Safety Form List

OCCUPATIONAL DOC NO.
:
REV NO.:
SAFETY & HEALTH REV DATE:
Page 1 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
THE PROPOSED CONSTRUCTION AND COMPLETION OF ROAD FROM KUALA TERENGGANU AIRPORT TO KUALA
TERENGGANU CITY CENTRE (KTCC), TERENGGANU DARUL IMAN FOR THE EAST CAST ECONOMIC REGION
DEVELOPMENT COUNCIL (ECERDC)PACKAGE 1B: UPGRADING OF THE EXISTING COASTAL PROTECTION FROM
CH.3440 TO CH.3740CONTRACT NO: 4600001330
MEETING / TRAINING REGISTER
MEETING / TRAINING DURATION : (min/hr) DATE / TIME :

SAFETY OFFICER : SIGNATURE :
PRESIDING OFFICER : SIGNATURE :
TOPICS :
NO NAME IC/ PASSPORT NO. DESIGNATION SIGNATURE

OCCUPATIONAL DOC NO.:
REV NO.:
Page 2 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
HEALTH AND SAFETY INDUCTION FORM

Project : Company Chop :
Name :
Trade : Date :
SAFETY ENVIRONMENTAL
1.0 Occupational Safety & Health Act 1994 1.0 Oil Spillge Control
1.1 Section 24
1.2 Section 25 2.0 Housekeeping
2.1 Material Arrangement
2.0 OSH Policy and Objectives 2.2 Loading & Unloading
2.1 OSH Policy 2.3 Ocean Contamination
2.2 OSH Objectives 2.4 Waste Management
3.0 Personal Protective Equipment INSURANCE

3.1 Safety Helmet (SIRIM) 1.0 CIDB Green Card
3.2 Safety Shoes (Steel toe and steel mid sole)
3.3 Safety Harness 2.0 Site Insurance / FWCS
3.4 Ear Plug FWCS – Foreign Worker Compensation Scheme
3.5 Eye Protection
3.6 Welding Shield EMERGENCY PROCEDURE
3.7 Gloves 1.0 Emergency Response Plan
3.8 Life Jacket 1.1 Emergency contact details
1.2 Emergency response plan
4.0 Unsafe Acts / Conditions 1.3 Emergency response team
4.1 Lifting Operations 1.4 Emergency rescue from fire
4.2 Working Heights 1.5 Emergency rescue for marine works
4.3 Marine Works 1.6 Emergency rescue from confined
4.4 Fabrication & Concreting Works space
4.5 Dredging Works
OTHERS
HEALTH 1.0 Workers required to rest at designated rest
1.0 Personnel area
1.1 Drugs & Alcohol
1.2 Personal Hygiene
2.0 Workers Quarters Serroundings

2.1 Vector Control
2.2 Accommodation
SECURITY
1.0 1.1 Work pass
1.2 No wandering into Terminal Zone
I, hereby acknowledge that I have received a Health & Safety Induction in the language that I understand which includes the above
mentioned topics. I will comply with regards to the above mentioned topics else receive a NCR – Non Conformance Report for non-
compliance
NAME & SIGNATURE NAME & SIGNATURE

WORKER HSE OFFICER/HSE SUPERVISOR
REV NO.: 00
Page 3 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
COMPANY NAME DATE BADGE NO. / PROJECT NO.

(NAMA SYARIKAT) (TARIKH) (NO. PASS / NO. PROJEK)
MEDICAL HISTORY
(SEJARAH PERUBATAN)
NAME IC / PASSPORT NO.

(NAMA) (NO. K/P / PASSPORT)
MALE (LELAKI)/
D. O. B AGE FEMALE (PEREMPUAN)
(TARIKH LAHIR) (UMUR)
EMERGENCY CONTACT :
(NO. HUBUNGAN KECEMASAN) NAME (NAMA) PHONE (NO. TELEFON)
ALLERGIES :
(ALAHAN)
PAST MEDICAL HISTORY (ie, HEART, LUNG, LIVER, ETC. : APPENDECTOMY,

TONSILECTOMY, HYSTERECTOMY, ETC.)
SEJARAH PERUBATAN YANG LALU (ie, SAKIT JANTUNG, PARU-PARU, HATI, dll. : APPENDECTOMY,
TONSILECTOMY, HYSTERECTOMY)
MEDICATION TAKEN
(UBATAN YANG DIAMBIL)
IF NOT TAKING ANY MEDICATION OR DO NOT HAVE A PAST MEDICAL HISTORY NOR
ALLERGIES, PLEASE WRITE IN N / A.
(JIKA TIDAK MENGAMBIL SEBARANG UBATAN ATAU TIADA SEJARAH PERUBATAN YANG LALU ATAU ALAHAN,
SILA TULIS TIADA.)
ALL MEDICAL INFORMATION WILL BE CONFIDENTIAL.

