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Fisa Instruire Individuala Privind SSM

Fisa Instruire Individuala Privind SSM

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Published by Victor Sarateanu
Fisa instruire protectia muncii
Fisa instruire protectia muncii

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Published by: Victor Sarateanu on Apr 09, 2013
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05/11/2015

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Anexa nr.

11
la normele metodologice
ÎNTREPRINDEREA/UNITATEA__________________________
FIŞĂ DE INSTRUIRE INDIVIDUALĂ
privind securitatea şi sănătatea în muncă
NUMELE ŞI PRENUMELE ________________________________________
LEGITIMAŢIA, MARA __________________________________________
GRUPA !ANGUIN" ______________________________________________
D#MIILIUL ____________________________________________________
Data $i loc%l na$terii _______________________________________________
ali&icarea ________________________ '%nc(ia _______________________
Loc%l de m%nc) __________________________________________________
A%tori*a(ii +I!IR, $,a,- ____________________________________________
Tra.e%l de de/la.are la/de la .er0ici% __________________________________
________________________________________________________________
Instruirea la angajare
1- Instruirea introductiv generală, a &o.t e&ect%at) la data _________________
tim/ de _________ ore, de c)tre _______________________________________
a02nd &%nc(ia de ____________________________________________________
on(in%t%l in.tr%irii __________________________________________________
_________________________________________________________________
!emn)t%ra cel%i
in.tr%it
!emn)t%ra cel%i care a
e&ect%at in.tr%irea
!emn)t%ra cel%i care a
0eri&icat 3n.%$irea c%no$tin(elor
4- Instruirea la locul de muncă, a &o.t e&ect%at) la data ________________
loc de m%nc)//o.t de l%cr% _______________________ tim/ de ________ ore,
de c)tre _______________________ a02nd &%nc(ia de ____________________
on(in%t%l in.tr%irii ____________________________________________
________________________________________________________________
!emn)t%ra cel%i
in.tr%it
!emn)t%ra cel%i care a
e&ect%at in.tr%irea
!emn)t%ra cel%i care a
0eri&icat 3n.%$irea c%no$tin(elor
3) Admis la lucru
N%mele $i /ren%mele ___________________________________
'%nc(ia +$e& .ec(ie, atelier, $antier etc,- _________________________________
Data $i .emn)t%ra _________________________________________________
Instruirea periodică
Data
in.tr%irii
D
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r
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t
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+
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c
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Material%l /redat
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Instruire periodică suplimentară
Data
e&ect%)r
ii
D
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r
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t
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+
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/
a
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Material%l /redat
!emn)t%ra cel%i
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Rezultatele testărilor
Data Material%l e6aminat ali&icati0 E6aminator
Accidente de muncă sau îmbolnăviri proesionale suerite
Data /rod%cerii
e0eniment%l%i
Diagno.tic%l medical
Nr, $i data P7
de cercetare a
e0eniment%l%i
Nr,
*ile
ITM
!anc"iuni aplicate
pentru nerespectarea reglementărilor de securitate #i sănătate în muncă
A8aterea .)02r$it)
!anc(i%nea
admini.trati0)
Nr, $i data
deci*iei
$%&'R%( )*+I$A( ,*RI%+I$
#8.er0a(ii de ./ecialitate
!emn)t%ra $i Data
/ara&a medic%l%i 0i*ei
de medicina m%ncii ,,,,
#8.er0a(ii de ./ecialitate
!emn)t%ra $i Data
/ara&a medic%l%i 0i*ei
de medicina m%ncii
#8.er0a(ii de ./ecialitate
!emn)t%ra $i Data
/ara&a medic%l%i 0i*ei
de medicina m%ncii
#8.er0a(ii de ./ecialitate
!emn)t%ra $i Data
/ara&a medic%l%i 0i*ei
de medicina m%ncii
#8.er0a(ii de ./ecialitate
!emn)t%ra $i Data
/ara&a medic%l%i 0i*ei
de medicina m%ncii ,,
#8.er0a(ii de ./ecialitate
!emn)t%ra $i Data
/ara&a medic%l%i 0i*ei
de medicina m%ncii
'*!'AR*A ,!I-%(%.I$/ ,*RI%+I$/
A/t /.i5ologic /entr%9
:
!emn)t%ra Data
/.i5olog%l%i
A/t /.i5ologic /entr%9
:
!emn)t%ra Data
/.i5olog%l%i
A/t /.i5ologic /entr%9
:
!emn)t%ra Data
/.i5olog%l%i
A/t /.i5ologic /entr%9
:
!emn)t%ra Data
/.i5olog%l%i
A/t /.i5ologic /entr%9
:
!emn)t%ra Data
/.i5olog%l%i
A/t /.i5ologic /entr%9
:
!emn)t%ra Data
/.i5olog%l%i
0
l%cr% la 3n)l(ime, l%cr% 3n condi(ii de i*olare, cond%c)tori a%to, etc,

Durata (h) Ocupaţia instruit Semnătura celui care a instruit instruireacare a verificat Data instruirii Instruirea periodică Materialul predat .

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