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[null,null,null,null,null,"様式第９号"]
[]
["是正（改善）報告書"]
[]
[null,null,null,null,null,"令和　　　年　　　月　　　日"]
[]
["　　　　　　労働基準監督署長　殿"]
[]
[null,null,null,"事業場の名称"]
[]
[]
[null,null,null,"事業の所在地"]
[]
[null,null,null,"代表者職氏名"]
[]
[]
["　令和　　　年　　　月　　　日、　　　　　　　　監督官から是正勧告書及び使用停止等命令書により是正を指示された事項並びに指導票による改善指導事項については、下記のとおり是正（改善）したので報告します。\n　なお、法条項欄に□印を付された事項については、点検整備体制の確立を指摘された機械設備等を、本報告書裏面に記載しました。"]
[]
["法条文又は\n指導事項番号","是正（改善）\n年月日",null,"是正（改善）状況"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["点検整備体制改善状況報告"]
[]
[]
["　是正勧告書等において□で囲まれた法条項については、下記のとおり点検整備体制を整え、今後同種違反を繰り返さないよう措置しました。"]
[]
[]
["点検整備体制の確立を指摘された機械設備等",null,"点検実施者\n職氏名",null,"点検時期\n（頻度）","点検の対象箇所","補修確認者\n職氏名"]
[]
[]
[]
[]
[]
[]
[]
["是正（改善）したことを証明する写真、領収書・免許証等の写し等の添付箇所"]
[]
[]
[]
[]
["※　貼り付ける写真等の大きさによっては、別紙を添付することとしても差し支えない。"]