PPA MONTHLY OHS

REPORT FORM

Please return this form to the PPA Health and Safety team by no later than the first (1st) day
of the new month. If you anticipate delays, please contact the PPA Health and Safety
team immediately.

Port Hedland, Dampier and Ashburton: PPAHealth&Safety@pilbaraports.com.au

Note: Employees include both permanent and casual and contractors directly employed by your organisation.

ORGANISATION
Month: Organisation:

PPA SITE RELATED HOURS

Total employee hours worked: Total subcontractor hours worked:

SAFETY STATISTICS
Have all incidents including injuries Number of Hazards reported:
been reported into PPA’s online
Incident Management System (Yes or
No). If no, they must be entered as
soon as practicable.
Number of Take 5s completed: Number of JHA’s/SWI’s/SWMS:
Number of Workplace inspections: Number of Toolbox/Safety meetings:

Note: Incidents and hazards reported through the PPA incident and hazard management
system will used in PPA’s monthly OHS Reporting. For further information regarding PPA
incident and hazard reporting, refer to the Incident Management Procedure and Hazard
Management Procedure.

REPORT COMPILED BY
Name:
Position Title:
Contact Phone Number:
Contact Email:

PROCESS OWNER
The Health and Safety Director is responsible for this form.
Date approved: 26 August 2022 Review date: 26 August 2024

Version: 10 Approved by: Health and Safety Director

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