The following EHS document templates (toolkits) are provided totally complimentary, free of charge to use as a starting point for ISO 14001:2015 and 45001:2018 compliance. These are the actual EMS documents currently in use for compliance with ISO 14001:2015 and 45001:2018 requirements. As each business is different, additional EHS documents or revisions would be required to meet your organization’s specific needs, requirements, context, risk profile, etc. If after reading through all of these documents, you feel like you still need a consulting partner to help you develop your new EHS documents – Contact Us. We’re always looking for interesting new clients and projects.
Aspects And Impacts Analysis Register
Overriding Criteria | Criteria | Total | Activity | |||||||||||
Sr.No. | Activity | Aspect | (R – O – A) | LC | IPC | Impact | SC | SE | Du | De | P | ( S* SE*P*DU *DE) | Significant or Non-Significant | Proposed Controls |
HAZARDS AND RISKS ANALYSIS REGISTER
Activity No. | Process / Activity | Nature Of Activity R/NR/E | Hazard | Likely Hazardous Incidence/ Situation | Risk Involved | Current Risk Control System | Risk Analysis | Risk Factor (AXB) | Is Risk Tolerable | If No, Proposed Risk Control System | |
Likelihood Of Occur (A) | Severity Of Consequence (B) | ||||||||||
SIGNIFICANT ASPECTS AND IMPACTS ANALYSIS REGISTER
Overriding Criteria | |||||||
Sr.No. | Activity | Aspect | (A-O-P-R-C) | LC | IPC | Impact | Controls |
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SIGNIFICANT HAZARDS AND RISKS ANALYSIS REGISTER
Nature Of Activity R/NR/E | Hazard | Likely Hazardous Incidence/ Situation | Risk Involved | Current Risk Control System | Is Risk Tolerable | If No, Proposed Risk Control System |
Targets and Objectives
Sr No | Description of Objectives | EHSMP Description | MP No, Rev No & Date | Present Status | Set Target | Time Frame | Derived From |
Training Plan for the year 2019
Sr. No | Training Topic | Target Group | Jan19 | Feb19 | Mar19 | Apr19 | May19 | Jun19 | Jul19 | Aug19 | Sep19 | Oct19 | Nov19 | Dec19 |
1 | Awareness Training on EOHS Management System. | All employees | ||||||||||||
2 | Awareness Training on EOHS Policy | All employees & Workers | ||||||||||||
3 | Awareness Training on Environmental Legal & Other requirements | Core Team Members | ||||||||||||
4 | Awareness Training on OH&S Legal & Other requirements. | Core Team Members | ||||||||||||
5 | Identification of Aspects & Impact & Evaluation of Environmental aspects. | Core Team Members | ||||||||||||
6 | Awareness Training on Significant Aspects | Core Team Members | ||||||||||||
7 | Identification of Hazard, Risk & Risk assessment | Core Team Members | ||||||||||||
8 | Awareness of Significant Hazard | Core Team Members | ||||||||||||
9 | Awareness of EOHS Objectives. | All employees & Workers | ||||||||||||
10 | Roles, responsibility & authority for effective implementation of EOHS Management System. | Core Team Members | ||||||||||||
11 | Communication with Interested parties | Security | ||||||||||||
12 | Awareness Training on Operational Control procedure. | Respective personnel from all areas | ||||||||||||
13 | Awareness training on Mock Drill | All employees including workers & Interested Parties | ||||||||||||
14 | Awareness training on safety requirement in shop floor during handling of product & Specific requirements | Employees & Workers | ||||||||||||
15 | Fire Fighting | ERT | ||||||||||||
16 | First Aid | ERT | ||||||||||||
17 | Emergency Preparedness & response | ERT | ||||||||||||
18 | Awareness of Handling Chemicals & Oils including Haz waste | Respective personnel | ||||||||||||
19 | Awareness of Material safety data sheet. | Respective personnel | ||||||||||||
20 | Hazardous waste Handling, storage & disposal | Personnel involved in Haz waste handling | ||||||||||||
21 | Waste Management | Workers | ||||||||||||
22 | Storage of oil barrels & used oils. | Workers | ||||||||||||
23 | Spillage management | ERT | ||||||||||||
24 | Identification of environmental Non-conformities. | Supervisors / ERT | ||||||||||||
25 | EOHS Internal Auditors Training | Core Team Members | ||||||||||||
26 | Fork Lift Maintenance | Maintenance | ||||||||||||
27 | Machine maintenance & Handling of different waste | Maintenance | ||||||||||||
28 | Scrap Handling, storage & Maintenance of scrap. | Workers |
Master List of waste
Non-Hazardous Waste ( General Waste) | Hazardous Waste | ||||||
Sr. No | Category | Name of Waste | Department | Sr. No | Category | Name of Waste | Department |
1 | Paper | Corrugated Boxes | QA, PDN, PUR | Oil | All type of Used Oil | PDN, QA, MNT, | |
2 | Toilet Paper | Admin | Used coolant | PDN, Tool Room, SNS, PAD/MFD Machine Shop | |||
3 | Old Records | All Depts. | Grease | Maint, Production | |||
4 | Waste paper & carbon | All Depts. | Oil soaked Gunny Bags | Maint, Production | |||
5 | Packing boxes etc. | QA, PDN, PUR | Oil soaked cotton waste & hand gloves, Cotton Rags | All Depts | |||
6 | Plastic | Packing material of welding rods | Tool Room | Oil filters | Maint | ||
7 | Plastic Articles, Cans | All depts. | Empty oil container | MNT, STR, QA, SNS, Tool Room | |||
8 | Empty water bottle | ALL | Paint Cans | Shipping, Maintenance, QA, Prod | |||
9 | Waste PP belt of packing | PDN, | Used Brushes | Production, Maintenance, TRM, QA | |||
10 | Broken Plastic Bins | STR | Oil Soaked Scrap | Maintenance, Production, QA, HT | |||
11 | Ferrous | Metal Flash | Production | Phosphating Chemicals | Production, QA | ||
12 | Metal End Pieces | SNS | Empty paint marker, permanent marker etc. | STR,PDN,QA | |||
13 | Forgings | QA | |||||
14 | Turning Burr & Boring Burr | Tool Room, SNS | |||||
15 | Welding rods | Tool Room | |||||
16 | Used tooling | Tool Room, Maint | |||||
17 | Maintenance scrap | ||||||
18 | Non Ferrous | Gun Metal Parts | Maintenance | ||||
19 | EDM Wire | Tool Room | |||||
20 | Stainless Steel | Metal Flash | Production | HCL Acid | QA Lab | ||
21 | Metal End Pieces | SNS | Ceramic Wool | HT | |||
22 | Forgings | QA | Choke, Ultra violate lamp, Tube light, all types of bulb, Cells | All Depts | |||
23 | Turning Burr & Boring Burr | Tool Room, SNS | Carbon paper, Printing ribbon, Toner cartridge | All Depts | |||
24 | Maintenance scrap | Maintenance | Magnaflux Powder | QA, Production | |||
25 | HRC Trays | Heat Treatment | Oil Based Die Lubricant | Production | |||
26 | Wood | Waste boxes of waste packing material | PDN, PUR | Water Based Die Lubricant | Production | ||
27 | Garden Waste | Admin | |||||
28 | Waste packing material | PDN, QA |
HSE INDUCTION TRAINING
General Information | ||||
Inductee Name: | Position: | Induction Date: | ||
Topics to be discussed | ||||
S/N | Description | Yes | No | Remarks |
1 | Project Description | |||
2 | Company HSE Policy | |||
3 |
Induction of Key Personnel | |||
4 |
Site Layout and Welfare Facility | |||
5 |
Site Rules (e.g. Drugs, alcohol & smoking policy, different signage’s, wearing PPE’s, avoid wearing pieces of jewelry, etc.) | |||
6 |
Site Specific Hazards/ Risks/ Near Miss | |||
7 | Risk Assessment | |||
8 |
Responsibility for accident prevention and the maintenance of a safe & healthful work environment | |||
9 | Work Permits | |||
10 | Environment and Waste Disposal | |||
11 |
Emergency Procedures (alarm system, first aid box, assembly point, evacuation plan, escape routes, fire warden, first aider) | |||
12 |
Employee and Supervisor for Reporting Accident | |||
13 |
Vehicle on Site (Traffic Management) | |||
14 |
Relevant and Applicable Laws |
INCIDENT REPORT AND INVESTIGATION
Contract No | Project Name | Location |
