Form 20

{See sub-rule (3) of Rule 68}

COMPLIANCE/IMPROVEMENT NOTICE

Inspector-cum-Facilitators notice to the employer/ of the establishment for compliance/ improvement

To,

The occupier/ employer,

……………………………

……………………………

Name and address of Location of work place where Registration number of Activities involved

the establishment such work is being caried on the establishment

1 2 3 4

Since the undersigned made an inspection in your establishment …………………………. located

at ……………….. on date …………………… and in the course of inspection, the undersigned found some

contraventions and is of the opinion that the following contraventions, which were found in your

establishment needs improvement as per the provisions of the Code, rules and regulations made thereunder

and other laws in force-

An inspection of the above-named establishment was made on ............., the following contraventions were

observed.

1. ……………………………………………..

2. ……………………………………………..

3. ……………………………………………..

4. ……………………………………………..

You are hereby required to remedy the said contraventions and send the compliance report in writing within

seven/fifteen days from the date of receiving this notice.

This notice is being issued without prejudice to any legal action which may be taken for these

contraventions. On hearing from you that the requirements have been complied with, the establishment may

be again visited as deemed necessary, with a view to verify the compliances done for contravention or

irregularities.

Order No. ……………………….

Dated at ……………. this …………… day of 20…..

Inspector Cum

Facilitator

under the

Occupational Safety, Health

and

Working Conditions

Code, 2020