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  • Proforma-I (Counter Check & Check List of Safety Measures)

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    sdo jatli
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    The document is a proforma for counter checking safety measures taken by line staff during emergency or maintenance works on 11kV lines. It lists the name of the subdivision, feeder, or grid station where the work took place. It records the nature and location of the work, the permit to work number and date/time. It contains 9 safety measures that were checked, including the presence of a supervisor, earthing done on both sides, use of safety hats, gloves, shoes, belts, beepers by line staff. It provides spaces to note whether each measure was followed with yes or no and any remarks. The form is signed and dated by the subdivisional officer after checking.

    Original Description:

    Spot checking performa

    Original Title

    Proforma-I (counter check & check list of safety measures)

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    The document is a proforma for counter checking safety measures taken by line staff during emergency or maintenance works on 11kV lines. It lists the name of the subdivision, feeder, or grid station where the work took place. It records the nature and location of the work, the permit to work number and date/time. It contains 9 safety measures that were checked, including the presence of a supervisor, earthing done on both sides, use of safety hats, gloves, shoes, belts, beepers by line staff. It provides spaces to note whether each measure was followed with yes or no and any remarks. The form is signed and dated by the subdivisional officer after checking.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    2 views1 page

    Proforma-I (Counter Check & Check List of Safety Measures)

    Uploaded by

    sdo jatli
    The document is a proforma for counter checking safety measures taken by line staff during emergency or maintenance works on 11kV lines. It lists the name of the subdivision, feeder, or grid station where the work took place. It records the nature and location of the work, the permit to work number and date/time. It contains 9 safety measures that were checked, including the presence of a supervisor, earthing done on both sides, use of safety hats, gloves, shoes, belts, beepers by line staff. It provides spaces to note whether each measure was followed with yes or no and any remarks. The form is signed and dated by the subdivisional officer after checking.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    PROFORMA FOR COUNTER CHECKING OF SAFETY MEASURES TAKEN BY LINE STAFF DURING

    EMERGENT / MAINTENANCE WORKS ON 11 KV LINES


    Name of Sub Name of Nature / Location PTW No. / Date Safety Measures Checked
    Division / Supervisor of Work / Time S. Safety Measures Remarks
    Feeder / Grid No. Yes / No
    Station
    01 Presence of Supervisor
    02 PTW taken
    03 Earthing done on both
    sides
    04 Safety Hat used by line
    staff
    05 Leather / Rubber Gloves
    used by line staff
    06 Safety Shoes used by line
    staff
    07 Safety Belt used by line
    staff
    08 Beeper used by line staff
    09 Other safety measures
    adopted

    Name / Signature of SDO


    Date: _________
    Time: _________

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