Prepared by [HSE Rep]: | Report No: | Date of Report: |
TYPE OF INCIDENT (check all that apply) | ||||
Injury/ Illness | Vehicle Damage | High Potential (Near Miss) | Quality | Fire |
Spill/ Release | Property Loss/ Damage | Permit or equivalent. Exceed | Security | Other |
GENERAL INFORMATION | |||||
Company or subcontractor Name (s): | |||||
Date of incident: | Day of Week: | Time: | |||
Supervisor on duty: | Phone: | Supv. On Scene? | Yes/No | ||
Location of incident: | |||||
Weather/ Lighting Conditions: |
DESCRIBE WHAT HAPPENED (step by step, use additional pages if necessary) |
1. What was the employee doing, or what was happening, just before the incident occurred? Describe the activity, as well as the equipment, tools, or materials in use. Be specific, e.g., “Climbing a ladder while carrying tools” or “Driving near the parking area.” |
2. What happened? What was the contact or event and how did it occur? E.g., “When the ladder slipped on the wet floor, the employee fell 20 feet” or “was distracted by a bee, swerved off the right side of the road and struck the stop sign” |
IMMEDIATE CORRECTIVE ACTIONS (use additional pages if necessary) |
AFFECTED EMPLOYEE INFORMATION (include injured person or employees whose activities resulted in the incident) | ||||
Name: | Male/Female | Company: | ||
Home Address: | ||||
Date of Birth: | Home Phone#: | |||
Job Classification: | Years in job classification: | |||
Time Employee began work: | Date of Hire: | |||
Did the incident relate to routine task for job Classification? | Yes | No |
INJURY/ ILLNESS INFORMATION | ||||
Nature of the injury or illness (Body part affected and how it was affected, e.g. strained back): | ||||
Object/ Equipment/ Substance causing harm: | ||||
First Aid Provided: | Yes/No | If Yes, Where? | On-Site | Off Site |
If Yes, who provide first aid? | ||||
Will the injury/ Illness result in: | Restricted Duty | Lost Time | Unknown |
TREATMENT OR EVALUATION INFORMATION (Attach Provider’s Report/Statement) |
Was the treatment or evaluation provided? Yes /No First Aid Evaluation Medical Treatment |
If yes, where? On-Site Dr.’s Office Hospital Others: |
Name of persons (S) Providing treatment or evaluation: |
Address where treatment or evaluation was provided: |
Type of treatment or evaluation: |
Was the employee hospitalized overnight? Yes/No |
PROPERTY LOSS OR DAMAGE INFORMATION |
Property or Vehicle involved? Yes/No |
Description of loss or damage: Estimated KWD Lost: |
SPILL OR RELEASE INFORMATION | ||
Substance spilled or released: | From Where: | To Where: |
Estimated quantity/Duration: | ||
The reportable quantity (RQ): RQ Exceeded? Yes/ No | ||
Released to Water of State? Yes/No CERCLA Hazardous Substance? Yes.No | ||
Response action is taken: | ||
PERSONS PREPARING REPORT (Employee and Supervisor to Complete Report) | |||||
Employee’s Name: | Signature: | Date: | |||
Employee’s Name: | Signature: | Date: | |||
Employee’s Name: | Signature: | Date: |
PERSONNEL NOTIFIED (Notify Health and Safety Representative Immediately) | |||
ORGANIZATION | NAME (S) | DATE/TIME | |
HS Department Head | |||
Project Manager | |||
Received by [HS Rep] : | Date/Time: | ||
Serious Incidents require immediate notification to the Corporate Safety Department. Fatalities or hospitalization (admittance) of three or more individuals requires notification to OSHA within 8 hours. Contact the Safety Manager to make the notification. If unavailable, the senior operations person on site should make the notification. |
INCIDENT SKETCH | |||||||
Write in street names and, if possible, the points of the compass. If a sketch appears on a police report or insurance form, this need not be completed. Attach the other report. |
GENERAL INFORMATION | |||||
Company: | Date of Incident: | Date of Investigation Report: | |||
