Safety Checklist for Site Supervisors
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Mohamed RizwanSafety Checklist for Site Supervisors
Uploaded by
Mohamed RizwanDAILY SAFETY INSPECTION CHECKLIST
Tank No : Contract No :CA-4079
Date : Scope of Work :
Permit Number : No of workers :
YES NO NA REMARKS
1 Availability of valid Work Permit
2 Availability of Risk assessment & Blind list
3 Toolbox Talk Topic conducted
4 Availability of CS Authorization & Log book
5 Availability of valid CS Entrant & Attendant card
6 Availability of valid Safety Certificate
7 Availability of fire hydrant authorization/ water filled in drums
8 Combustible materials removed/covered with Fire Blanket
9 Availability of Valid fire extinguisher & Fire Watch
10 Availability of Excavation authorization
11 Availability of protective barricade for excavation
12 Availability of appropriate scaffold tag
13 Proper use of safety harness with double lanyard
14 Availability of Air filter & Valid Breathing Certificate
15 Proper use of Air filter & Hoses & Whip lash arrestor
16 Availability of proper earthing for Equipment
17 Availability of sufficient illumination
18 Availability of ELCB
19 Proper use of PPE & H2S monitor
20 Housekeeping conditions are satisfied
Pre-start Check by:
Site Supervisor ID: Name : Signature:
SAFETY SUPERVISOR OBSERVATION:
Inspect by: Acknowledge by: Review by:
Safety Supervisor ID: Site Supervisor ID: Safety Engineer ID:
Name: Name: Name:
Signature: Signature: Signature:
DAILY SAFETY INSPECTION CHECKLIST
Tank No : Contract No : CA-3913
Date : Scope of Work :
Permit Number : No of workers :
YES NO REMARKS
1 Availability of valid work permit / CS authorization
2 Availability of risk assessment / Blind list
3 Toolbox Talk Topic conducted
4 Availability of valid CS entrant / attendant card
5 Availability of Log book for confined space entry
6 Availability of valid safety certificate
7 Availability of fire hydrant authorization/ water tanker
/ water filled in drums
8 Availability of Fire blanket & valid fire watch card
9 Availability of fire extinguisher with valid sticker
10 Availability of Excavation authorization
11 Availability of protective barricade for excavation
12 Availability of appropriate scaffold tag
13 Proper use of safety harness with double lanyard
14 Proper use of Air filter / Hoses / Whip lash arrestor
15 Availability of Air filter & Valid Breathing Certificate
16 Availability of proper earthing for Equipment
17 Availability of sufficient illumination
18 Availability of ELCB
19 Proper use of PPE /H2S monitor/ FR Coverall
20 Housekeeping conditions are satisfied
Site Supervisor
Employee ID: Name : Signature:
SAFETY SUPERVISOR OBSERVATION:
DSIC- (V-3)
Safety Supervisor Site Supervisor Safety Engineer
Employee ID: Employee ID: Employee ID:
Name: Name: Name:
Signature: Signature: Signature:
DSIC- (V-3)
DAILY SAFETY INSPECTION CHECKLIST
Tank No : Contract No : CA-3913
Date : Scope of Work :
Permit validity : No of workers :
YES NO REMARKS
1 Availability of valid work permit / CS authorization
2 Availability of risk assessment / Blind list
3 Toolbox Talk Topic conducted
4 Availability of valid CS entrant / attendant card
5 Availability of Log book for confined space entry
6 Availability of valid safety certificate
7 Availability of fire hydrant authorization/ water tanker
/ water filled in drums
8 Availability of Fire blanket & valid fire watch card
9 Availability of fire extinguisher with valid sticker
10 Availability of Excavation authorization
11 Availability of protective barricade for excavation
12 Availability of appropriate scaffold tag
13 Proper use of safety harness with double lanyard
14 Proper use of Air filter / Hoses / Whip lash arrestor
15 Availability of Air filter & Valid Breathing Certificate
16 Availability of proper earthing for Equipment
17 Availability of sufficient illumination
18 Availability of ELCB
19 Proper use of PPE /H2S monitor/ FR Coverall
20 Housekeeping conditions are satisfied
Other Observations
Site Supervisor Safety Supervisor
Employee ID: Employee ID:
Signature: Signature:
Date: Date:
DAILY SAFETY INSPECTION CHECKLIST
Tank No : Type of Work :
Date : Man Power :
Job started at : Job closed at :
YES NO REMARKS
1) Availability of permit box
2) Availability of valid permit / authorization
3) Availability of valid confined space entrant card
4) Availability of valid attendant card
5) Availability of Log book for confined space entry
6) Availability of valid safety certificate
7) Availability of fire hydrant authorization
8) Availability of valid fire watch card
9) Availability of barrication for excavation
10) Availability of risk assessment
11) Availability of all blind list
12) Availability of appropriate scaffold tag
13) Availability of fire extinguisher with valid sticker
14) Availability of whip lash arrestor
15) Availability of proper earthing for Equipment
16) Availability of 24V light inside the confined space
16) Tripping hazards controls
17) Availability of ELCB
18) Use of proper PPE
19) House Keeping
20) Toolbox Talk Topic conducted
Other Observations
Site Supervisor Safety Supervisor
Employee ID: Employee ID:
Signature: Signature:
Date: Date: