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  • 5-Monthly Safety Reporting Format

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    Alam Doo
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    This document is a monthly safety report from PT.Punljloyd Indonesia for their work on the Tunu 11 S project. It contains blank tables to report weekly and cumulative manhours, injuries including fatalities and lost time accidents, medical treatments, restricted work days, and environmental damages or production losses. Near misses and other anomalies are also tracked on a weekly and cumulative basis. A summary of any accidents, incidents or near misses that occurred during the week is included with description and date. The report is to be recorded, signed and dated upon completion.

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    5-MONTHLY SAFETY REPORTING FORMAT

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    This document is a monthly safety report from PT.Punljloyd Indonesia for their work on the Tunu 11 S project. It contains blank tables to report weekly and cumulative manhours, injuries including fatalities and lost time accidents, medical treatments, restricted work days, and environmental damages or production losses. Near misses and other anomalies are also tracked on a weekly and cumulative basis. A summary of any accidents, incidents or near misses that occurred during the week is included with description and date. The report is to be recorded, signed and dated upon completion.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    20 views2 pages

    5-Monthly Safety Reporting Format

    Uploaded by

    Alam Doo
    This document is a monthly safety report from PT.Punljloyd Indonesia for their work on the Tunu 11 S project. It contains blank tables to report weekly and cumulative manhours, injuries including fatalities and lost time accidents, medical treatments, restricted work days, and environmental damages or production losses. Near misses and other anomalies are also tracked on a weekly and cumulative basis. A summary of any accidents, incidents or near misses that occurred during the week is included with description and date. The report is to be recorded, signed and dated upon completion.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    TOTAL E&P INDONESIE

    MONTHLY SAFETY REPORTING

    Month: From: To:


    CONTRACTORs NAME: PHASE: EPSC:
    PT.PUNJLLOYD INDONESIA TUNU 11 S EPSC 5

    CONTRACTOR PERSONNEL
    DESCRIPTION CPY SITE CTR facilities (Yard,offices)
    OVERSEA NATIONAL TOTAL OVERSEA NATIONAL TOTAL

    Weekly Manhours (this week):


    Cumul (year):
    Cumul (from starting):

    Weekly FATALITY (this week):


    Cumul (year):
    Cumul (from starting):

    Weekly LTA (this week):


    Cumul (year):
    Cumul (from starting):

    Weekly DAY LOST(s) (this week):


    Cumul (year):
    Cumul (from starting):

    Weekly Medical Treatment Case(s)(this week):


    Cumul (year):
    Cumul (from starting):

    Weekly First aid Case[s] (this week)


    Cumul (year):
    Cumul (from starting):

    Weekly Restricted Work Day case(s)(this week)


    Cumul (year):
    Cumul (from starting):

    Weekly Environment Damages


    Cumul (year):
    Cumul (from starting):

    Weekly Material / Production loss


    Cumul (year):
    Cumul (from starting):

    Weekly Near Miss(es) ( this week)


    Cumul (year):
    Cumul (from starting):

    Weekly Anomaly(ies)(this week):


    Cumul (year):
    Cumul (from starting):

    SUMMARY OF ACCIDENT AND INCIDENT / NEARMISS OF THE WEEK


    DATE DESCRIPTION

    RECORDED BY: SIGNATURE: DATE:


    OTAL E&P INDONESIE
    NTHLY SAFETY REPORTING

    EPSC:
    EPSC 5

    GROSS
    TOTAL

    CIDENT AND INCIDENT / NEARMISS OF THE WEEK


    DESCRIPTION

    DATE:

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