Incident Cost: | Estimated: KWD | Actual: KWD | |||
OSHA Recordable: | Yes/No | # Restricted days: | # Days away from work: | ||
Was the activity addressed in an AHA? : | Yes (attach a copy) | No |
CAUSE ANALYSIS |
IMMEDIATE CAUSE- What actions and conditions contributed to this event? (See examples on next pages) |
BASIC CAUSES- What specific personal or job factors contributed to this event? (See examples on next pages, use SCAT chart for guidance) |
ACTION PLAN | ||||
REMEDIAL ACTIONS- What has been and/ should be done to control the causes listed? If applicable, include management program (see attached list) for control of incidents. | ||||
ACTION | PERSON RESPONSIBLE | TARGET DATE | DATE COMPLETED | VERIFIED BY |
PERSONNEL PERFORMING INVESTIGATION | |||||
Name: (Print) | Signature: | Date: | |||
Name: (Print) | Signature: | Date: | |||
Name: (Print) | Signature: | Date: | |||
Name: (Print) | Signature: | Date: |
REVIEW AND APPROVAL | |||||
HS Dept. Head: | Signature: | Date: | |||
Comments: | |||||
Project Manager: | Signature: | Date: | |||
Comments: | |||||
Operations Manager: | Signature: | Date: | |||
Comments: | |||||
NOTE: Attach additional information as necessary, i.e. pictures, statements, etc. |
EXAMPLES OF IMMEDIATE CAUSES | |
Substandard Actions | Substandard Conditions |
1.Operating equipment without authority
2. Failure to warn 3. Failure to secure 4. Operating at an improper speed 5. Making safety devices inoperable 6. Using defective equipment 7. Failure to use PPE properly 8. Improper loading 9. Improper placement 10. Improper lifting 11. Improper position for the task 12. Servicing equipment in operation 13. Horseplay 14. Under the influence of alcohol/drugs 15. Using equipment improperly 16. Failure to follow the procedure 17. Failure to identify hazard/risk 18. Failure to check/monitor 19. Failure to react/correct | 1. Inadequate guards or barriers
2. Inadequate or improper protective equipment 3. Defective tools, equipment, or materials 4. Congestion or restricted action 5. Inadequate warning system 6. Fire and explosion hazards 7. Poor housekeeping/disorder 8. Noise exposure 9. Exposure to radiation 10. Exposure to temperature extremes 11. Inadequate or excess illumination 12. Inadequate ventilation 13. Presence of harmful substances 14. Inadequate instructions/procedures 15. Inadequate information/data 16. Inadequate preparation/planning 17. Inadequate support/assistance 18. Inadequate communications hardware/software/process 19. Road conditions 20. Weather conditions |
EXAMPLES OF BASIC CAUSES | |
Personal Factors | Job Factors |
1. Inadequate physical/physiological capability
2. Inadequate mental/physical capability 3. Physical or psychological stress 4. Mental or psychological stress 5. Inadequate training or lack of knowledge 6. Lack of skill or qualifications 7. Improper motivation 8. Abuse or misuse | 1. Inadequate leadership/supervision
2. Inadequate engineering 3. Inadequate purchasing 4. Inadequate maintenance or calibration 5. Inadequate tools/equipment 6. Inadequate work standards or procedural controls 7. Excessive wear and tear 8. Inadequate communications |
MANAGEMENT PROGRAMS FOR CONTROL OF INCIDENTS | |
1. Leadership and administration
2. Management training 3. Planned inspections and maintenance 4. Task analysis and procedures 5. Task observation 6. Emergency preparedness 7. Rules and work permits 8. Accident/incident analysis 9. Personal protective equipment | 10. Health control
11. Program audits 12. Engineering and change management 13. Personal communications 14. Group communications 15. General promotions/awareness 16. Hiring and placement 17. Purchasing controls 18. Off-the-job safety |
EHS Management Program
