Professional Documents
Culture Documents
INSPECTION REPORT
Item Model :
Month SL NO …………………TO……………….……….
(P) Inspected & Satisfactory (X) Required Re-filling/damage
Compone SL NO SL NO SL NO SL NO SL NO SL NO SL NO SL NO
nt
Condition/Fault to be checked
Pressure reading within green
Pressure
section
Gauge
displacement
Inspected by : Sign :
……TO……………….……….
g/damage
Remarks
TAKREER CARBO
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
TAKREER CARBON BLACK & DELAYED COKER PROJECT
FIRST AIDER REGISTER
2 SWS-BFA-270615-22 6/26/2016
4 SWS-BFA-270615-20 11/26/2016
4 SWS-BFA-270615-19 11/26/2016
4 SWS-BFA-270615-18 11/26/2016
4 SWS-BFA-270615-17 11/26/2016
STATUS REMARKS
On Site
On Site
On Site
On Site
On Site
On Site
On Site
On Site
CARBON BLACK AND DELAYED COKER PROJECT
GENERATOR SET DAILY CHECKLIST
Activity
Tongue)
1 2/9/2016 RRE PUMP 44411267
2 2/9/2016 RRE PUMP 2343123
3 2/9/2016 RRE PUMP 109867
4 2/9/2016 RRE PUMP 1567432
5 2/9/2016 RRE PUMP 1567878
6 2/9/2016 RRE PUMP 8976544
7 2/9/2016 RRE PUMP 5346724 0
8 2/9/2016 RRE PUMP 3223642
9 2/9/2016 RRE PUMP 7432739
10 2/9/2016 RRE PUMP 78379820
Inspected By: Additional Comments:
________________________________________
n Checklist
Contract No.: CBDC/SV/SP003
Month: August
Activity
Lifeline
Hook-Safety Latch
Remarks
Date Inspected
TYPE OF LIFTING
S / NO. COMPANY
EQUIPMENT
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
829
830
831
832
833
834
835
836
837
838
839
840
841
842
843
844
845
846
847
848
849
850
851
852
853
854
855
856
857
858
859
860
861
862
863
864
865
866
867
868
869
870
871
872
873
874
875
876
877
878
879
880
881
882
883
884
885
886
887
888
889
890
891
892
893
894
895
896
897
898
899
900
901
902
903
904
905
906
907
908
909
910
911
912
913
914
915
916
917
918
919
920
921
922
923
924
925
926
927
928
929
930
931
932
933
934
935
936
937
938
939
940
941
942
943
944
945
946
947
948
949
950
951
952
953
954
955
956
957
958
959
960
961
962
963
964
965
966
967
968
969
970
971
972
973
974
975
976
977
978
979
980
981
982
983
984
985
986
987
988
989
990
991
992
993
994
995
996
997
998
999
1000
1001
1002
1003
1004
1005
1006
1007
1008
1009
1010
1011
1012
1013
1014
1015
1016
1017
1018
1019
1020
1021
1022
1023
1024
1025
1026
1027
1028
1029
1030
1031
1032
1033
1034
1035
1036
1037
1038
1039
1040
1041
1042
1043
1044
1045
1046
1047
1048
1049
1050
1051
1052
1053
1054
1055
1056
1057
1058
1059
1060
1061
1062
1063
1064
1065
1066
1067
1068
1069
1070
1071
1072
1073
1074
1075
1076
1077
1078
1079
1080
1081
1082
1083
1084
1085
1086
1087
1088
1089
1090
1091
1092
1093
1094
1095
1096
1097
1098
1099
1100
1101
1102
1103
1104
1105
1106
1107
1108
1109
1110
1111
1112
1113
1114
1115
1116
1117
1118
1119
1120
1121
1122
1123
1124
1125
1126
1127
1128
1129
1130
1131
1132
1133
1134
1135
1136
1137
1138
1139
1140
1141
1142
1143
1144
1145
1146
1147
1148
1149
1150
1151
1152
1153
1154
1155
1156
1157
1158
1159
1160
1161
1162
1163
1164
1165
1166
1167
1168
1169
1170
1171
1172
1173
1174
1175
1176
1177
1178
1179
1180
1181
1182
1183
1184
1185
1186
1187
1188
1189
1190
1191
1192
1193
1194
1195
1196
1197
1198
1199
1200
1201
1202
1203
1204
1205
1206
1207
1208
1209
1210
1211
1212
1213
1214
1215
1216
1217
1218
1219
1220
1221
1222
1223
1224
1225
1226
1227
1228
1229
1230
1231
1232
1233
1234
1235
1236
1237
1238
1239
1240
1241
1242
1243
1244
1245
1246
1247
1248
1249
1250
1251
1252
1253
