PROJECT SAFETY CHECKLIST Doc.

No: TRLK/PRJ/CS/09
Rev. No: 01/10.08.2020

Location.: HTK Contractor Supervisor: BIJOY SAHA

Department : PROJECT TRLK Site Incharge: SUBHAM SINHA
Contractor Name : FGKT Project Manager: SAMIR KAR
Date : Dept HOD: SOUMESH SAHU
SL No. OBSERVATIONS OK NOT OK NA Remarks
1 Job related SOP available & being followed ?
2 Right tools used for right job ?
3 Hand Tools inspected & good quality is used ?
4 PPEs used as per hand tools Requirments ?
5 Power tools certified from Dept.?
6 Suitable PPEs used for Power tools?
7 Workmen are trained on SOP, Conducted TBT ?
Job Card available with workmen & job specific training identified on
8
job card ?
9 Standard housekeeping maintained at work site?
10 Workmen Provided General Safety PPEs as per requirments?
11 Work permit taken for different activities?

12 Six Directional hazards properly filled & communicated to workmen?

13 Positive isolation followed as required?

14 Precaution taken against hot work job?
15 All height work activities conntrol measures taken?
Person not useing mobile phone while working & handed over to
16
supervisor?
17 Persons having valid gate pass engagged at site ?
18 All person's health condition is fit to work?
19 COVID-19 Safety followed & communicated on TBT?
Any mobile equipment/ vehicle being used at project site has been
20 checked for its fitness, daily check sheet filled in & TPI certificate
before starting of job.

21 All required daily check sheets filled up before starting of jobs ?

21 Any other points ?

Contract Agency Representative Sign
Date & Time
TRLK Representative
Sign Date & Time
Note: NA-Not Applicable
Workmen's Signature
SL No. Name Signature SL No. Name Signature
1 Rajib Maity 15 Khursheed
2 Palash Malik 16 Ali Imam
3 Dhiraj Paddan 17 Satan Gond
4 Sagar Roy 18 Md. Shahid Ansari
5 Sarajeet Malik
6 Sabbir Ali
7 Subrata Barik
8 Md. Irshad
9 Subir Mondal
10 Sudeb Malik
11 Purnabrata Mondal
12 Mohammad Ali Khan
13 Sanjay Kumar Pandey
14 Ram Ashis Prasad