DAILY SAFETY CHECKLIST

Location/Site...
Date.......
Name of site Engineer of Main
contractor.
Name of Safety Officer of main
contractor
Description of Jobs (planned on the day)

Use
N
o
1
2
3
4
5

of PPE/Safety Equipment:
PPE
Complianc
e
Safety Helmet
Safety Shoes
Hand gloves
Dust mask
Safety goggles

No

PPE

6
7
8
9
10

Face Shield
Full Body harness
Fall Areest System
Safety net
Life Line with Steel
Wire

Complian
ce

(Item no 1&2 are must for every body specie and ensure use of other safety Equipment as per job
requirement)

(UNSAFE CONDITION NOTICED (BASED ON SITE VISIT)

N
Conditions
o
1 Access to work site/Emergency escape clear.
2 Soil/loose earth kept away from excavated pit/slope/ladder
provided
3 Electrical wire welding lead laying entangled on
ground/welding machine both accessible
4 Elevated work platform/open ends are protected
5 Ground area cordoned-ff before lifting or erection at height
bottom area checked & cordoned.
6 Structural members/erected pipes/are safety anchored at
heights & are not likely to fall down
SAFETY PRECAUTIONS (Including lob Specific)

Yes/No

I have personally checked the above conditions and PPE compliances &
correct status are
inserted after verification. .

(Site Engineer)
Officer)

(Safety

TOOL BOX TALK REPORT

Name of the site: _______________________ Date & Time: __________________
Name of the foreman/supervisor controlling the specific gang/labourers
________________
Number of workmen present: __________________
Type of activities planned (Tick whichever is applicable)

Back filling
Excavation
Bar bending
Material handling(manually/mechanically)
Concreting(PCC/RCC)
Shuttering/De-shuttering
Working at & beyond 2mtr. Height
Welding/Gas cutting/Drilling/Grinding
Alignment of structures
Erection of steel/vessel/Equipment
Brick-works
Cable pulling/cable-laying
House keeping
TO DO

NOT TO DO

Signature of Foreman/Supervisor:_____________________________
Signature of site Engineer of contractor: _______________________________
Signature of Safety officer of contractor:_______________________________

List of Persons working at Height

Height work permit no:
S.N
o

Date

Name(s)
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6
1
2
3
4
5
6

Gate Pass
No.

Sign (Site
Engr.)

RADIATION WORK PERMIT

Project
Name of the work :
Name of contractor
Location of work

Source strength

Sr.No. :
Date :
Job No.:

Cordoned distance (m):

Name of Radiographing agency:
Owner/EIL
No. of workers engaged

Approved

by

The following items have been checked &compliance shall be ensured during
currency of the permit:
S.N
o.
1.
2.
3.
4.
5.
6.

Item Description

Don
e

Safety regulations as per BARC/AERB ensured while source in use/in transit &
during storage
Area cordoned off
Lighting arrangements for working during nights ensured
Warning signs/ flash lights installed
Cold work permit taken (if applicable)
PPEs like film badges, dosimeters used

Additional
precautions,
any_____________________________________________________________

if

(Radiography Agencys BARC/AERB authorized Supervisor)

(Contractors Safety Officer)
Permission is granted
Permit is valid from ___________AM/PM ____________Date to ____________ AM/PM
____________
Date
(Signature of permit issuing authority)
Name :
Permit renewal:
Permit
extended upto
Date
Time

Designation :
Additional precautions
required, if any

Date :
Sign of issuing
authority with date

Work completed/stopped/area cleared at ____________ Hrs of Date ____________

(Sign. of permit issuing authority)

DEMOLISHING/DISMANTLING WORK PERMIT

Project
Name of the work :
Name of contractor

Name of sub-contractor
be engaged:

Sr.No. :
Date :
Job No.:
No. of workers to

Line No./Equipment No./Structure to be dismantled :

Location details of dismantling! demolition with sketch : (clearly indicate the area)

