You are on page 1of 1

CHINA HARBOUR ENGINEERING LFTZE. CHINA HARBOUR ENGINEERING LFTZE.

LEKKI DEEP SEA PORT PROJECT IBEJU LEKKI LAGOS. LEKKI DEEP SEA PORT PROJECT IBEJU LEKKI LAGOS.

HIR- Hazard Identification Report (UA/UC/NEAR MISS) Form HIR- Hazard Identification Report (UA/UC/NEAR MISS) Form

Exact location……………………Date:…………………….. Exact location……………………Date:……………………..


Tick as appropriate; UA UC NM Tick as appropriate; UA UC NM

Housekeeping Environment Material Handing PPE Housekeeping Environment Material Handing PPE

Tools &Equipment Procedure Attitude Height Related Tools &Equipment Procedure Attitude Height Related

Structural Integrity Security Health Sign Structural Integrity Security Health Sign

Description of observation: ……………………………………………………………………………………………………… Description of observation: ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

Immediate Action Taken; ……………………………………………………………………………………………………… Immediate Action Taken; ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

Responsible party; ......................................................... Target Date................................. Responsible party; ......................................................... Target Date.................................

Observed by; .................................................................................................................... Observed by; ....................................................................................................................


Name/Sign Team indicator Date Name/Sign Team indicator Date

Status ( delete as applicable) OPEN/ CLOSE Status ( delete as applicable) OPEN/ CLOSE
Note ; HSE Supervisor to impute all high risks into formal tracking system Note ; HSE Supervisor to impute all high risks into formal tracking system

CHINA HARBOUR ENGINEERING LFTZE. CHINA HARBOUR ENGINEERING LFTZE.


LEKKI DEEP SEA PORT PROJECT IBEJU LEKKI LAGOS. LEKKI DEEP SEA PORT PROJECT IBEJU LEKKI LAGOS.

HIR- Hazard Identification Report (UA/UC/NEAR MISS) Form HIR- Hazard Identification Report (UA/UC/NEAR MISS) Form

Exact location……………………Date:…………………….. Exact location……………………Date:……………………..


Tick as appropriate; UA UC NM Tick as appropriate; UA UC NM

Housekeeping Environment Material Handing PPE Housekeeping Environment Material Handing PPE

Tools &Equipment Procedure Attitude Height Related Tools &Equipment Procedure Attitude Height Related

Structural Integrity Security Health Sign Structural Integrity Security Health Sign

Description of observation: ……………………………………………………………………………………………………… Description of observation: ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

Immediate Action Taken; ……………………………………………………………………………………………………… Immediate Action Taken; ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

……………………………………………………………………………………………………… ………………………………………………………………………………………………………

Responsible party; ......................................................... Target Date................................. Responsible party; ......................................................... Target Date.................................

Observed by; .................................................................................................................... Observed by; ....................................................................................................................


Name/Sign Team indicator Date Name/Sign Team indicator Date

Status ( delete as applicable) OPEN/ CLOSE Status ( delete as applicable) OPEN/ CLOSE
Note ; HSE Supervisor to impute all high risks into formal tracking system Note ; HSE Supervisor to impute all high risks into formal tracking system

You might also like