1254
1255
1256
1257
1258
1259
1260
1261
1262
1263
1264
1265
1266
1267
1268
1269
1270
1271
1272
1273
1274
1275
1276
1277
1278
1279
1280
1281
1282
1283
1284
1285
1286
1287
1288
1289
1290
1291
1292
1293
1294
1295
1296
1297
1298
1299
1300
1301
1302
1303
1304
1305
1306
1307
1308
1309
1310
1311
1312
1313
1314
1315
1316
1317
1318
1319
1320
1321
1322
1323
1324
1325
1326
1327
1328
1329
1330
1331
1332
1333
1334
1335
1336
1337
1338
1339
1340
1341
1342
1343
1344
1345
1346
1347
1348
1349
1350
1351
1352
1353
1354
1355
1356
1357
1358
1359
1360
1361
1362
1363
1364
1365
1366
1367
1368
1369
1370
1371
1372
1373
1374
1375
1376
1377
1378
1379
1380
1381
1382
1383
1384
1385
1386
1387
1388
1389
1390
1391
1392
1393
1394
Tahtan General Contracting
CARBON BLACK DELAYED COKE
HSE DEPARTMENT
LIFTING/RIGGING REGIST
GENERAL INFORMATION
Name: _____________________________________________________Age: ________________
Any Work Experience in Construction before: ( ) YES ( ) NO If YES, how many years? _______________
MEDICAL INFORMATION
BP: __________ 0
Weight in Kg: _________ Urination at night: ( ) YES ( ) NO
Loss Weight within a year: __________ Increased thirst: ( ) YES ( ) NO
Gain Weight within a year: __________ BMI: ______________
Height: __________
PERSONAL INFORMATION
Vision: _________________________________________________________________________________________
Fear of heights, or confined spaces: ( ) YES ( ) NO
Remarks: _______________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
_________________________________________________________________________________________________________
______________________________________________
Name of Physician or Nurse
ELECTRICAL/HANDTOOLS INSPECTION REGISTER
(TAHTAN)
■TAKREER RRE PACKAGE# 02 and 04
■INSPECTOR: Mr Regi (SIGN)
SUBCON
SL NO SECL NO. EQUIPMENTS NO. TYPE OF HANDTOOLS CAPACITY
NAME
1 WM-151 TAHTAN N/A Welding Machine 220V
2 OV-07 TAHTAN N/A ELECTRO HEAT RODE OVEN 220V,250 W
3 WM-08 TAHTAN N/A Welding Machine 220V
4 WM-14 TAHTAN N/A Welding Machine 220V
5 WM-151 TAHTAN N/A Welding Machine 220V
6 HEG-74 TAHTAN N/A HEAT GUN 230V,2000W
7 HEG-75 TAHTAN N/A HEAT GUN 230V,2000W
8 WM-12 TAHTAN N/A Welding Machine 220V
9 BOD-65 TAHTAN N/A BATTERY OPERATED DRILL.M
10 CSM-32 TAHTAN N/A CHOPPE SAW MACHINE
11 PF-03 TAHTAN N/A PEDESTAL FAN 3.6A,770 W RPM 2700
12 PF-04 TAHTAN N/A PEDESTAL FAN 3.6A,770 W RPM 2700
13 PF-05 TAHTAN N/A PEDESTAL FAN 3.6A,770 W RPM 2700
14 PF-06 TAHTAN N/A PEDESTAL FAN 3.6A,770 W RPM 2700
15 HDM-124 TAHTAN N/A HAMMER DRILL MACHINE 3.7A,850W
CTION REGISTER SEPT 2016
AN)
■INSPECTION DATE: 10/9/2016
■APPROVAL: (SIGN)
INSPECTED BY INSPECTED BY
MANUFACTURER REMARKS
SUBCON. SECL
MILLER TAHTAN OK
TECH WELD TAHTAN OK
MILLER TAHTAN OK
MILLER TAHTAN OK
MILLER TAHTAN OK
BLACK& DECKKER TAHTAN OK
BLACK& DECKKER TAHTAN OK
MILLER TAHTAN OK
DEWALT TAHTAN OK SS 015- SOUTH
DEWALT TAHTAN OK SS015-EAST
AL MANORD TAHTAN OK
AL MANORD TAHTAN OK
AL MANORD TAHTAN OK
AL MANORD TAHTAN OK
DEWALT TAHTAN OK
Refresh Training Request Card SECL Refresh Training Request Card SECL
1. Company : 1. Company :
2. Name / Job
Date Inspected 2. Name / Job Title :
3. Date : 3. Date :
4. Location : 4. Location :
5. Observations : 5. Observations :
0
6. Training (Every 18:00 PM ~ 19::00 PM) 6. Training (Every 18:00 PM ~ 19::00 PM)
Sat. Sun. Mon. Tue. Wed. Thur. Sat. Sun. Mon. Tue. Wed. Thur.
Safety PPE/ Working Lifting Defensive Safety PPE/ Working Lifting Defensive
Hot Work Hot Work
Leadership Basic Rule @ Height Safety Driving Leadership Basic Rule @ Height Safety Driving
7. Confirmed by 7. Confirmed by
Refresh Training Request Card SECL Refresh Training Request Card SECL
1. Company : 1. Company :
3. Date : 3. Date :
4. Location : 4. Location :
5. Observations : 5. Observations :
6. Training (Every 18:00 PM ~ 19::00 PM) 6. Training (Every 18:00 PM ~ 19::00 PM)
Sat. Sun. Mon. Tue. Wed. Thur. Sat. Sun. Mon. Tue. Wed. Thur.
Safety PPE/ Working Lifting Defensive Safety PPE/ Working Lifting Defensive
Hot Work Hot Work
Leadership Basic Rule @ Height Safety Driving Leadership Basic Rule @ Height Safety Driving
7. Confirmed by 7. Confirmed by
Done
DONE
Sr. Serial
ID No. Model Number Manufacturer
No Number
1 BL-01 94361 AD 3CX SiteMaster JCB, England
2 TC-01 351913 MC235B J10-2C Potain by Manitowoc
3 TC-02 351565 MC205B-2C Potain by Manitowoc
4 TC-03 352919 MC310 K12-2C Potain by Manitowoc
5 TC-04 353199 MC205B-2C Potain by Manitowoc
6 HC-19 6210098 SR-700L KATO, JAPAN
7 G-01 15561 / 15568 ZLP 630 ZLP
8 G-02 15542 / 28365 ZLP 630 ZLP
9 G-03 15573 / 15570 ZLP 630 ZLP
10 15569 / 15543 ZLP 630 ZLP
11
12 G-04
13
14
15 TL-01 1840 1999 Mercedes
16 2/91031 AD AFT 110G-5 TADANO
EQUIPMENT TPI Record
Certificate No DESCRIPTION CAPACITY SWL
COOLER COOLER
FILTER WATER
COOLER NO. CAPACITY EARTHING AREA
CONDITION FILLING DATE
(USG) CLEANING
Nationality Hot work Working at height Lifting & Rigging Defence Driving Heat Stress
Indian Done Done
Pak Done
Pak Done
Pak Done Done Done
Indian Done Done Done
Indian Done Done Done
Indian Done Done Done
Indian Done Done Done
Pak Done Done Done
Indian Done Done Done
Indian Done Done Done
Indian Done Done Done
Indian Done Done Done
Indian Done Done Done
Indian Done Done Done
Pak Done Done Done
Done Done
Pak
Done Done
Pak
Pak Done Done
Pak Done Done
Pak Done Done Done
Pak Done Done Done
Pak Done Done Done
Pak Done Done Done
Pak Done Done Done
Pak Done Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Pak Done Done
Confined Space Fire Watcher Flag Man
Done
Done
Done
Done
Done
Done
Done Done
Done Done
Done Done
Done
Done
Done
Done Done
Done
Done
Done
Done
Done Done
Done Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Tahtan
TAKREER CARB
SCAF
Scaffold Usage
Company Tag/Ref. No