(SEMUA MAKLUMAT PERUBATAN AKAN DIRAHSIAKAN)
THIS IS TO BE BENEFIT YOU IN CASE OF AN EMERGENCY INJURY OR ILL NESS.

(MAKLUMAT INI ADALAH PENTING UNTUK ANDA SEKIRANYA BARLAKU KECEDERAAN, KECEMASAN ATAU
KESAKITAN.)
REV NO.: 00
Page 4 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
RULES & REGULATIONS

(PERINTAH & UNDANG-UNDANG)
1. I have been instructed and understood the HSSE rules and regulation and agree to
abide by them
(Saya telah menghadiri induksi HSSE dan memahami peraturan-peraturan kerja yang selamat dan berjanji
untuk mematuhi segala peraturan-peraturan itu.)
2. I have been instructed and understood that if I have any questions or concerns then I
should consult with my immediate supervisor. If he is unable to give a solution then I
have aright to seek higher assistance from the Safety Supervisor or Project Manager.
(Sekiranya saya tidak memahami sesuatu, saya berhak bertanya kepada penyelia saya untuk mendapat
tunjuk ajar yang sesuai. Sekiranya penyelia saya tidak dapat bagi tunjuk ajar atau penyelesaian yang saya
perlu , saya berhak bertanyakan kepada penyelia atasan, Safety Officer atau Pengurusan Projek.)
Name of Employee :
(Nama Pekerja)
Designation :
(Jawatan)
Project Badge No. :

(No. Pas Projek)
NRIC / Passport No. :

(No. K/P / Pasport)
Employee Signature :
(Tandatangan Pekerja)
Date Inducted :
(Tarikh Induksi)
REV NO.:
Page 5 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
CONDITION OF SAFETY HARNESS
Name Nationality
Company Occupation
ID/EP/WP No. Date of Expiry
IF THE ITEM/S IS BAD IN CONDITION IT MUST BE REPLACE IMMEDIATELY
VISUAL CHECK CONDITION
S/ NO. ITEM GOOD BAD
1 Safety Harness
2 Back “D” Ring
3 Fixing Buckles (Stitching)
4 Leg straps
5 Big Hook
6 Energy Absorber Lanyard
7 Adjustment Buckles
8 Carabineer
Notes :-
It is my responsibilities to carry out visual check before each and every time when use
Signature :
Date :
REV NO.: 00
Page 6 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
TOOL BOX MEETING
Tool Box Meeting Conducted In: A) English ❑ B) Mandarin ❑ C) Malay ❑ D) Tamil ❑

No Topics To Be Discussed : Safety Issue Date :
1.
2.
3.
4.
No Topics To Be Discussed : Safety Work Procedure Date :

1.
2.
I/C No / Work
No Participants Signature Remarks
Permit No
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Briefing Conducted By :
_
HSE Department PM/DPM
(Name and Signature) (Name and Signature)
REV NO.:
Page 7 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
WEEKLY SITE INSPECTION CHECKLIST
Items Inspected Tick Comment Items Inspected Tick Comment

Yes No Yes No
1. Housekeeping 2. PPE
a. Access a. Safety Helmet
b. Stairways b. Safety Boots
c. Signs c. Eye Protection
d. Lighting d. Ear Protection
e. Waste Disposal e. Gloves
f. Overall / Apron
g. Filter / Dust Mask
3. Lifting Activity 4. Equipments (W/Set, Generator, Compressor)

a. Crane/ Skylift Inspected a. Guards
b. Lift Permit/Prelift Check b. Emergency Stop
c. Barricade/ Signs c. Fire Extinguisher
d. Signalman d. Oil Leaks
e. Taglines e. PMT
f. Vehicle Entry Permit f. Earthing
g. Supervision g. Leads/ Cables
h. Oil/ Fuel/Radiator Cap
5. Work Areas 6. Electrical