The following items have been checked &compliance shall be ensured during
currency of the permit:
Not
S.N
Item Description
Done
Applicabl
o
e
1.
Services like power, gas supply, water, etc.
disconnected
2.
Dismantling! Demolishing method reviewed &
approved
3.
Usage of appropriate PPEs ensured
4.
Precautions taken for neighbouring structures
5.
First-Aid arrangements made
6.
Fire fighting arrangements ensured
7.
Precautions taken for blasting

(Contractors Supervisor)
Officer)
Permission is granted.
(Permit issuing authority)
Name :
Date :

(Contractors

Safety

Completion report:
Dismantling/Demolishing is completed on ______________ Date at _____________ Hrs.
Materials/debris transported to identified location
applicable)
Services like power, gas supply, water, etc. restored
(Permit issuing authority)

Tagging

completed

(as

VEHICLE FITNESS CHECKING

Car/Jeep/Mini Bus/Bus/Pick-up Van
ITEM DESCRIPTION
YES

S.N.
Documents
1
Valid Driving Licence of Drivers
2
Vehicle Registration document
3
Valid third pay Insurance
Fitness Check
4
Proper Number plate in front & back
5
Name of, contractor & Logo
written in bold on front & back
6
Tyre fitness
7
Clear window view
8
Side mirrors
9
Brakes
10
Parking brakes
11
Horn
12
Reverse alarm
13
Reverse lights
14
Tail light
15
Front head lights
16
Parking lights
17
Brake lights
18
Side indicator lights (front)
19
Side indicator lights (back)
20
No. Tinted Glass

Sign. of Site Eng./Sup.

Sign. of Safety Officer

NO

VEHICLE FITNESS CHECKING

Tractor Trolley
ITEM DESCRIPTION

S.N.
Documents
1
Valid Driving Licence of Drivers
2
Vehicle Registration document
3
Valid third pay Insurance
Fitness Check
4
Proper Number plate in front & back
5
Name of, contractor & Logo
written in bold on front & back
6
Tyre fitness
7
Clear window view
8
Side mirrors
9
Brakes
10
Parking brakes
11
Horn
12
Reverse alarm
13
Reverse lights
14
Tail light
15
Front head lights
16
Parking lights
17
Brake lights
18
Side indicator lights (front)
19
Side indicator lights (back)
20
No. Tinted Glass
21
Trolley fitted with side panel & rear panel

Sign. Of Site Engg. /Sup.

Sign.Of Safety Officer

YES

NO

VEHICLE FITNESS CHECKING

Transmit Mixer
ITEM DESCRIPTION

S.N.
Documents
1
Valid Driving Licence of Drivers
2
Vehicle Registration document
3
Valid third pay Insurance
Fitness Check
4
Proper Number plate in front & back
5
Name of, contractor & Logo
written in bold on front & back
6
Tyre fitness
7
Clear window view
8
Side mirrors
9
Brakes
10
Parking brakes
11
Horn
12
Reverse alarm
13
Reverse lights
14
Tail light
15
Front head lights
16
Parking lights
17
Brake lights
18
Side indicator lights (front)
19
Side indicator lights (back)
20
No. Tinted Glass
21
Condition of brakes on drum
22
All moving parts with guards

Sign. Of Site Eng. /Sup.

Sign. Of Safety Officer

YES

NO

VEHICLE FITNESS CHECKING

Dumpers/Trucks
ITEM DESCRIPTION

S.N.
Documents
1
Valid Driving Licence of Drivers
2
Vehicle Registration document
3
Valid third pay Insurance
Fitness Check
4
Proper Number plate in front & back
5
Name of, contractor & Logo
written in bold on front & back
6
Tyre fitness
7
Clear window view
8
Side mirrors
9
Brakes
10
Parking brakes
11
Horn
12
Reverse alarm
13
Reverse lights
14
Tail light
15
Front head lights
16
Parking lights
17
Brake lights
18
Side indicator lights (front)
19
Side indicator lights (back)
20
No. Tinted Glass
21
Dumper back door/flaps

YES

Sign. of Site Eng./Sup.

