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GOLDEN FALCON TECHNICAL SERVICES Form No : GFTS-MR-DHSEI-FM-01

Rev No. : 00
DAILY HSE INSPECTION Issue Date : Feb 2018

Date: __________________ Project/Area :____________________

This report follows a safety inspection of the above Project/Area on the date stated, the items indicated by a (X) are
Commented upon.
1. EXCAVATION 4. PLANT & EQUIPMENT 7. HOUSEKEEPING
Adequate access provided? Safe working condition? Project site tidy?
Barrier in place? Safety guard in place? Materials storage area tidy?
Shoring /benching provided? Periodical maintenance? Material stacks secured?
Safe to work inside? Any leaks or spillage spotted? Timber de-nailed?
Soil stored clear of edge? Safe & secured position? All working area clean/safe?

2. WORKING AT HEIGHT 5. LIFTING OPERATIONS 8. WELFARE FACILITIES


Working platform provided? Lifting gear condition? Toilets clean?
G/rails & toe boards in place? Suitable for the job? Drinking water hygienic?
Ladders provided /secured? Banks man present? Washing area clean?
Bearing of std adequate? Tag lines provided? Rest shed provided/clean?
Bracing or ties in place? Adequate slinging? Canteen areas clean?
Safety harness provided & used? Color coded?

3. ELECTRIC TOOLS & SUPPLY 6. PERSONAL PROTECTIVE EQUIP. 9. OTHERS


110V/AC tools in use? Hard hats worn at all times? Flammables correct storage?
Safe working condition? Eye protection in use? Adequate fire prevention?
Correct socket in use? Ear protection in use? Cylinders stored under shade
Condition of cables? Safety harness in use? Adequate warnings in place?
Grinders fitted with guard? Hand gloves provided & used? Flashback arrestors fitted?
Work permit system in place? Respiratory protection (mask)? Welding Sets terminations?
Action
Action
Item # Observation & comments When Taken
by
Y/N

Status column will be filled by respective HS Officer and a copy of the same will be forwarded to HS department

Safety inspection by Name: Signature:


Designation : Time :

Cc:

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