRE FISA cf. Proces Verbal reconstituire fisa pierduta/deteriorata;

  • fisa de aptitudine dupa ultimul control medical periodic anual valabil, a lucratorilor .............................................................., va fi anexata in copie, la Fisa de instruire SSM; 

  • pe pagina 4 se va continua cu instructajul periodic urmand sa fie efectuat/consemnat  conform tematicii anuale- incepand luna .....................................; 

  • Fisa PSI va avea aceeasi cronologie a reconstituirii.                                                                                  

 

        Mentionez ca pierderea/degradarea totala a fiselor de instructaj a fost constatata in data de ................................. .

                                                                                                                     XXXX

Data ..............                                                                                      Semnatura........................                                                                             

 

                                                                                                   

 

NOTA:

Am luat la cunostinta de pierderea/degradarea fiselor individuale de instruire SSM/PSI-SU si confirm faptul ca am fost instruita/am participat/semnat instruirea SSM-PSI/SU, de la data angajarii si pana in luna ...................................................-inclusiv.

  1. ............................ (Lucrator salubritate cai publice)           - semnatura.............................../ DATA. .....................;

  2. .................................... (Lucrator salubritate cai publice) - semnatura..................................../ ................................;