(Type of Activities)
TAHTAN 26 PIPING
TAHTAN 24 PIPING
TAHTAN 30 PIPING
TAHTAN 17 PIPING
TAHTAN 40 PIPING
TAHTAN 14 PIPING
TAHTAN 13 PIPING
TAHTAN 22 PIPING
TAHTAN 1 PIPING
TAHTAN 34 PIPING
TAHTAN 50 PIPING
TAHTAN 51 PIPING
TAHTAN 52 PIPING
TAHTAN 19 PIPING
TAHTAN 15 PIPING
TAHTAN 14 PIPING
TAHTAN 53 PIPING
TAHTAN 44 PIPING
TAHTAN 45 PIPING
TAHTAN 18 PIPING
TAHTAN 34 PIPING
TAHTAN 43 PIPING
TAHTAN 54 PIPING
TAHTAN 55 PIPING
TAHTAN 56 PIPING
TAHTAN 57 PIPING
TAHTAN 58 PIPING
TAHTAN 59 PIPING
TAHTAN 60 PIPING
TAHTAN 61 PIPING
TAHTAN 62 PIPING
TAHTAN 42 PIPING
TAHTAN 41 PIPING
TAHTAN 40 PIPING
TAHTAN 39 PIPING
TAHTAN 38 PIPING
TAHTAN 34 PIPING
TAHTAN 33 PIPING
TAHTAN 32 PIPING
TAHTAN 31 PIPING
TAHTAN 30 PIPING
TAHTAN 29 PIPING
TAHTAN 28 PIPING
TAHTAN 27 PIPING
TAHTAN 37 PIPING
TAHTAN 36 PIPING
TAHTAN 35 PIPING
TAHTAN 1 PIPING
TAHTAN 2 PIPING
TAHTAN 3 PIPING
TAHTAN 26 PIPING
TAHTAN 24 PIPING
TAHTAN 23 PIPING
TAHTAN 22 PIPING
TAHTAN 20 PIPING
TAHTAN 11 PIPING
TAHTAN 7 PIPING
TAHTAN 30 PIPING
TAHTAN 5 PIPING
TAHTAN 25 PIPING
TAHTAN 27 PIPING
TAHTAN 23 PIPING
TAHTAN 29 PIPING
TAHTAN 50 PIPING
TAHTAN 51 PIPING
TAHTAN 52 PIPING
TAHTAN
Tahtan General Contracting LLC
TAKREER CARBON BLACK & DELAYED COKER PROJECT
SCAFFOLD REGISTRY
Scaffold Dimension
Scaffold Type Scaffold Duty (L x W x H)
Location / Area
SLUNG L 0 UTILITY
Tag
Status
Issuance Inspector
(Active/Dismantled/Date)
Date
Name
Mr Anoop
Mr Vidyanand
Nos. of HSE (06) Mr Imran
Mr Rashid
Mr Sahid
Mr Danish
Number of Construction Equipments
Capacity Operator Name
Crane 70 Ton Razzak
Crane 70 Ton Khurshid
Crane 50 Ton Jahagir
Crane 50 Ton Mujjafar
Boom Truck 10 Ton Afzal
Trailor 25 Ton Ali
Trailor 25 Ton Mukarab
Prepared By:
Name: P.Pandey
Designation: HSEM
Date: 8/17/2016
Signature
PAGE
fety and Environment 1
Weekly HSE Report REV
Date Inspected 0
CBDC PKG # 04 Month Ending : Sep 2016
Cumulative Man-
Overall Total Cumulative to Date 123,100
hours to Date
Lost Time Injuries (LTI) 0
LTI Days 0
Restricted Work Injuries (RWI) 0
RWI Days 0
Medical Treatment Injuries 0
First Aid Cases 0
Accident / Incidents 0
Property Damage 0
Near Miss 0
Safety Meeting 17
Tool Box Talk Conducted 1145
Safety Induction 196
Indirect 36
Number of Manpower on Site: Direct 160
Other 0
TOTAL 196
Toilet Cleaning Checklist (Dec. 2016) Toilet Cleaning Checklist (Jan 2017)
Toilet No. Toilet No.
SR # Time SIGNATURE SR # Time SIGNATURE
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
FRIDAY/HOLIDAY WO
Date Inspected
▣ SUBCONTRACTOR:
▣ PROJECT NAME-
2
2
Site Manager :
Working Time
Position Name
In Out
Manager
Engineer
Supervisor
HSE
Manager 0
Engineer
Supervisor
HSE
Working Time
Position Name
In Out
Manager
Engineer
Supervisor
QA/QC
HSE
Manager
Engineer
Supervisor
QA/QC
HSE
e Manager : (sign)
____________________________________(Sign)
TOOL BOX TALK FORM
DATE TOPIC:
PERMIT NUMBER
PERMIT TYPE
PROJECT TITLE CBDC
AREA LOCATION
CREW MEMBERS DETAIL
S/N NAME DESIG. EMPL. NO. COMPANY
1 Mr.Asiq I/C Incharge T-107 Tahatn
2 Abdul Latif Lead Man T-113 Tahatn
3 Rufiquee Fitter T-03 Tahatn
4 Niaz Fitter T-179 Tahatn
5 Javeed Fitter T-199 Tahatn
6 Luqman Fitter T-120 Tahatn
7 Tanveer Helper T-127 Tahatn
8 Malik dad Helper T-224 Tahatn
9 Din.M Helper T-222 Tahatn
10 M.Sahid Helper T-109 Tahatn
11 M.Farooq Scaffolder T-230 Tahatn
12 Om Prakash Scaffolder T-231 Tahatn
13 Virendra Ram Rigger T-348 Tahatn
14 M.Asger Helper T-225 Tahatn
15
16
17
18
19
20
21
22
23
24
25
26
GENERAL REMARKS:
JP NAME & SIGNATURE HSE SITE INCHARGE SIGNATURE
(The TOOLBOX shall be conducted by the Job Performer/ Site Supervisor/ or Site in-charge
presence of TAHTAN Safety officer. All TOOL BOX reports will be recorded and submitted fo
and monitoring.)
TALK FORM
SIGNATURE
0
ARGE SIGNATURE
or Site in-charge in
d and submitted for review
TAHTAN GENERAL CONTRACTING LLC
CARBON BLACK & DELAYED COKER PROJECT
Status
Sr. Description
Satisfactory Unsatisfactory
1 TBT done
2 Crane daily inspection done
3 Proper tools available
4 Inspection of tools (if required)
5 Colour coding of tools
6 Area barricaded
7 Workers are using full body harness
8 Workers are Third Party Certified (if necessary)
9 No loose material at deck
10 No loose tools at deck
11 Tools are latched
12 No unauthorized person at site
13 Wind Speed ≤ 32km/hr
SLIPFORMS
Remarks
SECL HSE
Summary of First Aider and Authorized Gas Tester for RREast Area and RRWest Area
RRE RRW
Location Remarks
First Aider AGT First Aider AGT
Utility Area Anoop S Nair Anoop S Nair
Easement Mahendra Singh
Crude Area Md Rashid Md Rashid
Naptha Area Md Sahid Iqbal Md Sahid Iqbal
Oil Movement
Md Danish
/Pump House Area
1 Anoop S Nair RRE Basic First Aid 2/20/2016 Euro Gulf 5071352-6
welding activite going and fire watch man not SLIPS & TRIPS LOW
present
Poor housekeeping observed area the store SLIPS & TRIPS LOW
Off loading matierials of scaffolding tube sling not SLIPS & TRIPS LOW
properly use load unbalance
cable management not good west site silo SLIPS & TRIPS LOW
Rigger give tha signal of tower crane opprater SLIPS & TRIPS LOW
catch tha bucket at a time no usr tha tag line
Bus was parked on the road that block the ACCESS LOW
access
vibrater not insepction and not color code SLIPS & TRIPS LOW
Some wokers not using chin strip while working SLIPS & TRIPS LOW
at height
tower crane hook not color code SLIPS & TRIPS LOW
silo up side D.P no singe for DANGER and SLIPS & TRIPS LOW
electrion phone no
scaffolding matiral not proper arange and SLIPS & TRIPS LOW
barication missing
silo up side D.P no singe for DANGER and FIRE PROTECTION LOW
electrion phone no
Poor cable management in ground level, PWHT SLIPS & TRIPS LOW
cable laying ground improperly.
