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THERMAX LIMITED ( POWER DIVISION) Format No :OHS / FT36

SITE SAFETY SEVERITY INDEX REPORT Doc No: OHS / D 36

Rev No. 02

Site Name: Date: 06.07.2018

Location:
Severity Rating Criteria- Audit Team:
1 = Untidy area minor issues sets pool example
2 = Restricted access, unacceptable trash, disorderly
3 = Rule or procedure violation, potential injury

4 = High potential risk: incident likely to happen that can cause serious injury Audit Time:

Note:
5 = Dangerous practices: stop work and correct immediately; will cause fatality / permanent 1. For severity 4 and 5 violations stop the job immediately and rectify the unsafe practice.
disability / Heavy property losses 2. For average severity is 4 and above work at all the locations shall be stopped and corrective actions shall be
taken.

Number
Respon Leading
Personnel Violations
sible Indicators
Observed

Number of

Unsafe Act
Safe Workmen

Unsafe Condition
Thermax Engineer

Contractor

Violators

Violations

Violations x
Severity
4&5

PPE
Observation

Severity
classification Target
Sl No Description (from 4th sheet -
Area Action to be taken Action by
Date
Status
Summary of MIS)

10

11

12

13

14

15

16

17

18

19

SUB TOTAL 0 0 0 0 0 0 0 0 0 0

Percentage of Workmen Observed Working Safely #DIV/0!

Number of Violations 0

Average Severity of Violations #DIV/0!

Number of Severity 4 & 5 Violations 0

Percentage of 4 & 5 Violations #DIV/0!

Approximate Number of Workers Observed 0

Number of People on Site 0

Percentage of Workers Observed #DIV/0!

Formulas used:
Average Severity = ( Violations x Severity ) / Number of Violations.
Percentage of Person observed working safely = Number of safe workmen / ( Number of safe workmen + Violators )
Percentage of 4 and 5 Violations = ( Number of 4&5 Violations) / Number of Violations
Percentage of workers Observed = Number of workers observed / Number of People on site.

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THERMAX LIMITE
SITE SAFETY SEV

Site Name:
Location:
Severity Rating Criteria-
1 = Untidy area minor issues sets pool example
2 = Restricted access, unacceptable trash, disorderly
3 = Rule or procedure violation, potential injury

4 = High potential risk: incident likely to happen that can cause serious injury

5 = Dangerous practices: stop work and correct immediately; will cause fatality / permanent
disability / Heavy property losses

Observation
classification
Sl No Description (from 4th sheet -
Area
Summary of MIS)

6
7

10

11

12

13

14

15

16

17

18

19

SUB TOTAL

Percentage of Workmen Observed Working Safely

Number of Violations

Average Severity of Violations

Number of Severity 4 & 5 Violations

Percentage of 4 & 5 Violations

Approximate Number of Workers Observed

Number of People on Site


Percentage of Workers Observed

Formulas used:
Average Severity = ( Violations x Severity ) / Number of Violations.
Percentage of Person observed working safely = Number of safe workmen / ( Number of safe workmen + Violato
Percentage of 4 and 5 Violations = ( Number of 4&5 Violations) / Number of Violations
Percentage of workers Observed = Number of workers observed / Number of People on site.
ERMAX LIMITED ( POWER DIVISION)
ITE SAFETY SEVERITY INDEX REPORT

Audit Team:

Audit Time:

Note:
ty / permanent 1. For severity 4 and 5 violations stop the job immediately and rectify the unsafe practice.
2. For average severity is 4 and above work at all the locations shall be stopped and corre
taken.

Number
Respon Leading
Personnel Violations
sible Indicators
Observed
Number of
Safe Workmen

Unsafe Condition
PPE
Unsafe Act
Thermax Engineer

Contractor

Violators

Violations

Violations x
Severity
4&5
Severity

Action to be taken
0 0 0 0 0 0 0 0 0 0

#DIV/0!

#DIV/0!

#DIV/0!

0
#DIV/0!

of safe workmen + Violators )

n site.
Format No :OHS / FT36

Doc No: OHS / D 36

Rev No. 02

Date: 06.07.2018

rectify the unsafe practice.


shall be stopped and corrective actions shall be

Target
Action by Status
Date
Total points
Sr. No. Open points closed points Average Severity
observed

Total / Average 0 0 0 #DIV/0!


4-5 Severity points

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