Sign. of Safety Officer

VEHICLE FITNESS CHECKING

NO

JCB/Excavator
ITEM DESCRIPTION

S.N.
Documents
1
Valid Driving Licence of Drivers
2
Vehicle Registration document
3
Valid third pay Insurance
Fitness Check
4
Proper Number plate in front & back
5
Name of, contractor & Logo
written in bold on front & back
6
Tyre fitness
7
Clear window view
8
Side mirrors
9
Brakes
10
Parking brakes
11
Horn
12
Reverse alarm
13
Reverse lights
14
Tail light
15
Front head lights
16
Parking lights
17
Brake lights
18
Side indicator lights (front)
19
Side indicator lights (back)
20
No. Tinted Glass
JCB/Excavator
1
Roof lights fitted in front back
2
Drivers cabin with floors & Glass
3
Drivers seat rotating type

YES

NO

Sign. of Site Eng./Sup.

Sign. of Safety Officer

VEHICLE FITNESS CHECKING

Tyre mounted crane
ITEM DESCRIPTION

S.N.
Documents
1
Valid Driving Licence of Drivers
2
Vehicle Registration document
3
Valid third pay Insurance
Fitness Check

YES

NO

4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Sign.

Proper Number plate in front & back

Name of, contractor & Logo
written in bold on front & back
Tyre fitness
Clear window view
Side mirrors
Brakes
Parking brakes
Horn
Reverse alarm
Reverse lights
Tail light
Front head lights
Parking lights
Brake lights
Side indicator lights (front)
Side indicator lights (back)
No. Tinted Glass
Valid load test certificate.
Due date of testing written
Hooks fitted with safety latches.
SWL written on crane
Load Chart in the operator cabin
Boom angle indicator
Outriggers in working condition
Boom Over load limit switches & alarm
working
Hoist over limit switch working
Operator with Adequate Knowledge.
Guard provided on moving parts
General condition of the crane
of Site Eng./Sup.

Sign. of Safety Officer

VEHICLE FITNESS CHECKING

Crawler Crane
S.N.
ITEM DESCRIPTION
Documents
1
Valid Driving Licence of Drivers
2
Vehicle Registration document
3
Valid third pay Insurance
Fitness Check
4
Proper Number plate in front & back
5
Name of, contractor & Logo
written in bold on front & back
6
Tyre fitness
7
Clear window view
8
Side mirrors
9
Brakes
10
Parking brakes
11
Horn
12
Reverse alarm
13
Reverse lights
14
Tail light
15
Front lights
21
Valid teat certificate from pent agency
22
Next Due date of test written on the crane
23
Max Safe working load written
24
Hook fitted with safety latches
25
Hoist limit switches & alarm are working
26
Boom limit switch & alarm working
27
Load Chart/Load indicator provided
in the operator cabin
28
Operator Cabin with proper arrangement
29
All moving parts fitted with guards
30
Knowledge of the crane operator
adequate for operation of crane
31
General condition of the crane
Sign. of Site Eng./Sup.
Sign. of Safety Officer

YES

NO

SAFETY CHECKS FOR WELDING GENERATORS

Equipment Make:
Equipment Model:
Sr.No.:
S.N
o.
1
2
3
4
5
6
7
8
9

Date:

Item

Status

Remarks

All safety guards on moving parts are in

place
All cables are provided as per load
requirements
Condition of tyres.
Wiring with proper clamps etc.
Condition of Engine.
Engine exhaust without leak and
damage.
Availability of fire Extinguisher near by.
Provision of earthing proper with clams
etc.
Other Remarks.

