Professional Documents
Culture Documents
SR.NO
N OF PERSONS PRESENT IN SAFETY CONTACT TALK SR.NO. NAME AGENCY DESIGNATION CARD NO.
Sr. No. 01 02 03 04 05 06 07 08 09
Description of Check CONTRACTOR : WORK PERMIT NO. JOB LOCATION : TYPE: GENERAL/HEIGHT/ HOT/VESSEL ENTRY COMPLETED PERMIT RETURNED VALIDITY OK/NOT OK PERMIT VALIDITY NOT EXCEEDED PPE TICKED ACTUALLY BEING USED SUPERVISION 100% FOR HIGH HAZARD/ADEQUATE NOT ADEQUATE.
Action Taken
Remarks
2)
AUDITORS NAME :
DATE : Sr. No. 01 02 03 04 05 06 07 08 09 10 11 Description of Check CONTRACTOR : WORK PERMIT NO. JOB LOCATION : TYPE: GENERAL/HEIGHT/ HOT/VESSEL ENTRY COMPLETED PERMIT RETURNED VALIDITY OK/NOT OK PERMIT VALIDITY NOT EXCEEDED PPE TICKED ACTUALLY BEING USED SUPERVISION 100% FOR HIGH HAZARD/ADEQUATE NOT ADEQUATE. SAFETY OFFICER OF CONTRACTOR PRESENT AT SITE SUPERVISION OR OF CONTRACTOR PRESENT AT SITE Action Taken Remarks
SR. NO.
CONTRACTOR NAME
ID CARD NO
DESIGNATION
OBSERVATION
DATE OF AUDIT : NOTE : SR. NO. NAME OF THE CONTRACTOR LADDER NO. LADDER HEIGHT TYPE OF LADDER OBSERVATIONS
SIGNATURE
Project Garden
OBSERVATIONS : 1 2 3 4 5 6 7 8 9 10 Vehicle No. At Desalted Place Display Board Driver's Name Driver Available at site Driving License Key Kept at Security Officer During Tea/Lunch Break Engine Auto Start Seat Belt Provided First Aid Box with Medicine VALID / INVALID YES / NO YES / NO YES / NO YES / NO YES / NO YES / NO
ELECTRICIAN
ELECTRICAL ENGINEER
SR.NO
PARTICULARS
AGENCY
DESCRIPTION OF AUDIT
REMARKS
AUDITED BY
SR. NO.
ID CARD NUMBER
PPE REQUIRED FOR THE JOB - HELMET - SAFETY SHOES - FULL BODY HARNESS - GOOGLES & GLOVES FOR WELDERS - OTHER SPECIFY
REMARKS
- HELMET - SAFETY SHOES - FULL BODY HARNESS - GOOGLES & GLOVES FOR WELDERS - OTHER SPECIFY
- HELMET - SAFETY SHOES - FULL BODY HARNESS - GOOGLES & GLOVES FOR WELDERS - OTHER SPECIFY
1 2 3 4 5 6 7 8 9 10 11 12 13 14
CONTRACTOR PERMIT NO DATE TIME STARTS TIME END JOB LOCATION MENTIONED JOB DESCRIPTION MENTIONED PPE USED FOR THE JOB HAZARD IDENTIFICATION COLUMN PROPERLY FILLED PRECAUTION CHECKLIST SIGNATURE OF ISSUER SIGNATURE OF ENGG OFFICER SIGNATURE OF SAFETY OFFICER SIGNATURE OG. H.O.D
YES YES YES YES YES YES YES YES YES OK YES YES YES
NO NO NO NO NO NO NO NO NO NOT OK NO NO NO
1 2 3 4 5 6 7 8 9 10 11 12 13 14
CONTRACTOR PERMIT NO DATE TIME STARTS TIME END JOB LOCATION MENTIONED JOB DESCRIPTION MENTIONED PPE USED FOR THE JOB HAZARD IDENTIFICATION COLUMN PROPERLY FILLED PRECAUTION CHECKLIST SIGNATURE OF ISSUER SIGNATURE OF ENGG OFFICER SIGNATURE OF SAFETY OFFICER SIGNATURE OG. H.O.D
YES YES YES YES YES YES YES YES YES OK YES YES YES
NO NO NO NO NO NO NO NO NO NOT OK NO NO NO
TOPIC DISCUSSED :
NAME
ID
NAME
ID
SIGNATURE : SUPERVISOR/ENGINEER
DATE :
SR.NO. 1 2 3 4 5 6 7 8
DESCRIPTION OF CHECK
ACTION TAKEN
REMARK
ID WITH PHOTO AVAILABLE WITH PERSON DESIGNATION ID VALIDITY : SAFETY OFFICER PRESENCE : ALL LIFTING TOOLS TACKLES ELEC. ITEMS PERMTTED BY SAFETY OFFICER YES/NO LABOUR ENTRY LOG AT SECURITY : YES / NO OTHERS
SR.NO
NAME
I.D. CARDS
JOB
REMARKS
SR.NO 1 2 3 4 5 6 7 8 9 10
CONTRACTOR COTTON
ITEMS TO CHECK
OBSERVATIONS
BANDAGES EYE WASH GLASS BERNOL SOFRAMYEIN IODEX DETOL BAND -AID A PAIR OF SCISSIORS SILVIDYNE