Contractor name

Contractor
LOGO
LIST OF OPERATION CONTROL CHECKLIST - SAFETY

OCC NO. OPERATION CONTROL CHECKLISTS PERIODICITY

1 Builder Hoist Inspection Checklist Weekly

2 Passangers Hoist Inspection Checklist Weekly

3 Gantry Crane Inspection Checklist Weekly

4 Tower Crane Inspection Checklist Weekly

5 Mobile Crane Weekly Inspection Checklist Weekly

6 Diesel Generator Inspection Checklist Weekly

Weekly / Before
7 Scaffolding and Staging Inspection Checklist
engaging to work

8 Mobile Scaffolding Inspection Checklist Weekly

9 Ladder Inspection Checklist Weekly

10 Routine Vehicle Inspection Checklist - Weekly Weekly

11 ELCB/RCB/MCCB/Weekly Inspection Checklist Weekly

12 Electrical Inspection Checklist Fortnight

13 Equipment Inspection Checklist Fortnight

14 Power Tools Inspection Checklist Fortnight

15 Hand Tools Inspection Checklist Monthly

16 Scrap Generation and Utilisation Checklist Monthly

17 Stores Inspection Checklist Monthly

18 Housekeeping Inspection Checklist Weekly

19 Weekly Labor Camp Inspection Checklist Weekly

20 Labor camp after Installation Checklist New setup

21 Fire Extinguisher Inspection Checklist Fortnight

22 Safety Belt and Lifeline Rope Inspection Checklist Weekly

23 Cutting Machine Inspection Checklist Weekly

24 Gas Cutting Set Inspection Checklist Weekly

25 Welding Machine Inspection Checklist Weekly

26 Batching Plant Safety Inspection Checklist Weekly

27 Piling Work Inspection Checklist Weekly

 Weekly /Every
28 Lifting Bucket Inspection Check list
location change
Note: Fortnight means once in two weeks.
 Doc. No. Rev. Date Page
LOGO CONTRACTOR NAME
RBIPL/OCC. 01 00 01.04.17 1 of 1

BUILDERS HOIST INSPECTION CHECKLIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT:

DATE:_____________________________ LOCATION:________________________________________

HOIST IDENTIFICATION
Yes
S.no Inspection Points /No / Remarks
NA
1 Whether hoist is supported by strong structure?

2 Whether over height control limit switch provided?

3 Whether hoist movement area is protected and covered by safety net?

4 Whether platform is good condition?

5 Whether moving platform is guarded to prevent material fall?

6 Whether moving platform is running without jerk?

7 Whether hoist entry points contain gate?

8 Whether hoist rope free from damage?

9 Whether prime mover (electrical motor or DG) is fixed firmly?

10 Whether prime mover is running without abnormal noise?

11 Whether the movement area is protected to prevent trip & fall hazard?

12 Whether the operator is trained?

13 Whether SWL is displayed?

14 Whether materials weight chart for safe lifting is displayed?

15 Whether III party Competent person certification is obtained with validity date?

16 Whether worker’s awareness posters display in the area?

Comments: Builder’s hoist is Suitable / Not suitable to operate.

P&M Representative Safety Engineer/Supervisor

Name: Name:
Signature Signature:
LOGO
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 02 00 01.04.17 1 of 1

PASSENGER'SHOIST INSPECTION
Issue No/Date 01/01.04.17
CHECKLIST
NAME OF THE PROJECT:

DATE:_____________________________ LOCATION:________________________________________

HOIST IDENTIFICATION

S.no Inspection Points Yes /No / Remarks

NA
1 Whether hoist is supported by strong support?

2 Whether hoist movement area is protected?

3 Whether over hoist limit switch fixed and working condition?

4 Whether moving platform is guarded to prevent human fall?

5 Whether car door limit switches are functioing?

6 Whether floor limit switches are functioninig?

7 Whether SWL / No. of persons travelling display inside the car?

8 Whether car movement bell is available?

9 Whether car emergency alarm is available?

10 Whether car is running without abnormal noise?

11
Whether passenger hoist weekly preventive maintenance work is carried out?
12 Whether hoist rope free from damage?

13 Whether prime mover (electrical motor or DG) is fixed firmly?

14 Whether prime mover is running without abnormal noise?

15 Whether the rope movement area is protected to prevent trip & fall hazard?

16 Whether the operator is trained?

17 Whether III party Competent person certification is obtained with validity date?

18 Whether dos and don't display at hoist area of inside the car?

Comments: Passenger's hoist is Suitable / Not suitable to operate.

