WEEKLY SAFETY REPORT

DIVISION:
WEEK NO.: WEEK ENDING: MONTH: CHECKED BY:

S. NO. DESCRIPTION TOTAL CUMULATIVE

1 Man Hours worked

2 Total Manpower on Site (Average)

3 No. of Category I – Accidents (Death/Serious

Injury/Damage above Dhs. 10,000/-)

4 No. of Category II – Accidents (Lost Time Injury

Cases/damage below Dhs. 10,000/-), Near misses

5 No. of Category III – Accidents (First Aid Cases/

Damage below Dhs. 1,000/-)

6 Property Damage/Fire incident

7 Safety Inspection/Audit

8 Number of Tool Box Meeting Conducted

9 Safety Default Notices Issued During This Week

10 Total Safety Induction Attended

PREPARED BY :

DATE AND SIGNATURE

Doc. No. HI – RAK – MRI – FOR – 033 – 17, Rev.0 21 November 2017 Page 1