Hindustan Coca-Cola Beverage’s Pvt.

Ltd

CONFINED SPACE DRILL

Emergency Drill log Sheet & Check List

EMERGENCY DRILL LOG SHEET

Date: Site: Nature of Incident:

Time of Occurrence:

Emergency Declared:

Emergency Controller name:

Incident Controller Name:

Emergency Over Declared on:

No. Of Person Present at the plant:

No. of persons Responded:

No. of Confined Space rescuer present:

Response Time of Fire Brigade / Ambulance: No fire brigade Participated. ambulance took 35
second to reach place of incidence.

Any Incident Reported (Slip/Trip/fall): Nil

Post Emergency Inspection:

EMERGENCY CONTROLLER REMARKS:

Safety Representative Remarks:

Other Remarks: -----

Classified - Internal use

 Hindustan Coca-Cola Beverage’s Pvt.Ltd

Action Plan:

Observation Action Plan Responsibility Status

POST DRILL MEETING CONDUCTED AT 9.35PM

Snap Shot of Emergency Drill:

Classified - Internal use