P&M Representative Safety Engineer/Supervisor

Name: Name:

Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 03 00 01.04.17 1 of 1

GANTRY CRANE INSPECTION CHECK

Issue No/Date 01/01.04.17
LIST
NAME OF THE PROJECT: DATE:

Location: Crane Identification no:

Yes
S.no Inspection Points Remarks
/No / NA
1 Is hook latch available on the hook?

2 Is abnormal erosion in the hook?

3 Is any damage noticed on the lifting rope?

4 Are all the limit switches are working condition?

5 Is gantry movement siren working condition?

6 Is operator eye fitness OK?

7 Whether person engaged on other side for safety purpose?

8 Are moving rails good condition?

9 Are track end limit switches are working condition?

10 Is communication media working well?

11 Is there any abnormal noise from hoist?

12 Is there any abnormal noise from gantry movement?

13 Is any over loading of crane takes place?

14 Is lifting sling / hooks using in gantry crane safe?

15 Is SWL visibly displayed?

Comments:

Equipment is Fit / Unfit to operate

P&M Representative Safety Engineer/Supervisor

Name: Name:

Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 04 00 01.04.17 1 of 1

TOWER CRANE INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT: DATE:

Location: Crane Identification:

S.no Inspection Points Yes/No/NA Remarks

1 Is hook latch available on the hook?

2 Is any abnormal erosion in the hook?

3 Is any damage noticed on the lifting rope?

4 Are all the limit switches are working condition?

5 Is load chart displayed?

6 Is operator health fitness & vision fitness OK?

7 Is signal man Trained?

8 Is signal man wear reflective jacket?

Is there any communication media between operator and signal
9
man?
10 Is communication media working well?

11 Is access to tower crane is clear?

Is there fall grap arrestor provided while climbing to tower crane
12
operator cabin?
13 Is any over loading of crane takes place?

14 Is Aviation lamp working condition?

15 Is lifting sling using in tower crane safe?

16 Is SWL visibly displayed?

17 Is there Preventive maintenance carried out?

18 Third party competent person certificate renewal date

19 Is there any other points?

Comments:

The above inspected Tower Crane is Fit / Unfit to operate

P&M In-Charge Safety Engineer/Supervisor

Name: Name:
Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 05 00 01.04.17 1 of 1

MOBILE CRANE WEEKLY INSPECTION

Issue No/Date 01/01.04.17
CHECK LIST
NAME OF THE PROJECT: DATE:

Location: Crane Identification no:

Observation (OK/Not
S.no Inspection Points Measures
OK)
1. Hook and Hook Latch
2. Over-Hoist Limit Switch
3. Boom-Limit Switch
4. Boom Angle indicator working
5. Boom-Limit cut-off switch working
6. Condition of boom
7. Condition of Ropes
8. Size and condition of the sling suitability
9. Stability of crane
10. Soil Condition
11. Swing Brake & Lock
12. Propel Brake & Lock
13. Hoist Brake & Lock
14. Boom Brake & Lock
15. Main clutch
16. Leakage in hydraulic cylinders
17. Out riggers fully extendible
18. Tyre pressure
19. Condition of Battery and Lamps
20. Guards of moving parts
21. Load chart provided
22. Reverse horn
23. Crane load test certificate &Operators Fitness Renewal date:
24. Fire Extinguisher in operators cabin
25 Any other defects?
26 Whether the crane fit to run? Yes / No
P&M Representative Safety Engineer/Supervisor
Name: Name:
Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 06 00 01.04.17 1 of 1

DIESEL GENERATOR INSPECTION

Issue No/Date 01/01.04.17
CHECKLIST
NAME OF THE PROJECT:

DATE:_____________________________ DG SET LOCATION:________________________________________

Yes
S.no Inspection Points /No / Remarks
NA
1 Whether the continuity and tightness of earth conductor are checked?

2 Whether Earth leakage relay (ELR) fitted and tested?

3 Whether MCB / OLR fitted in DG set?

4 Whether earth resistance is checked or measured ? (Mention the value)?

5 Is DG provided under shed / cover?

6 Whether entry is restricted into the DG room?

7 Whether the cables are covered or routed under the ground or over the head
level?

8 Is insulation provided on the battery terminals?

9 Is thermal insulation done for the DG exhaust?

10 Whether stack height is maintained as per Environment requirements given in

procedure manual?

11 Whether DG exhaust is diverted out side the shed?

12 Are all the rotating parts of DG guarded (coupling, radiator fan)?

13 Whether any leakage of fuel / oil in the DG room?

14 Whether DG surrounding is free from flammable material?

15 Whether fire extinguisher / fire buckets with stand are provided?

16 Whether DG is fitted with Acoustics & Noise proof insulations?

17 Whether Emergency OFF button is provided and in working condition?

Comments: (Any nonconformity to be attended by the respective person)

P&M Representative Safety Engineer/Supervisor

Name: Name:
Signature Signature:
 Date Page
CONTRACTOR NAME
1 of 1

SCAFFOLD AND STAGING INSPECTION

Issue No/Date
CHECK LIST
NAME OF THE PROJECT: Pragati, Mondelez Malanpur
DATE:
Location:

S.no Inspection Points Yes/No/NA Remarks

1 Is proper leveling done at the base of the structure?

Are solid base / proper base plates provided at staging base

2
frame?

