Project No.

Document No.

Revision No. 0
MONTHLY HSE REPORT Date:
Page : -1-

TO: Project Manager: Date:

Month: Serial No:

PROJECT NAME: Report No:

Sub-Contractors Contractor Total.

1. Total employees on site – Daily average

2. First-Aid Cases

3. Reportable Accidents

4. Near Misses

5. Lost Time Accidents

6. Days Lost due to reportable accidents

7. Total Man-hours worked

(MEDMAC & Sub-contractors.)

8. Tool-box meetings (workforce)

9. Safety meetings

_____________________

Lead HSE Engineer

C.C: CM / PC