Above Welding generator found (

) suitable (

) not suitable for use at

construction site.
Site Engineer
(Main contractor)
Name:
Signature:

Safety officer
(Main contractor)
Name:
Signature:

(Sticker shall be displayed on machine if it is found suitable for use)

SAFETY CHECKS FOR GAS CUTTING SET

Equipment Make:
Equipment Model:
Sr.No.:
S.N
o.
1
2
3
4
5
6
7
8
9
10

Date:

Item

Status

Remarks

Gas cylinder color as per code

Flash back arrester provided
Cylinder valves are 1SI marked.
Valve keys available.
Both hoses free from joint bums and
cracker.
Proper caps provided at both ends of
hoses.
Color of hoses proper:
Oxygen-Black Acetylene-Red
Length of both hoses should be equal.
Proper goggles and leather hand gloves
available.
Other Remarks.

Above portable gas cutting set found (

) suitable (

) not suitable for use at

construction site.
Site Engineer
(Main contractor)
Name:
Signature:

Safety officer
(Main contractor)
Name:
Signature:

(Sticker shall be displayed on machine if it is found suitable for use)

SAFETY CHECKS FOR PORTABLE GRINDING MACHINE/TOOL

Equipment Make:
Equipment Model:
Sr.No.:

S.N
o.
1
2
3
4
5
6
7
8
9

Date:

Item

Status

Remarks

Proper wheel guard provided

All body covers/electrical insulation in
sound condition
Three core electrical cable provided.
Electrical plug top provided.
Provision of earthing.
Cable without joint and sound condition.
Wheel RPM matches with machine RPM.
Availability of face shield and gloves for
grinder.
Other Remarks : (If any)

Above portable grinding machine found (

) suitable (

) not suitable for use

at construction site.
Site Engineer
officer
(Main contractor)
Name:
Signature:

Safety

(Main contractor)
Name:
Signature:

(Sticker shall be displayed on machine if it is found suitable for use)

SAFETY CHECKS FOR LIFTING TOOL AND TACKLES

Equipment Make:
Equipment Model:
Sr.No.:
S.N
o.
1

2
3
4
5
6
7
8

Date:

Item

Status

Remarks

Proper and valid load test certificate

available from authorized representative of
chief inspector of factories.
Maximum safe working load displayed on
equipment in Kg.
All guard such as guard over gear, rotating
shaft etc. are in place.
Wire rope without kinks/loose or broken
strands/excessive wear.
Chain/hook without physical damage.
Date of last load test done.
Next testing due on
Other Remarks : (If any)

Above lifting tolls and tracks found (

) suitable (

) not suitable for use at

construction site.
Site Engineer

Safety officer

(Main contractor)
Name:
Signature:

(Main contractor)
Name:
Signature:

(Sticker shall be displayed on machine if it is found suitable for use)

SAFETY CHECKS FOR WELDING MACHINE/DG SET

Equipment Make:
Equipment Model:
Sr.No.:
S.N
o.
1
2
3
4
5
6
7

Date:

Item

Status

Remarks

All body covers/electrical insulation in

sound condition.
Electrical cables without joints.
Cables including welding & ground cable
without worn out or cracker insulation.
Earthing arrangement proper.
Availability of proper face shield and
leather gloves for welder.
Condition of welding holder and its
insulation.
Other Remarks :

Above portable welding machine found (

at construction site.

) suitable (

) not suitable for use

Site Engineer
(Main contractor)
Name:
Signature:

Safety officer
(Main contractor)
Name:
Signature:

(Sticker shall be displayed on machine if it is found suitable for use)

ELCB TEST REGISTER

Name of the Site:_____________

Date

of

Testing:

_____________

S.N
o

ELCB No.

