You are on page 1of 1

HSE MONTHLY REPORT

A. HSE REPORT
SL. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Description No. of Employees Monthly Man-hours worked Reported Incidents Reported Near Miss Reported First Aid Injuries No of Occupational Illnesses No of Fire Incidents No of Vehicle Accidents Reported Property Damage No. of LTIs* LTI Frequency Rate (LTI FR) LTI Severity Rate (LTI SR) H.S.E Induction Training H.S.E In House Training HSE Tool Box Meeting H.S.E Meeting H.S.E Inspections Emergency Evacuation Drills Reported Environmental Incidents (Spill / Release / Discharge) Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 YTD Kg/ Month Kg/ Month No/Month Kg/ Month Kg/ Month Kg/ Month Kg/ Month No/Month Kg/ Month Kg/ Month Kg/ Month No/Month Kg/Month Unit Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 YTD Remarks

B. Non- Hazardous Waste


Type Jan-14 Cans (Aluminum/Tin) 0 Concrete Debris 0 Drums Empty & Clean (Metal & Synthetic) 0 Filters/Filter elements (All) 0 Glass (All types) 0 Grit Blasting Media-Collected for disposal 0 Kitchen Waste (Food, Packing, Paper, etc.) 5 Metal (Recyclable) 0 Other Scrap (Not included elsewhere e.g. 6 Wood, Metal, Synthetics, Rags, and Paper (Office waste) 2 Plastic Bottles 0.5 Toner Cartridges 0 Other Waste Materials 0 (e.g. Cable, A/C units, Rubber/Gasket Belts Electrical Components, Tires, Grinding Discs, etc.) C. Hazardous Waste Category Type Quantity IT & Telecoms 0 Lighting (Lighting, Flourescent Tubes, CRT 0 Tubes) Monitoring & Control devices 0 Category Industrial Solid Waste EEE with hazardous substances Electrical Tool Insulation Material Batteries (Sizes A, AA, AAA & C) / 6V & 12V Power/Distribution Transformers Catalyst (Spent) CFC's (Halon & Others) Laboratory Waste Medical Waste Class A Chemical Class B Chemical Class C Chemicals Class D Chemicals Air Filters Synthetic Oil (e.g. used lube oil) PCB's Other items containing Asbestos Mercury Lead Empty Contaminated Containers Other - (Please Specify)
Definitions: EEE - Electric & Electronic Equipments Chemicals Classification: Class A Chemicals from generic industrial processes: solvents, thinners Class B Chemicals from specific industrial processes: water treatment chemicals Class C Acute or toxic chemicals, that are no longer in use but still in stores Class D- Less toxic chemicals, that are no longer in use but still in stores

Unit

Quantity

Unit

Quantity

Unit

Quantity No/Month No/Month No/Month No/Month No/Month No/Month No/Month No/Month No/Month Kg/Month Kg/Month Kg/Month Kg/Month Kg/Month Kg/Month Kg/Month Liter/Month Kg/Month Kg/Month Kg/Month Kg/Month No/Month

Unit

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Waste Oil Chemical & Waste Greas

Completed by:

Date:

1 of 1