a. Housekeeping a. ELCB Functional
b. Ladders/ Platforms b. Industrial Cable
c. Hand Tools c. Proper Connections
d. Obstruction d. Correct Plug
e. Access e. BD Condition
f. Floor Opening f. Cable Management
g. Overhead Works
h. Emergency Exits
i. Working At Floor Edge
7. Weld/ Cut/ Grind 8. Machinery

a. Cylinder Secured a. Inspection Certificate
b. Flash-back Arrestor b. Noise
c. Regulator/ Hose/ Torch c. Oil Leakage
d. Fire Extinguisher d. Smoke Emission
e. Hand Tools
f. PPE
g. Hot Work Permit
h. Housekeeping
REV NO.: 00
Page 8 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
WEEKLY SITE INSPECTION CHECKLIST
Items Inspected Tick Comment Items Inspected Tick Comment

Yes No Yes No
9. Fire Equipment 10. First Aid
a. Extinguisher (type/qty) a. First Aid Box
b. Hydrant/ Hose/ Nozzle b. Signage
c. Smoke/ Heat Detector c. Adequate Stock
d. Suppression System d. Readily Accessible
11 Hygiene / Welfare
a. Toilet Facilities
b. Drinking Water
c. Canteen
d. Garbage Disposal
e. Housekeeping
f. Rest Area/ Surau
Conducted By :
NAME DESGNATION SIGNATURE / DATE
Verified By : (Supervisor)
NAME DESIGNATION SIGNATURE / DATE

REV NO.:
Page 9 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
INSPECTION FOR CONSTRUCTION VEHICLE / MACHINERY
Company : Inspection Date :
Registration No. Name of Driver

Type NRIC No.
Model License No
R/ Tax Expiry Class of License
Date Inspection License Expiry Date
Next Inspection Signature of Driver
S/No Item Description Yes No N/A Remarks

1 Pedal brakes in good condition
2 Hand brake in good condition
3 Engine start smoothly
4 Any fuel / oil leakage
5 Fuel / oil / radiator cap in place
6 Rear view mirror available
7 Head Light
8 Tail Light
9 Horn
10 Reverse alarm / buzzer
11 Tyre condition
12 Signal light
13 Stop light
14 Condition of bucket (excavator / backhoe)
15 Spark arrestor
16 Any obstruction of visibility from cabin
Comments :
NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

OPERATOR / DRIVER HSE DEPARTMENT PM / DPM
REV NO.:
Page 10 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
INSPECTION FOR CRANE / SKYLIFT
Company Crane Operator Inspection Date

Crane Type Crane No. Rated Capacity
DOSH Reg. No. PMA No. PMA Expiry
S/No Item Description Tick Remarks
Yes No
1 Tires in good condition and inflated
2 All wheels off the ground
3 Oil leakages
4 Lifting / Rigging equipments acceptable
5 Horn / buzzer / hazard lights functional
6 Valid Road Tax / Insurance
7 Lights / Signals in working condition
8 Any damage to wire ropes
9 Operator registered with DOSH
10 Valid PMA
11 Fire extinguisher available
12 Load chart available
13 Any welds / visible cracks on the boom
14 Outriggers fully extended and pads available
15 Noise / smoke level acceptable
16 Extension jib safely secured
17 Height limit alarm functioning
18 Hoist brakes functioning
19 View from operator cabin not restricted
20 Boom angle indicator accurate
21 Lifting blocks / hooks in good condition
22 Safely latches in good condition
23 Barricades and signs installed
24 Taglines available
25 Signalman available
26 Operator / Signalman familiar with signals
27 Crane crew safety briefed
Attached are true copies of :-
Valid PMA Load Chart
Operator’s Competency Cert. (DOSH/JPJ License) Road / Insurance Tag Reg.
Inspection Results : PASSED FAILED

ACCEPTED WITH COMMENT

REV NO.: 00
Page 11 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
INSPECTION FOR LIFTING SLING, CHAIN AND WIRE ROPE
Inspected Item Visual Inspection Remarks

Yes No N/A
a. Is lifting chain / sling / wire in good working order (visual check)?
b. Is safe working load clearly labeled on individual lifting
chain/sling/wire?
c. Is there are register to encompass all lifting chains/slings/wire?
d. Any signs of worn or frayed slings/wires?
e. Is standard operating procedure for using lifting chains/slings/
wires?
f. Is there clear access to retrieve or return lifting chains/slings/
wires?
g. Any signs of excessive corrosion on lifting chains/wires?
h. All fastening devices intact?
i. Is there any proper storage for lifting chains/slings/wires?
j. Is there a record a proper functional and load testing on lifting
chains/slings/wires?
k. Is there any signs of proper maintenance of lifting chains/sling/
wires?
l. Is there any sign-in or signed-out procedure of retrieving/returning
lifting chains/sling/wires?
m. Are lifting chain/slings/wires appropriate for their use?
Note : Responsible persons must record and maintain the monthly checklist for 24 months
Inspected By : HSE Department
NAME SIGNATURE DATE

REV NO.:
Page 12 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
INSPECTION FOR FIRE EXTINGUISHER
Visual Inspection
Inspected Item And Functional Test Remarks
Yes No N/A
a. Is fire extinguisher conspicuously located?
b. Is there any proper space demarcation for fire extinguisher.
c. Is trigger pin intact?
d. Is wire seal of fire extinguisher unbroken?
e. Is standard operating procedure for using fire extinguisher
displayed?
f. Is there clear access to fire extinguisher?
g. Is discharge hose and horn in good working condition and free from
cracks and surface grazing?
h. Is pressure indication gauge within the green zone?
i. Is the body of fire extinguisher free from corrosion?
j. Is the fire extinguisher close to hazard area (i.e 1.5 m apart at high
free hazard area)
k. Is the fire extinguisher affixed with approved labels?
l. Is the fire extinguisher inspected by licensed fire extinguisher
contractor annually?
m. Is the fire extinguisher appropriate for the area served?
Note : Responsible persons must record and maintain the monthly checklist
Inspected By : HSE Department
NAME SIGNATURE DATE

REV NO.:
Page 13 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
INSPECTION FOR FIRE EXTINGUISHER
Visual Inspection
Item description And Functional Remarks
Item Test
Yes No N/A
EQUIPMENT / PLATFORM
1 Is the engine running in good operating condition?
2 Any sign of oil leakage / hydraulic oil at engine.
3 Is the steering system functioning well?
4 Is the electrical system safe and running well?
5 Is the navigation instrument functioning well?
6 Is the communication device / radio functioning well?
7 Is the pulling / tie rope in good condition?
8 Is the housekeeping satisfactory?
PROTECTIVE EQUIPMENT
The following Personnel Protective Equipments are to be
used:
• Safety Helmet
• Life Jacket
• Gloves
• Safety Shoes
• First Aid Box
• Fire Extinguisher
This is to certify that I have checked the area and equipment to be worked on and is satisfied that
theAbove mentioned work can be carried out safely.
NAME SIGNATURE DATE

REV NO.: 00
Page 14 of 68
(OSH) MANUAL
SAFETY DEPARTMENT
INSPECTION CHECKLIST – WORKBARGE / DREDGER
Item Item Description Yes No Remarks

EQUIPMENT / PLATFORM
1 Have you checked any loose bolts nuts between crane boom
and bucket.
2 Is the pulley functioning well?
3 Is the breaking system functioning well?
4 Any sign of breakage / cracking at wire rope.
5 Any sign of oil leakage / hydraulic oil at engine.
6 Is the engine running in good operating condition?
7 Is the electrical system safe and running well?
8 Are the winches in good operating condition?
9 Is the welding or other fastening device on deck
maintaining and use properly?
10 Is the communication device / radio in good operating
condition?
11 Is the housekeeping satisfactory?
PROTECTIVE EQUIPMENT
The following Personnel Protective Equipments are to be
used :-
• Safety Helmet
12 • Life Jacket
• Gloves
• Safety Shoes
• Safety Glass
• Ear Plug
• First Aid Box
• Fire Extinguisher
• Safety Harness (When climbing frame)
This is to certify that I have checked the area and equipment to be worked on and is satisfied that the
Above mentioned work can be carried out safely.

HSE MANAGEMENT SYSTEM
ECER PROJECT
PERMIT TO WORK
1 INFORMATION
THE PROPOSED CONSTRUCTION AND COMPLETION OF ROAD FROM KUALA TERENGGANU AIRPORT TO
KUALA TERENGGANU CITY CENTRE (KTCC), TERENGGANU DARUL IMAN FOR THE EAST CAST ECONOMIC
REGION DEVELOPMENT COUNCIL (ECERDC)PACKAGE 1B: UPGRADING OF THE EXISTING COASTAL
PROTECTION FROM CH.3440 TO CH.3740CONTRACT NO: 4600001330
CONTRACTOR : LANDHON BUILDERS SDN. BHD.

WORK ACTIVITY :
2 TYPE OF PERMIT
CRITICAL LIFTING NIGHT WORK
WORKING AT HEIGHT DEEP EXCAVATION
HOT WORK OTHERS
3 DOCUMENT SUBMITTED
METHOD STATEMENT PLAN LAYOUT / SKETCH
PE DESIGN & CALCULATION EMERGENCY PROCEDURES
MACHINERIES PMA/PMT HIRARC
AUTHORITIES APPROVAL COMPETENCY
OTHERS
4 SPECIAL REQUIREMENTS
5 RECEIVING AUTHORITY
We hereby undertake the accountability to ensure the works activities approved under this permit are executed safely in according to condition
of contracts, Malaysian legal requirement, standards code of practice and PMC safety requirements.
Name Signature
Contractor's PM :
Contractor's Site Safety Supervisor :
6 ISSUANCE AUTHORITY (KLCCPSB)

Validity : 3 MONTHS Date issued : Expired Date :
Name Signature
Issued by :
In the event of non compliance with the legal requirements, standards code of practice or any safety required requirement imposed by PMC, the
permit is automatically invalid and and PMC reserves the right to stop works immediately
FOR SAFETY AND HEALTH DEPT. USE
PERMIT TO WORK Document No. : OHS-PYT-P/001
NO WORK IS SO URGENT THAT WE CANNOT TAKE TIME TO DO IT SAFELY Rev. No. : 0
Permit No. : SHE/PTW - G - ( )

DEPARTMENT/DIVISION :
SECTION 1 - REQUISITION ( TO BE FILLED BY APPLICANT / WORK LEADER/ SUPERVISOR)
APPLICANT NAME : DEPARTMENT/COMPANY :

LOCATION / FACILITY :
DESCRIPTION OF WORK :
START DATE / TIME: EXPECTED COMPLETION DATE / TIME : NO.
OF PERSONNEL INVOLVED IN THIS WORK
SECTION 2 - HAZARD/ HAZARDOUS ACTIVITIES (TO BE FILLED BY APPROVING AUTHORITY) - TICK ( / ) WHERE APPLICABLE
Gas & Fumes Working at Height Saw / Cold Cut Compressor Crane Fork Lift
Chemical Falling Object Battery Operated / Generator Vacuum Truck
Steam Scaffolding Electrical Tools Hydrojetting
Dust Jack Hammer Excavation Electronic Device Others :
Hot Surface Drilling Radiography Calibration Electrical
Shock Lifting Pressure Testing Rotating Equipment
SECTION 3 - WORKSITE PREPARATION / PRECAUTIONS TO BE CARRIED OUT ( TO BE FILLED BY SHO/SSS ) - TICK ( / ) WHERE APPLICABLE
Supervisor Present Warning Sign Secure Tools / Material Against Falling

Safety Briefing Area Barricaded Others :
Flagman / Traffic Controller Equipment / Line Depressured
Line Disconnected Scaffolding to be certified safe
Electrically Isolated and Tagged Lighting
SECTION 4 - PERSONAL PROTECTIVE EQUIPMENT ( TO BE FILLED BY SHO/SSS) - PLEASE TICK (/) WHERE APPLICABLE
Mandatory Respiratory Pro Eye, Face & Body Protection Hand Protection Fall Protection
Safety Helmet Half Mask Respi rator Safety Glasses Leather Gloves Full Body Harness
Safety Shoes Full Face Respiratory Goggles Chemical Gloves Life Line
Approved Coverall SCBA Face Shield Cotton Gloves Life Jacket (working above water)
Airline BA Disposal Suit Other :
Dust Mask Chemical Apron Hearing Protection
Chemical Suit Ear Plug
Chemical Boot Ear Muff
SECTION 5 - WORK SITE INSPECTION BEFORE WORK START / APPROVAL ( TO BE SIGNED BY SUPERVISOR)
I have personally checked the area and equipment to be worked on and I am satisfied the work requested can be carried out safely
Name : Date/Time :
Signature :
APPROVED BY SAFETY AND HEALTH DEPARTMENT AGREED BY APPLICANT/WORK LEADER

The approval is hereby granted for the work to be carried out as nessecary preve I declare that I have taken all nessecary precautions and shall be responsible for the
actions and safety precautions have been taken by sub contractor involved. safety of the worker and the public before, during and on completion of work above.
* Permit will be revoked if the safety instructions/ procedures/ requirements The equipments and machineries are already inspected and safe to use.
is breached.
Name : Name :
Department : Department :
Signature : Signature :
Date/Time : Date/Time :
SECTION 6 - REVALIDATION (ALL COPIES TO BE ATTACHED WHEN SIGNING)
APPLICANT/WORK LEADER APPROVING BY SAFETY AND HEALTH DEPARTMENT

DATE
DAY DAY NIGHT
SECTION 7 - HAND BACK (ALL COPIES TO BE ATTACHED WHEN SIGNING)
Work Completed Incomplete Hand-Back (Equipment Status, Reason for Hand-

Back, Etc.) This work is complete and the site left tidy.
HANDED OVER BY APPLICANT/WORK LEADER ACCEPTED BY SAFETY AND HEALTH DEPARTMENT
Name : Name :
Department : Department :
Signature : Signature :
Date : Date :
STOP WORK AND EVACUATE AREA ON HEARING OF EMERGENCY ALARM

Distribution: Original : Displayed at Worksite Copy No. 1 : Safety & Health Department ( Respective Site/ Project)

Safety Form List

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Safety Form List

Uploaded by

Copyright:

Available Formats

OCCUPATIONAL DOC NO.

MEETING / TRAINING REGISTER

MEETING / TRAINING DURATION : (min/hr) DATE / TIME :

NO NAME IC/ PASSPORT NO. DESIGNATION SIGNATURE

HEALTH AND SAFETY INDUCTION FORM

3.0 Personal Protective Equipment INSURANCE

2.0 Workers Quarters Serroundings

NAME & SIGNATURE NAME & SIGNATURE

COMPANY NAME DATE BADGE NO. / PROJECT NO.

NAME IC / PASSPORT NO.

PAST MEDICAL HISTORY (ie, HEART, LUNG, LIVER, ETC. : APPENDECTOMY,

ALL MEDICAL INFORMATION WILL BE CONFIDENTIAL.

THIS IS TO BE BENEFIT YOU IN CASE OF AN EMERGENCY INJURY OR ILL NESS.

RULES & REGULATIONS

Project Badge No. :

NRIC / Passport No. :

CONDITION OF SAFETY HARNESS

ID/EP/WP No. Date of Expiry

IF THE ITEM/S IS BAD IN CONDITION IT MUST BE REPLACE IMMEDIATELY

VISUAL CHECK CONDITION

S/ NO. ITEM GOOD BAD

TOOL BOX MEETING

Tool Box Meeting Conducted In: A) English ❑ B) Mandarin ❑ C) Malay ❑ D) Tamil ❑

No Topics To Be Discussed : Safety Work Procedure Date :

WEEKLY SITE INSPECTION CHECKLIST

Items Inspected Tick Comment Items Inspected Tick Comment

3. Lifting Activity 4. Equipments (W/Set, Generator, Compressor)

5. Work Areas 6. Electrical

7. Weld/ Cut/ Grind 8. Machinery

WEEKLY SITE INSPECTION CHECKLIST

Items Inspected Tick Comment Items Inspected Tick Comment

NAME DESGNATION SIGNATURE / DATE

NAME DESIGNATION SIGNATURE / DATE

INSPECTION FOR CONSTRUCTION VEHICLE / MACHINERY

Company : Inspection Date :

Registration No. Name of Driver

S/No Item Description Yes No N/A Remarks

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

INSPECTION FOR CRANE / SKYLIFT

Company Crane Operator Inspection Date

Inspection Results : PASSED FAILED

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

INSPECTION FOR LIFTING SLING, CHAIN AND WIRE ROPE

Company : Inspection Date :

Inspected Item Visual Inspection Remarks

Inspected By : HSE Department

NAME SIGNATURE DATE

INSPECTION FOR FIRE EXTINGUISHER

Company : Inspection Date :

Inspected By : HSE Department

NAME SIGNATURE DATE

INSPECTION FOR FIRE EXTINGUISHER

Company : Inspection Date :

NAME SIGNATURE DATE

INSPECTION CHECKLIST – WORKBARGE / DREDGER

Company : Inspection Date :

Item Item Description Yes No Remarks

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

CONTRACTOR : LANDHON BUILDERS SDN. BHD.

CRITICAL LIFTING NIGHT WORK

WORKING AT HEIGHT DEEP EXCAVATION

HOT WORK OTHERS

METHOD STATEMENT PLAN LAYOUT / SKETCH

PE DESIGN & CALCULATION EMERGENCY PROCEDURES