Exact
Location

Brief
details
of
Equipme
nts
connect
ed

Test
resul
t

ELCB
Ratin
g
(Amp
s)

Leaka
ge
Curren
t (mA)

Remar
ks

(Signature of Electrical Engineer)

(Signature

of HSE Officer)
Name:

Name:

ELECTRICAL INSTALLATION CHECKLIST

Name of Main Agency____________________
Date____________
Location/panel no/Substation No___________________
Time____________
Inspected By _______________________
S.No

Description

Switchboards installed properly in order to be protected

from rain and water logging.
All incoming and out going feeders have MCCB/Switch
and IC fuse of proper rating.
Switch boards are of industrial type.(Wooden not
allowed)
Switchboards earthed at two points.
Switch boards have adequate operating space hi front.
Adequate illumination provided for switch board
operation during night hours.
Labeling of Incoming and outgoing feeders done.
All incoming and out going cables are properly glanded
and terminated with lugs.
Danger plates and shock treatment chart displayed.
Fire Extinguisher (IDCP/Co2) and sand buckets kept near
switchboards.
Rubber mats of proper voltage rating provided in front
of Switch board.
All temporary connections provided through ELCB of
30mA rating.
Plug and socket units used are of industrial type.
Temporary cables-are three core double insulated and
free from cuts and joints & third core is earthed at both
ends.

2
3
4
5
6
7
8
9
10
11
12
13
14

Yes

No

Remark
s

15
16
17
18
19
20
21
22
23
24
25

Socket boards for temporary are properly mounted on

stand and protected from water ingress.
All hand lamps are of 24 volts supply.
All electrical equipments operating on 415 volts shall
have Two earthings.
Weekly testing of ELCBs done and records available at
site.
Name and mobile No of licensed electrician/wiremen
displayed at work site and all electricians wearing
yellow helmet with red band.
Cable route markers of U/G cables provided.
Monthly inspection report of hand tool done and records
available at site.
Overall single line electrical drawings/sketch available
at site.
Rubber hand gloves available at site.
Availability of CAUTION Boards for shutdown/repairing
work.
Sealing of unused holes in switch boards done.

Inspection done by.

Name &Signature
Electrical Engineer.
Officer
(Main Contractor)

Name &Signature
Safety
(Main contractor)

DETAILS OF FIRST AID BOX

S.N
o
1

Description
Small size Roller Bandages, 1 Inch Wide

Medium size Roller Bandages, 2liiches Wide

Large size Roller Bandages, 4 Inches Wide

Large size Burn Dressing

5
6

Cotton Wool
Antiseptic Solution Dcttol (100 ml) or
Savalon
Mercurochrome Solution (100 ml) 2% in
water
Sal-volatile (20 ml. Amonia)
A pair of scissors
Adhesive Plaster (1.25 sms. x 5 Mtr.)
Eye pads in Separate Sealed Pkt.
Tourniquet
Tine IODINE (100 ml.)
Polythene-Wash cup for washing eyes
Potassium Permaganate (20 gms.)
Tinc. Behzoine (100 ml.)
Triangular Bandages
Band Aid Dressing
Iodex/move spray
Tongue Depressor
Boric Acid Powder (20 gms.)
Sodium Bicarbonate (20 gms.)
Dressing Powder (Nebasulf) (10 gms)
Medicinal Glass
Duster
Booklet (English & Local Language)
Soap
Toothache Solution
Vicks (22 gms.)
Forceps
Cotton Buds (5 Nos.)
Note Book
Splints
Lock
Life Saving/Emergency/Over-the counter
Drugs

7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35

Note : Type of Box

Size

Quantity
(Finger Dressing
small)
(Hand & Foot
Dressing)
(Body Dressing
Large)
(Burn Dressing
Large)
(20 gms packing)

6 Pcs.
6 Pcs.
6 Pcs.
4 Pkts.
4 Pkts
1 Bottle
1 Bottle
1 Bottle
1 Piece
1 Spool
4 pcs.
1 no
1 bottle
1 no.
1 pkt
1 bottle
2 nos
5 pcs
1 bottle
1 no
2 pkt
1 pkt
1 bottle
1 no
1 no.
1 no. each
1 no.
1 no.
1 bottle
1 no.
1 pkt
1 no.
4 nos.
1 piece
As decided at
site

Aluminium
14x12x4