Grinding machine used without guard CUT LOW
I observe lose matiral (bollts) shefting old vist SLIPS & TRIPS LOW
Material lying in area not properly stacked SLIPS & TRIPS LOW
welding activite going and Fire Protection watch FIRE PROTECTION LOW
man not present
During the painting silo no 1 down side area not HOUSEKEEPING LOW
barricated
Rigger give tha signal of tower crane opprater FALLING OBJECTS LOW
catch tha bucket at a time no usr tha tag line
Worker found not using safety goggle with face PPE LOW
sheild
I observe lose matiral (bollts) shefting old vist FALL PROTECTION LOW
Face shield not using during steel plate cutting. PPE MEDIUM
Falling Objects work was carried out without tag FALL PROTECTION LOW
line
Bus was parked on the road that block the STRUCK / HIT LOW
access
Sharp edges found at the access to main deck at ACCESS LOW
silo no. 2
Good Housekeeping in workshop POSITIVE
During tha welding activity not use proper fire FIRE PROTECTION LOW
blanket welding sports fell down
Toe board found in a scaffold not properly tied FALL PROTECTION LOW
Some people were taking breakfast on pipe rack WELFARE FACILITIES LOW
acces to the office area found blocked SLIPS & TRIPS LOW
upside silo avalible first add box and eye washers SUPERVISION LOW
observed the rigger Falling Objects steel box FALLING OBJECTS MEDIUM
with out using softner
Rebar storage area not properly barricaded SLIPS & TRIPS LOW
Patrol cain was found near welding plant and HOUSEKEEPING LOW
Electrical D B
Signal man doing the job with out flags SUPERVISION LOW
Unprotected cable lying across the way SLIPS & TRIPS LOW
De-shackles witout color code COLOR CODE LOW
Unprotected cable lying across the way SLIPS & TRIPS LOW
EPORT
Status Closed Date Observer Corrective Action
Close RASHID
22-Sep-16 MAHMOOD Adviced to rigger on tha sports
should be load balance
Close 22-Sep-16
RASHID Informed to welding supervisor
MAHMOOD proper arangment
Name Sign
CARBON BLACK A
Contracto
S.NO. Date Time Observer Location Area/Dept r/Compa
ny
Name
Action
Observation Positive/Negative Status
(Yes/No)
Housekeeping Required : Rubbish pile and loose material need removal Negative Y OPEN
Concrete and Wood scrap need removal Negative Y OPEN
Metal @ concrete waste need removal Negative Y OPEN
Great Progress on Cleaning Waste / Debris Pile Positive N CLOSED
Good traffic flow during peak times Positive N CLOSED
Worker without safety glasses Negative Y OPEN
SE Corner - Cable drums ans wood scrap need removal - FIRE HAZARD Negative Y OPEN
SE Corner - Rebar, metal scrap and paint cans need removal Negative Y OPEN
GENERAL HOUSEKEEPING needed Wood scrap, cable trays,etc Negative Y OPEN
BLAST AREA - Need Housekeeping against South Fence Negative Y OPEN
KER PROJECT
Lack of Resources
Lack of Training
Lack of Belief
SOR
Others
SOR
escribe Immediate
Describe Action
Corrective
toDescribe
Prevent
ActionIndirect
Recurrence
Cause Remarks Reported (Closed
Date Date)
Date : Model:
G REPORT
Toxic
Remarks
H2S(PPM) SO2(PPM) CO(PPM)
Serial No:
Signature:
CARBON BLACK & DELAYED COKER PROJECT
LOCATION OF OFFENCE :
DESCRIPTION OF OFFENCE :
:
ISSUED BY : NAME
DESIGNATION : SIGNATURE
NOTE:
GNATURE
Indent Request Form
Indent No. _____________________
Quantity
Sr. No. Material Description Unit
Requested Approved
1 FILE CABINET Nos 1
2 OFFICE CALCULATER Nos 1
3 WHITE BOARD Nos 1
4 MARKER (BLACK ) Nos 2
5 MARKER (RED ) Nos 2
6 DUSTER Nos 1
7 PRINTER CATRIDGES (BLACK & WHITE) Nos 2
8 PRINTER CATRIDGES (COLOUR) Nos 2
9 FILE FOLDER Nos 10
10 GLUE STICK Nos 1
11 PLASTIC COVER FOR FILLING PKT 2
12 FILE DIVIDER PKT 2
13 HIGHLIGHTER (GREEN,RED,YELLOW) PC 2E
14 WHITNER PC 1
15
16
17
18
19
20
P.PANDEY
Requested By Recommended By
Name: PRIYARANJAN PANDEY Name:
DesignatLEAD HSE Designation:
nt Request Form
Date: _____06-01-2016____
mmended By Approved By
Site Manager