Is staging structure free from excavation pit or at a safe distance

3
from excavation pit? (3.0 meters away from excavation pit)

4 Is verticality of the structure properly maintained?

5 Are ties of the structure properly maintained?

6 Is the staging properly supported?

7 Is the working platform properly tied?

Is the working platform width maintained 600MM for men only?

8
(Not for material)

9 Is the working platform properly fenced? (Guard rail & Toe board)

10 Is there safe access provided to the working platform?

11 Is there any provision to anchor Safety belt /Life line?

12 Whether scaffolding is tie with every six meter height?

Whether there is no uninsulated electric wire exists within 3m of

13
the working platform of the Scaffold?
Is wooden plank thickness maintained as per standard:
14 i) 1.5meter span - 1.5”thick
ii) 2.6Meter span – 2.0” thick

Is there any hazardous and slippery substances (grease, mud,

15
paint, gravel etc.,) are spilled on and around the scaffold?

Comments:

Site Engineer Safety Engineer/Supervisor

Name: Name:
Signature Signature:
 Doc. No. Rev. Date Page

RBIPL/OCC. 08 00 01.04.17 1 of 1

MOBILE SCAFFOLDING INSPECTION

Issue No/Date 01/01.04.17
CHECK LIST
NAME OF THE PROJECT: DATE:

Location:

S.no Inspection Points Yes/No/NA Remarks

1. Whether the Mobile scaffold number displayed?

2. Whether the scaffolding is stable enough?

3. Whether proper access is available to reach the platform?

4. Whether the platform is sufficiently secured?

5. Whether the platform provide with guard?

6. Whether trolley wheel brake working condition?

7. Whether the wheel properly fixed with scaffold?

8. Whether the Mobile scaffold working floor is free from slope?

9. Whether the scaffold secured with outrigger support ?

Wheather the height of mobile scaffold at height is within four

10
times of the smaller base dimension?

11 Whether the mobile scaffold is suitable to engage the work?

Note 01: In case the mobile scaffold requires to work on edges of the floor, it should be properly secure (tie up) on
stable structure.

Note02:Display 'Safe to Use' board if suitable or Display 'Unsafe to use' board if not suitable.

Note 03: Inspection to be done on weekly basis.

Note 04: Ensure mobile scaffold Base vs Height ratio 1:4

Comments:

P&M Representative Safety Engineer/Supervisor

Name: Name:

Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
00 1 of 1

LADDER INSPECTION CHECK LIST Issue No/Date

NAME OF THE PROJECT: Pragati, Mondelez Malanpur

DATE:
Location (Note: metal ladders alone are permitted to work inside the site) : Location-

In case of usage,
Rungs free from Verticals free from In case of usage, REMARKS(Can be used at site or
Ladder No. placement is
defects defects properly tied up Not)
satisfactory

Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Yes/No Yes/No Yes/No Yes/No Yes/No

Expected rungs Defects:

1. Crack on rungs

2. Bend on rungs

3. Rivet damage or loose

4. MS ladder welding crack

Vertical pole Defects:

1. Visible crack on pole

2. Bend on pole

Position of ladder:

1. Ladder should extend one meter above the landing platform

2. Ladder shall be positioned as 4:1 (Vertical to Horizontal ) 3. rejected ladders are to be tagged as 'not usable'
Inspected by:

Safety Engineer Name & Signature:

 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 10 00 01.04.17 1 of 1

ROUTINE VEHICLE INSPECTION CHECKLIST - WEEKLY Issue No/Date 01/01.04.17

NAME OF THE PROJECT: DATE:

Location:

Insurance Rear view Back door

S.No Vehicle No Driver License Auto.Rev.Horn Indicator light Brake Remarks
expiry mirror condition

Comments:

Inspected by

Name:

Signature
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 11 00 01.04.17 1 of 1

ELCB / RCCB / MCCB WEEKLY

Issue No/Date 01/01.04.17
INSPECTION CHECK LIST
NAME OF THE PROJECT:

DATE:_____________________________

ELCB/RCCB/ MCCB Working/ Not Body Rain

S.no D.B.no Location Remarks
Testing Working Earthing Protection

Note: If ELCB / RCCB / MCB condition / body earthing / rain protection ( rainy time) is not acceptable, don’t permit to lineup the
power. Issue instruction based on the inspection.

