PROJECT HSE PLAN REVIEW CHECKLIST

Reference No. :
Package : B4
Review Date : 4th May 2021
Review by : CSTR HSE Team

NO. ITEMS STATUS REMARKS

FRONT PAGE
1. Front page of PHSE Plan must include the following Completed HSE Plan has been signed by the
items: respective parties.
a. Prepared by who (SHO/SSS/HSE Practitioner)

b. Endorsed by who (Line manager for

SHO/SSS/HSE Practitioner)
c. Approved by who (Highest available position in
your company)
2. The front page must have title box with revision To be Document Number to be provided
number, revision date and document number provided
REVISION HISTORY PAGE
1. A revision page history must have a table of the Completed. Provided in page V.
following items
a. Details of the revision

b. Effective date of the revision

c. Name of the person who revise

INTRODUCTION
1. Scope Completed

a. Pertaining to the scope of the PHSE plan is

required to ensure what area of the project the
document will be enforced
2. HSE Policies Completed

a. Attached a copy of company's HSE Policies.

Policies must be signed by the highest position
in the company
3. Roles and Responsibilities Completed

a. Must have the list HSE roles and

responsibilities for every key person in the
company (e.g.: SHO, CM, PM, SSS,
Supervisors)
4. Safety and Health Committee To be To be provided as soon as the
provided total manpower (management
a. Established Safety and Health Committee and operation is over 40 pax)
members using organisation charts
b. Each roles of the committee members e.g.
Chairman, Secretary, employee and employer
representative must be assigned with a specific
person
c. Each role must have details of their duties and
responsibilities within the Safety and Health
Committee
 PROJECT HSE PLAN REVIEW CHECKLIST

NO. ITEMS STATUS REMARKS

MAIN CONTENT
For main content of the PHSE plan, must include the following items:
1. Hazard Identification, Risk Assessment and Risk To be
Control (HIRARC) provided
a. For HIRARC, must include on procedure to To provide HIRARC on specify
identify hazards, what are the risk assessments activity
and propose of the risk control
b. For risk assessments, 5x5 matrix (guideline Provided at page 17.
from DOSH) is recommended to be used
c. Risk control must follow Hierarchy of Control To provide Hierarchy of Control.
and risk control must be practical and the
company can execute the risk control
d. Full HIRARC table available (follow DOSH To provide full HIRARC table.
guideline) and to be attached in the appendix
or within the PHSE Plan itself
2. Emergency Response Plan (ERP) To be
provided
a. Identified all potential emergency scenarios Provided in Appendix 8.
that have the probability to occur
b. Organisation chart of Emergency Response Provided in Appendix 8.
Team (ERT). Each role must have specific
person who assigned to it with contact details
c. Details of duties of each member To provide details of duties.

d. For certain roles e.g. First Aider, must attached To attach certified competency
certified competency certificate for reference certificate.
3. Safety Data Sheet (SDS) To be To provide Safety Data Sheet
provided (if (SDS) for chemical hazardous to
a. Identified all chemicals used at site necessary) health as per listed in Schedule I
or II (Use and Standards of
b. Provide SDS for all chemicals used at site
Exposure of Chemicals
c. Company provide method on labelling and Hazardous to Health Regulation)
storage of chemicals under Environmental
Quality Act 1974 Environmental Quality
(Scheduled Waste) Regulation 2005 (if
applicable)
4. Legal and other Requirements Completed

a. All legal and other requirements are identified

that are relevant to the project and tabulated in
a table
b. Company to propose and conduct any required
HSE mattes to comply with all identified
relevant legal and other requirements

Approval Status

No objection

X Resubmission Required
Comments: