Doc No:CORP-EHS-F-17

CUSTOMER FEEDBACK FORM FOR

Date:11/01/2024
EHS PERFORMANCE Rev. No: 01
Please indicate your satisfaction level of our EHS performance with respect to the following indicators.
Performance Year: 2023-2024
BU:
WO No & Project : 4300075643
Date of Assessment:11.01.2024
Assessment from : 13th January 2023 Assessment to: 11th January 2024
Key Performance Rating
Indicator Remarks
area (Selection)
Performance of the project team to adopting / managing the EHS requirement of the client.
Performance
Ensuring continual improvement of EHS performance through adopting the best practices.
Commitment
Ownership of EHS implementation by line management of project team.
Strength of site EHS organization.
Performance of Project team to managing emergency situations.
Utilization of Active and Passive fall protection system during height work.
Enforcement of PPE Compliance.
Visualization of EHS awareness at site.
Quality of Medical facilities and First Aid facility at site.
Performance
Periodic inspection ,maintenance and monitoring of Plant,Equipment,Machineries & lifting tools
tackles.
Pre-job Planning with consideration of EHS requirements in the activity.HIRA and EIA of all
activity before start the work.
Adequate arrangement at workmen camp.
Adherence of Legal requirements.
Regularly communicating,Educating and imparting training on environment,health,safety and
Training & hygiene to all employee ,contractor and contractor’ workers.
awareness Effectiveness of EHS induction to new joinee / Visitors.
Effectiveness of periodic promotional activities.
Overall skill level (Knowledge, skill, development and handling ability) of EHS personnel.
Overall effectiveness of Project team as a service provider being cooperative, collaborative,
Competency effectively resolving your EHS requirements.
Competency level of the equipment operator (Crane,Hydra,JCB,Excavator…)
Performance of Project team in identifying innovative ideas to achieve EHS objectives.
Total

Rating : 1 to 5
(1 : Unsatisfactory 2 : Below Expectation 3: Meets Expectation 4: Exceeds Expectation 5: Outstanding)

Please mention any EHS concerns which you have observed

Please suggest how we can meet your expectation and improve our EHS effectiveness

Name of the customer

Stamp of the
Organization
customer 's organization

Contact Details

THANK YOU VERY MUCH FOR YOUR TIME AND YOUR COOPERATION