Project Name /

No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

Month:
[The first revision shall be named as “0” followed by 1, 2, and 3 for the subsequent revisions. The revision
number shall be indicated on the header of the document i.e. [Project no.] – COMPANY- 0). The amendments
shall be described in the amendment record.]

Comments: Needs improvement, Very poor – need urgent attention, Needs improvement, Needs urgent
attention, Satisfactory, Not available,

1. HOUSE KEEPING

 General
 Access/Egress
 Storage/Stacking
 Illumination
 Disposal of Rubbish
 Walkways
___________________
_________________
___________________
___________________
___________________
___________________

2. PERSONAL PROTECTIVE EQUIPMENT (PPE)

 Helmets
 Safety Shoes
 Overalls
 Eye Protection
 Gloves
 Mask
 Ear Protection
 Stock/Availability
 Safety Harness/ belts
__________________
___________________
____________________
____________________
____________________
____________________
____________________
____________________
____________________

3. FIRE FIGHTING EQUIPMENTS

 Fire Extinguishers ______________

 Hoses/Nozzles ______________
 Others ______________ Nill

4. EMERGENCY ARRANGEMENTS

 Fire service ___________________

 Ambulance Service ____________________
 Police Service ____________________
 Medical Facilities ____________________
 First-aid ____________________

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

HSEAUDIT REPORT CONTINUES

5. PLANT/MACHINERY

 Electrical Connections ____________________

 Guards
 Emergency Stop
 Refueling Procedure
 Spark Arrestors
 Information/Signs
____________________
____________________
____________________
____________________
____________________

6. SCAFFOLDS/MOBILE ACCESS TOWERS

 Access/Egress ____________________
 Handrails/Toe boards ____________________
 Base plate/Footing Base ____________________
 Bracings Fittings ____________________
 Inspections ____________________
 Scaff-tag ____________________
 Castor Breaks ____________________

7. SAFETY PROCEDURES

 Safety meeting ____________________

 Tool Box Meeting
 Training
 Accident/Incident
 Permit System
 Fire Prevention
 Emergency Procedures
____________________
____________________
____________________
____________________
____________________
____________________

8. HEALTH/WELFARE/ HYGIENE

 Food Handling ____________________

 Drinking Water Facilities
 Toilet/Washing Facilities
 Accommodation
 Kitchens/Canteens Facilities
 Rest Area
____________________
____________________
____________________
____________________
____________________

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

9. MOBILE PLANTS
 Licensed Operator
 Vehicle Condition
 Horn
 Rear View Mirrors
 Reverse Alarm
 Head Lights
____________________
____________________
____________________
____________________
____________________
____________________

10. EXCAVATION

 Barricades ____________________

 Warning Signs ____________________

 Slope ____________________

 Access/Egress ____________________

 Warning Lights ____________________

11. EDGE PROTECTION

 Hand rails ____________________

 Mid Rail ____________________

 Toe Boards ____________________

 General ____________________

12. TOWER CRANE/MOBILE CRANE

 Third Party Test Certificate ____________________

 Rigger/Slinger ____________________

 Out Riggers ____________________

 Hooks/Safety Catch ____________________

 Slings Conditions ____________________

 Reverse Alarm ____________________

 Lights ____________________

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

13. TEMPRORY ELECTRICAL CONNECTIONS/DISTRIBUTION BOARDS

 ELCB ____________________

 Sockets ____________________

 Electrical Cables Conditions ____________________

 Electrical Cables on Access/Water ____________________

 Distribution Boards Covered ____________________

 Distribution Boards Earthed ____________________

All the hazards identified are expected to be jointly taken care of by the
contractors concern.

HSE Coordinator __________________________ Signature_________________

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

Pictures To Show Some Of The Hazards Identify

PIC 1- Poor Housekeeping – Vita Construction

Location -Basement

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

PIC 2 – Poor Housekeeping –Nairda Ltd

Location - Basement

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

PIC 3 – Unidentified workers without PPE-Vita

Location – First Floor

PIC 4 – Opening Shaft: Vita Construction

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

Location – second & third floor

PIC 5 –

Workers

seeing

working

without

safety boot:

Vita

Location –
Basement
Area

NAI-HSE-010
 Project Name /
No.
Project Manager:
Document No. NAI-HSE-010

HSE Audit Checklist Revision No.

NAI-HSE-010