Comments:

P&M Representative Safety Engineer/Supervisor

Name: Name:
Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 12 00 01.04.17 1 of 1

ELECTRICAL INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT:

DATE:_____________________________

Yes
S.no Inspection Points Remarks
/No / NA
I CABLES

Whether the condition of Cable is checked and free from physical

1
damage?

2 Are all main Cables, taken either underground / Overhead?

3 Are welding Cables routed properly above the Ground?

4 Are welding & Electrical Cables overlapping?

5 Is any improper joint of Cable wires prevailing at Site?

6 Are any cable end found open on the ground?

II DBs / SDBs

7 Is earth conductor continued upto DB / SDB?

8 Whether DBs & extension boards are protected from rain / water?

9 Is there any overloading of DBs?

10 Are correct / proper fuses provided in main boards & sub- boards?

III ELCB

11 Whether the connections are routed through ELCB / RCCB?

12 Is ELCB sensitivity maintained at 30 mA?

13 Are the ELCB numbered & tested periodically & test results recorded?

IV EARTHING

14 Whether proper earthing provided to all the panels?

Is neutral earthing ensured at the source of power (Main DB at Gen. or

15
Transformer)?

16 Whether the continuity & tightness of earth conductor are checked?

 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 12 00 01.04.17 1 of 1

ELECTRICAL INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT:

DATE:_____________________________

Yes
S.no Inspection Points Remarks
/No / NA
17 Mention the value of Earth Resistance.
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 12 00 01.04.17 1 of 1

ELECTRICAL INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT:

DATE:_____________________________

Yes
S.no Inspection Points Remarks
/No / NA
V ELECTRICALLY OPERATED MACHINES / ACCESSORIES
Whether the plug top provided everywhere?
Are all metal parts of electrical equipment’s & light fittings / accessories
grounded?
Is there any shed / cover for welding machines?
Are Halogen lamps fixed at proper places?
Are Portable power tools maintained Equipment Fitness sticker?
VI POWER DISTRIBUTION ROOM / SHED
Is the room maintain good flooring?
Shock proof rubber sheet spread on near the board?
Is danger signage board displayed?
Proper earthing provided for entire distribution board?
Any other information

Comments:

P&M Representative Safety Engineer/Supervisor

Name: Name:
Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 13 00 01.04.17 1 of 1

EQUIPMENT INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT:

DATE:_____________________________ TYPE OF EQUIPMENT:________________________________________

Yes /No /
S.no Inspection Points NA Remarks

1 Whether Machine placement – proper leveling?

2 Whether Machine located free from debris?

3 Whether Machine guards are fixed?

4 Whether Machine noise is under permissible level?

5 Whether Machine OFF /ON button working condition?

6 Whether Emergency OFF button is provided and in working condition?

7 Whether Machine properly earthed?

8 Whether Power supply cable free from damage?

9 Whether Heat from the machine is under control?

10 Whether the operator wear proper PPEs?

11 Whether Machineis operated by trained / experienced person?

12 Whether Machine painting condition is good?

13 Any other points:

Other Observations:

Comments: This equipment is fit / unfit to use in our site premises.

P&M Representative Safety Engineer/Supervisor

Name: Name:

Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 14 00 01.04.17 1 of 1

POWER TOOLS INSPECTION CHECK

Issue No/Date 01/01.04.17
LIST
NAME OF THE PROJECT: DATE:

Location:

S.no Inspection Points Yes/No/NA Remarks

1 Power tool Identification number

2 Is power chord connected with plug top?

3 Is any joint noticed in power chord?

4 Is power chord earth properly connected?

5 Is tool body properly earthed?(In case of metal body)

6 Is proper guarding provided in moving parts?

7 Is the machine operate above the speed limit?

8 Is the tool switch in good operating condition?

9 Any abnormal noise coming from the tool?

10 Whether trained person operate the machine?

11 Is there any damaged part in the tool?

12 Whether this power tool is fit for usage?

13 Name of the user

14 Signature of the user

Comments:

P&M Representative Safety Engineer/Supervisor

Name: Name:

Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 15 00 01.04.17 1 of 1

HAND TOOLS INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT: DATE:

Location:

S.No Inspection Criteria Yes/No/NA Remarks

1 Tool Set Identification

2 Any damaged tools noticed?

3 Whether spanner set mouth expand?

4 Whether proper insulator provided in cutting player?

5 Whether proper insulator provided in tester?

6 Any abnormality noticed in the tools?

7 Any mushroom head noticed in chisel?

8 Any corrosion or erosion noticed in tool?

9 Whether handle fixed properly in hammer?

10 Area person name

11 Area person signature

Comments:

P&M Representative Safety Engineer/Supervisor

Name: Name:

Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 16 00 01.04.17 1 of 1

SCRAP GENERATION, UTILISATION AND

Issue No/Date 01/01.04.17
DISPOSAL CHECKLIST
NAME OF THE PROJECT: DATE:

Location:

Nature of
S.No Area Generated Reused Non usable Scrap Dispatched
Scrap

Wood

Steel

Others1

Others2

Others3

Others4

Remarks: Scrap Accumulated in the area:

Safety Engineer/Supervisor Project In-Charge

Name: Name:

Signature Signature:

Respective Site Engineers:

3
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 17 00 01.04.17 1 of 1

STORES INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT: DATE:

Location:

S.no Inspection Points Yes/No/NA Remarks

1 Are adequate fire extinguishers provided?

2 Whether No smoking board displayed?

Whether flammable materials are stored separately in storage

3
yard with identification marking?
Whether storage of diesel less than 2500 liter/ Petrol less than 30
4 liter throughout the month as per legal? (Write the current
stock).
Whether DA/O2 cylinders are stored vertically with proper
5
protection?

6 Are clear identifications provided for materials stored?

Whether stacking of materials are proper inside the stores and

7
yard?

8 Whether any trip and fall hazard inside the stores?

Are proper access provided to approach the materials in stock

9
yard?

10 Is house keeping inside the stores /stock yard maintained?

11 Whether proper stacking inside the yard maintained?

12 Are empty drums kept separately?

13 Are safety materials stock list available?

14 Any rejected safety material inside the stores?

Whether used paint drums / Thinner are kept safely to avoid

15
land / water contamination?
Whether waste oil stored separately in hazardous waste stock
16
room?
Comments:

Stores In-Charge Safety Engineer/Supervisor

Name: Name:
Signature Signature:
 Doc. No. Rev. Date
CONTRACTOR NAME
RBIPL/OCC. 18 00 01.04.17

HOUSEKEEPING CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT: DATE:

S.no Inspection Points Observation Measures

CIVIL AREA

All approach, aisle, ingress / egress to / from site,

1 excavated pits, ramps, walkways kept clear of
material debris tools etc.
Scaffolding material,(Couplers / APS units /
2 Ledger pipes, clamps, scaffold) shuttering
boards, spans etc. are stacked properly at site.
Stacking of bricks, hollow blocks are done in safe
3
manner.
Nails removed from wooden planks / timber and
4
not protruding out.
Saw dust, wood chips and scrap wood cleared
5
from carpentry shop and disposed suitably.
Debris from demolition and excavated earth
6
cleared from site and accesses

STEEL FABRICATION YARD/ERECTION AREA

All approach, aisle, ingress / egress to / from to

1
the yard and erection area

Stacking of Structural members and

2
reinforcement rods in safe manner.

3 Scraps are collected and stored properly

4 Collected scraps are disposed in proper manner

ELECTRICAL INSTALLATION AND BOOTHS

1 Approach to DB, Panels, Switches kept clear

Fire extinguishers installed at an easy accessible
2
location.
Welding cables and power cables are routed
3
separately.
Routing of cables are done properly to avoid
4
obstruction & tripping hazards.

5 Floor of electrical booths kept dry.

6 Rubber mats are in place at electrical panels.

Page:- 29/47
 Doc. No. Rev. Date
CONTRACTOR NAME
RBIPL/OCC. 18 00 01.04.17

HOUSEKEEPING CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT: DATE:

S.no Inspection Points Observation Measures

STORES

1 Walkways, entry and exits kept clear.

2 Materials placed on racks are safely accessible.

Compressed gas cylinders are segregated as full

3
or empty and type of gas.
Vertically stored cylinders are secured / chained
4 to avoid toppling and horizontal once guarded
against rolling down.
Flammable storage areas are isolated from store,
5
office and work areas.
Cement bags are stacked in proper gradient
6
safely.

Corrosive material (e.g. acids, alkalis) are stored

7 away from other material and kept on collection
trays to safeguard against accidental leakage.

8
Storing area for lifting tools & tackles, ropes,
wire ropes & PPE is dry, clean & free of
corrosive material
9 Easy accessibility to installed fire extinguishers
ensured in store.
GENERAL
1 Separate scrap yard is allocated for the site.
2
Approaches to workstations, offices, time offices,
stores, P&M are well laid and demarcated.

3 Site roads are kept clear of stacked material for

free & safe vehicular movement.
4 Heavy materials stacking are taken care of to
prevent slips, collapse and rolling.
5 Collection and removal of debris from the site.

Comments:

Inspected by (Sign):-

(Inspection report is to be sent to Project in charge for necessary action.)

