Health Safety Environment Security Daily Report Health Safety Environment Security Daily Report

PERSONAL DETAIL/REPORTING AREA:

HSES NON CONFORMANCES
Name: Area/Unit:
Date: Shift:
NON Conformance/NON Compliance/Unsafe Act/Unsafe Condition
Company: Permit No:
MAJOR ACTIVITIES PERFORMED FOR THE SHIFT 1
1 2
2
3 ACCIDENTS / INCIDENTS
AREAS OF HSES CONCERN
1 Reportable Accidents / Incidents: Restricted Work Case
2 Medical Treatment Case First Aid Case
Near Miss Others
DAILY MANPOWER LOADING
Manpower Recorded : PAX HSES AUDIT

Safe Man-Hours : hours = Hours Audit Performed:

Audit Area/Location: Audit members:
= Hours Significant Audit Finding:

HSES MEETING
HSES STATISTIC
HSES Meeting Attended (Tool Box Meeting, Job Safety Analysis Meeting, etc)
Performance Indicator Today Cumm
Lost Time Injury (LTI) 1
Restricted Work Case (RWC) 2
Medical Treatment Case (MTC)
POSITIVE OBSERVATION
Total Reportable Case (TRC)
First Aid Case (FAC) Positive Observation Throughout Shift
Near Miss
1
Minor Spill
2
Loss of Containment
Minor Fire LESSON LEARNT / IMPROVEMENT
Audits
Lesson Learnt Throughout Shift
BS Observation
Manpower Loading 1
Alcohol Testing (Conducted/Positive) 2
Drug Testing (Conductive/Positive)
OTHERS:
PERMIT TO WORK
Permit To Work Issuance for the SHIFT: Day
HOT Work COLD Work CONFINED SPACE ENTRY
TOTAL:
Permit: Permit: Permit:
PTW NON Conformances: N/A

“NO WORK IS SO URGENT OR IMPORTANT THAT WE CANNOT TAKE TIME TO DO IT SAFELY”

“NO WORK IS SO URGENT OR IMPORTANT THAT WE CANNOT TAKE TIME TO DO IT SAFELY”