1. INFORME N°______________
DAÑOS A LA PROPIEDAD
Nombre del Operador: __________________________________________________ Fecha evento: _____/_____/____
Lugar del Evento: _______________________________ Cod. Unidad: ___________ Guardia: _______ Turno________
Supervisor a cargo: ______________________________________________________________________________
Daños al equipo: ____________________________________________________________________________________
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Descripción del Evento: ______________________________________________________________________________
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Firma del Operador
Nº D.N.I.: Fecha presentación: ____/____/_____
Informe de Mantenimiento: __________________________________________________________________________
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Firma Jefe de Taller
Nombres: Fecha presentación: ____/____/_____
2. Informe de Seguridad: _______________________________________________________________________________
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Firma de Ingeniero de Seguridad
Nombres: Fecha presentación: ____/____/_____
Conclusiones Residencia: _____________________________________________________________________________
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Sello y VºBº Ingeniero Residente
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VºBº Operador
Fecha presentación: ____/____/_____
Seguimiento y Conformidad Administración: _____________________________________________________________
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Firma del Administrador
Nombres: Fecha archivo: ____/____/_____