Page:- 30/47
 Doc. No. Rev. Date Page
CONTRACTOR NAME
RBIPL/OCC. 20 00 01.04.17 1 of 1

WEEKLY LABOR CAMP INSPECTION

Issue No/Date 01/01.04.17
CHECK LIST
NAME OF THE PROJECT: DATE:

S.no Inspection Points Yes/No/NA Remarks

1 Is there good water provided for cooking & drinking?

2 Is drinking water chlorinated?

3 Is drinking water tank properly cleaned?

4 Whether sump is cleaned periodically?

5 Is water stagnating in the labour quarters?

6 Is house keeping properly maintained?

7 Is sufficient waste container provided & maintained?

8 Is there regular disposal of wastage?

9 Whether toilets are kept clean?

10 Free from fly and mosquitoes?

11 Whether electrical points are maintained properly?

12 Is proper cover provided for D.B., SDB? provided?

13 Are Distribution board earthed?

14 Is insertion of loose wire in sockets?

15 Is free lying of electrical cable on ground & conductive materials?

12 Are ELCB/MCB provided & checked?

13 Whether sufficient Fire Extinguishers are provided?

14 Whether First Aid Box is available with medicine?

15 Any other specific points

Comments:
Name & Signature of Safety Engineer / Supervisor Name & Signature of Labor camp in-charge
 Doc. No. Rev. Date
CONTRACTOR NAME
RBIPL/OCC. 21 00 01.04.17

LABOR CAMP AFTER INSATALLATION

Issue No/Date 01/01.04.17
CHECK LIST
NAME OF THE PROJECT: DATE:

S.no Inspection Points Observation Measures

ACCESS & EGRESS
Are the entry roads / walkways / passages to
1
camp kept clear?
Are the walkways & roads are even and free
2
from water logging?

3 Is the entry inside workmen camp restricted?

4 Is Illumination level OK in access / egress?

GENERAL
Are dustbin / garbage bins allocated for each &
1
every colony?
Is the garbage being disposed off on regular
2
basis?
Are the drinking water facilities adequate in the
3
Workmen camp?
Is there any emergency communication system
4
established?
Are Fire Extinguishers & Fire Buckets available
5
and maintained regularly?

6 Are First-aid facilities available?

Whether disinfection activities carried out on

7
weekly basis?
LIVING AREA
1 Whether Cement Flooring provided?

2 Condition of the Side walls / Roof Sheet

Is shelter strong enough to with stand wind

3
pressure?
Whether the electrical connections provided are
4
safe.

5 Is the ventilation of the rooms adequate?

6 Is the illumination of the rooms adequate?

7 Are the doors and windows in good condition?

Is the general hygienic condition of the rooms

8
adequate?
Page:- 33/47
 Doc. No. Rev. Date
CONTRACTOR NAME
RBIPL/OCC. 21 00 01.04.17

LABOR CAMP AFTER INSATALLATION

Issue No/Date 01/01.04.17
CHECK LIST
NAME OF THE PROJECT: DATE:

S.no Inspection Points Observation Measures

KITCHEN
1 Are kitchens kept clean and tidy?
2 Is the water supply adequate for cooking?
Is the garbage of kitchen being disposed off every
3 day?

4 Are the utensils are being cleaned on regular basis?

Are gas cylinders & other flammable materials kept in

5 safe area (away from fire)?
Are suitable regulator, Connecting tube &
6 connections with the cylinder O.K
7 Are fire extinguishers kept out side kitchen?
UTILITIES AREA
1 Are adequate toilets available?

2 Are the toilets are being cleaned on regular basis?

Is there adequate water facility available for toilet

3
and bath?

4 Are the septic tanks and soak pit working properly?

Is area around bathrooms cleaned & kept dry and

5
non slippery?
6 Is proper drainage provided?
7 Is water tank tap not leaking?
8 Is water tank cleaned regularly?
Any Other Information:

Name & Signature of Safety Engineer / Supervisor Name & Signature of Labor camp in-charge

Page:- 34/47
 Contractor Doc. No. Rev. Date Page
Contractor Name
LOGO
00 1 of 1

FIRE EXTINGUISHERS INSPECTION CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT: Pragati, Mondelez, Malanpur DATE:

Choke free Safety Pin

Cylinder free from Label Display Correct Pressure
S.No. F.E. No. Location in Hose Available Remarks
Corrosion (Y/N) (Y/N) (Y/N)
(Y/N) (Y/N)

10

Comments:

Safety Engineer/Supervisor Site in charge

Name: Name:
Signature Signature:
 Doc. No. Rev. Date Page
CONTRACTOR NAME

FULL BODY HARNESS CHECKLIST Issue No/Date

NAME OF THE PROJECT: Pragati, Mondelez malanpur

DATE:

Location:

Safety Belt checking Phenomena:

1. Ensure belt strap free from damage.

2. Ensure Lan yard free from damage

3. Ensure Lan yard splicing sleeve available

4.Any Damage of D, Ring (Rust, Crack)

5. Condition Of Buckel ( Rust, Crack)

###
6. Ensure Snap hook lock safe

7. Ensure the shock absorber are free from damage

8. Any other defects please specify:

No of belt No of belt
S.No Sr. No of Belt Remarks
rejected cleared
RBIPL/MDLZ/FBH/

RBIPL/MDLZ/FBH/

RBIPL/MDLZ/FBH/

RBIPL/MDLZ/FBH/

RBIPL/MDLZ/FBH/

RBIPL/MDLZ/FBH/

RBIPL/MDLZ/FBH/

Comments:

Note:.

Inspected by:

Safety Engineer Name & Signature:

 LOGO CONTRACTOR NAME

CUTTING MACHINE INSPECTION CHECKLIST

2
5

4 3
1

Site Name Location Weekly Inspection

Date of inspection to be noted on every week

DESCRIPTION Yes No REMARKS

SL NO

Cutting Wheel free from Crack and

1
Damage

2 Presence of Cutting machine wheel guard

Presence of locking system for the wheel

3
& Guard

4 Presence of job clamp and its condition

5 Presence of handle and its condition

Cable condition(Any cut,wear etc) and

6
presence of wire plug top

7 Presence of cutting dust guard

FITNESS OF THE MACHINE

If Fit to Use, put a
If Not Fit to Use, put r

Name
Checked by the operator / Responsible
Sign
person including contractor machine
Date

Name
Checked by safety Department
Sign
personal
Checked by safety Department
personal
Date
 Doc. No. Rev. Date Page
CONTRACTOR NAME 00 01.04.17 1 of 1

GAS CUTTING SET INSPECTION CHECKLIST Issue No/Date 01/01.04.17

2 4 5

7
1 6

3
8

Site Name Machine No Weekly Inspection

Date of inspection to be noted on every week

SL NO DESCRIPTION WEEK - 1 WEEK - 2 WEEK - 3 WEEK - 4 WEEK - 5 REMARKS

Pressure gauges two for each

cylinder(inlet & out)are in working
1
condition(both Oxygen & Acetylene
gas)
Flash back arrestor (FBAs) is provided
2
for acetylene & oxygen cylinders

Non return valves (NRVs) is provided

3
for both acetylene & oxygen cylinders.

Tight Crimping of hoses with jubilee

4
clamps.

5 Hose free from damage(cut and cracks )

6 Cylinder secured by chain to the trolley.

7 Trolley tire shall be free from damages.

Availability of industrial type lighter(no

8
match box / commercial lighters).

Cutting area Should be barricaded and

9
warning boards to be displayed.
Cutting area shall be free from debris
10
and flammable materials.
Availability of PPE (Cutting Goggles,
11
Leather gloves Etc.)
Hot Work Permit has been taken for the
12
job.
FITNESS OF THE MACHINE

If Fit to Use, Put a

If Not Fit to Use, Put r
Name
Checked by the operator /
Sign
Responsible person
Date
Name
Checked by the safety department
Sign
personal
Date
 Doc. No. Rev. Date Page

CONTRACTOR NAME 00 01.04.17 1 of 1

WELDING MACHINE INSPECTION

Issue No/Date 01/01.04.17
CHECKLIST

Site Name Location Machine No

6
2 2

5
4 3
8

Description WEEK-1 WEEK-2 WEEK-3 WEEK-4 WEEK-5 REMARKS

Sl. No.
1 ON / OFF knob is provided(Check for
damage and uninsulated knob)

2 Regulator with indicator is provided

3 Welding cables connected to the welding

machine with lugs at the joints

4 No damage in the insulation of welding

cables

5 Electrode rod holder and earthing holder

are without damage

6 Industrial type Plug for power tapping cable

of welding machine

7 No internal live electrical parts of welding

machine is exposed

8 Trolley without damaged wheels

Fire extinguisher and fire bucket with sand

9
availability
Proper earthing has been provided for the
10
machine and job.
Hot Work Permit has been taken for the
11
job
FITNESS OF THE MACHINE
If Fit to use put a

If Not Fit to use put r

Name

Checked By welder Sign

Date

Name
Checked by safety department Sign
personal
Checked by safety department
personal
Date
 Doc. No. Rev. Date Page
CONTRACTOR NAME
00 01.04.17 1 of 1

BATCHING PLANT SAFETY INSPECTION

Issue No/Date 01/01.04.17
CHECKLIST
NAME OF THE PROJECT: DATE:

S.no Inspection Points Yes No N/A Remarks

1 Whether appropriate PPEs isused to workers?
2 Whether First Aid box provided?
3 Whether Fire extinguishers provided?
Whether all the equipments are earthed properly? (Double
4
earthing including silo)

5 Whether rotary / moving parts are guarded at accessible points?

Whether Cautionary, Warning and Awarness Signage boards

6
displayed?
Whether batching plant emergency stop button is in working
7
condition?
8 Whether access to elevated platform was provided?
Whether sufficient illumination provided around batching plant
9
(To be decided in night time)
Whether transit mixer vehicle access route is safe to reach
10
discharge chute?
Whether work permit system followed during batching plant
11
maintenance work?

12 Whether the dust filter cleaned properly and maintained well?

13 Whether the hopper / drum mixer free from spillage?

Whether mixer chute free from spillage during discharge to
14
transit mixer?
Whether the power supply is routed through ELR (Earth Leakage
15
Relay) or ELCB or RCCB?
16 Whether feed hopper ramp sloping is safe?
17 Whether hopper feeding loader contains reverse horn?
18 Whether area is free from stagnation water?
19 Whether dust level is under control?
Whether area has been alloted for keeping waste materials and
20
maintained well?
21 Any abnormal noise noticed?
22 Whether lightening arrestor fitted in Silo?
23 Any other issues if any
Name & Signature of Safety Engineer / Supervisor Name & Signature of Project In-charge
 Doc. No. Rev. Date Page
CONTRACTOR NAME
00 01.04.17 1 of 1

PILING WORK INSPECTION CHECKLIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT: DATE:

LOCATION OF PILING / PILING NO: PILING EQUIPMENT NO:

S.no Inspection Points Yes No N/A Remarks

Whether winch and slings Shackles are certified by III party
1
competent person and checked for free from damage?
2 Whether Excavation permit obtained for the piling area?

Whether tripod is positioned firmly, supported and stable for the

3 work? / In case rotary piling whether the truck positioned stable
with outriggers positioned properly?
Whether tripod and pulley lock pin provided safely? In case of
4
rotary piling whether the structural assembly fixed properly?

5 Whether ‘D’ Shackles with lock pin are provided for hooking?

6 Whether ‘D’ Shackles are free from erosion?

7 Whether moving parts are protected with guards?

Whether Diesel cane is fitted firmly on stand? / In case of

8 electrically motor driven pile, whether the cable routed properly
over the head?
Whether casin point (Drilling point) is protected with sand bags
9
to avoid human fall?
Whether welding machine kept outside the tripod area / truck in
10
case of rotary piling?

11 Whether hot work permit obtained for welding work?

12 Whether bentonite pit protected with hard barricade?

Whether electrical cables removed from the bore point and

13
tripod area?
Whether workers working in the pile work wear safety helmet,
14 safety shoes or gumboots and safety harness above 1.8 m
height?

15 Whether the workers are skilled to work in the piling work?

The above piling checklist points are checked and FIT / NOT FIT for execution.

Signaturehazards
Potential of Sub contractor supervisor
are explained Signature of Site Engineer – Piling work
in the tool box talk for execution.
Signature of Site safety Personal:
 Doc. No. Rev. Date Page
CONTRACTOR NAME
00 01.04.17 1 of 1

LIFTING BUCKET(CONCRETE/ OTHER

MATERIALS/ MEN) - CHECK LIST Issue No/Date 01/01.04.17

NAME OF THE PROJECT:

DATE:_____________________________ LOCATION:________________________________________

BUCKET IDENTIFICATION NUMBER:

Yes
S.no Inspection Points Remarks
/No / NA
If yes, validity till
1 Whether the lifting bucket is certified by third party? ___________
If yes, validity till
2 whether the lifting bucket slings are certified by third party?

3 Whether the lifting bucket is free from corrosion and painted?

Whether the llifting bucket lifting weight (SWL) display in terms of weight /
4
volume?
Whether the lifting bucket hooking points / joints/ legs free from erosion and
5
damage?

6 Whether the lifting bucket bottom platform free from damage?

7 Whether the lifting bucket gate or shutter properly closed?

Whether short guy rope tie on the bucket for proper guidane to keep the bucket
8
in position?

9 Whether tool box talk given to the workers regarding lifting bucket handling?

10 Whether the crane having the capacity to lift the bucket with materials /Men?

11 Whether the lifting bucket landing points are leveled safely?

12 Any other points,

Comments: Lifting bucket is Suitable / Not suitable for operation.

P&M Representative Safety Engineer/Supervisor

Name: Name:

Signature Signature: