NAVI HEALTH AND SAFETY PLAN COMMENTS

SRN DESCRIPTION COMMENTS PROVIDE TIMEFRAME

Submit Safety Policy with
1 Safety Policy signed of the owner of the
company
Provide PPE issuance form
Personal Protective that was signed by
2 employees
Equipment
Conduct PPE Safety
Orientation
Provide names and Table of
3 Safety Committee Organization of safety
committee

Emergency Response Provide names Table of

4 Organization of Emergency
Team
Response Team
5 Minutes of Meeting Submit Minutes of Meeting
form
Incident/Accident Submit Incident/Accident
6
Investigation Report Form
Submit Safety Inspection
Checklist
Submit Safety Findings Form
7 Safety Inspection
Submit Vehicle Equipment
Inspection Checklist
Submit HIRAC / JHA
8 Housekeeping Submit Housekeeping
Inspection Checklist
9 Excavation Submit Excavation Entry
Permit Form
10 Working at Height Submit working at Height
Permit Form
11 Hotworks Submit Hotwork Permit
12 Lockout/ Tagout Lockout/Tagout Form and
Permit
Submit List of Penalties and
13 Disciplinary Policy Sanctions
Violation Ticket
Inspection Tag
14 Fire Extinguisher Provide Fire Extinguisher
Inspection Checklist
15 Trainings Provide List of Trainings and
Schedule
16 Health First Aider
17 Safety Program Submit Safety Program
Submit Working at Height
18 Additonal Safety Forms Form, Hotworks Form,
Lockout Tagout Form,
19 Registration of Provide DOLE Registry of
Establishment Establishment
20 PCAB Provide PCAB License
21 Bulletin Board Provide Bulletin Board
22 Manhour Monitoring Provide Safety Statistics
Report
COMMENTS
REMARKS

Note: Please provide timeframe for each comments and remarks of the status
ks of the status