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Wednesday, 01 September 2010 05:30

Download Application for Safety Award

Download forms for state: Puducherry
Form Details
StatePuducherry
DepartmentLabour and employment
TitleApplication for Safety Award
LanguageEnglish
Document Size177.8 KB
Text of the PDF document(for quick reference)
GOVERNMENT OF PONDICHERRY Labour and Employment Department OFFICE OF THE CHIEF INSPECTOR OF FACTORIES AND BOILERS APPLICATION FOR SAFETY AWARD - (Contest Year) The application in this proforma giving the particulars specified below should be filled and accompanied by a separate crossed postal order endorsed to the Member-Secretary Safety Awards Committee for the value of Rs.500/- (Rupees Five Hundred Only) should be sent direct to the Member-Secretary Safety Awards Committee, Office of the Chief Inspector of Factories and Boilers, Vazhudavur Road, Gandhi Nagar, Pondicherry -605 009, on or before the 30th April of the current year. 1. Name and address of the Factory : 2. Name and address of the Occupier : 3. Name and address of the Manager : 4. Registration Number of the Factory : 5. Group (A,B or C) according to nature of work as mentioned in the enclosed Annexure : 6. Nature of Industry : Previous Year Contest Year 7. Average Number of Workers Employed during the year (including contract workers) : 8. Total Number of Working days during the year : 9. Total Man-Hours worked during the year (This should be the total man-hours including overtime actually worked inside the factory during the calendar year by the workers as defined in the Factories Act, 1948) : 10. Number of Fatal Accidents during the Year : 11. Number of non-fatal accidents reportable under Factories Act, 1948 causing disability or loss of time for 48 hours or more during the year : 12. Total Number of man-days lost due due to non-fatal accident 13. Number of dangerous occurrences as defined under the Pondicherry Factories Rules, 1964 (Give a brief description of each occurrence particularly covering cause, damage, loss and impact outside the factory) : FROM TO 14. Particulars of longest accident free period during the year (contest year) (a) Period (Furnish dates) : (b) Number of days in the period of (a) above : (c) Number of working days in the period (a) above : (d) Longest accident free period in man-hours including over time : 15. Safety promotional activities conducted during the year (Contest year) (Furnish Details) : 16. Particulars of the Postal Order Enclosed: Number Date Amount Station: Signature of the Station: Signature of the Manager Inspector of Date: Date: Factories
Last Updated on Friday, 17 December 2010 05:30
 

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