A. Significant Environmental Aspect/Hazard: | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1. Objective(s): | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
2. Target(s): | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
3. Reason for Significance: | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
4. Legal or Other Requirements: | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
5. Program Description, Budget, and Responsibility:
| Sr. No. | Action | Responsibility | Timeline | Budget | Remark | Sr. No. | Action | Responsibility | Timeline | Budget | Remark | Sr. No. | Action | Responsibility | Timeline | Budget | Remark | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Sr. No. | Action | Responsibility | Timeline | Budget | Remark | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Sr. No. | Action | Responsibility | Timeline | Budget | Remark | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Sr. No. | Action | Responsibility | Timeline | Budget | Remark | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
6. Other Documents Related to this EMP (Operational Control or Procedure): | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
7. Records and Documents: Person Responsible and Location: | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
8. Person(s) Responsible for Program Management:
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List of Safety Committee/CFT/Fire fighting team/First aid team
Sr. No. | Name of the person | Designation | Status | Department | Contact number |
HOUSEKEEPING INSPECTION CHECKLIST
General Information | |||||||||||||||||||||||||||||||||||||||
Area/Location: | Date: | ||||||||||||||||||||||||||||||||||||||
Conducted by [HS Rep]: | Signature: | ||||||||||||||||||||||||||||||||||||||
Description | |||||||||||||||||||||||||||||||||||||||
S/N | ITEM | EVALUATION | REMARKS
(Corrective action and recommendations) | ||||||||||||||||||||||||||||||||||||
YES | NO | N/A | |||||||||||||||||||||||||||||||||||||
1 | Proper signage’s posted on the fence, lay-down area and around the offices? | ||||||||||||||||||||||||||||||||||||||
2 |
Roads in good condition and dust control are maintained? | ||||||||||||||||||||||||||||||||||||||
3 |
No water accumulation and floors are dry? | ||||||||||||||||||||||||||||||||||||||
4 |
Clear and safe access to work areas? | ||||||||||||||||||||||||||||||||||||||
5 |
All stairways, passageways, gangways, and access ways shall be kept free of materials, supplies, and obstructions at all times. | ||||||||||||||||||||||||||||||||||||||
6 |
Tools, materials, extension cords, hoses, or debris shall not cause tripping or other hazards. | ||||||||||||||||||||||||||||||||||||||
7 |
Form and scrap lumber and debris shall be cleared formwork areas and access ways | ||||||||||||||||||||||||||||||||||||||
8 |
Site office and the site area in general cleanliness and orderliness? | ||||||||||||||||||||||||||||||||||||||
9 |
Construction waste and debris collected in the designated area? | ||||||||||||||||||||||||||||||||||||||
10 |
Adequate rubbish container and rubbish removed daily? | ||||||||||||||||||||||||||||||||||||||
11 |
Old timber de-nailed and all protruding steel bars are capped? | ||||||||||||||||||||||||||||||||||||||
12 |
Material stacking and any loose materials had been properly stored? | ||||||||||||||||||||||||||||||||||||||
13 |
Site in general cleanliness and orderliness? | ||||||||||||||||||||||||||||||||||||||
Note: Corrective and recommended actions must be implemented immediately. ( references in parenthesis) | |||||||||||||||||||||||||||||||||||||||
| Reviewed by [HS Dept]: | POSITION | NAME | SIGNATURE | DATE | Reviewed by [HS Dept]: | POSITION | NAME | SIGNATURE | DATE | Reviewed by [HS Dept]: | POSITION | NAME | SIGNATURE | DATE | ||||||||||||||||||||||||
Reviewed by [HS Dept]: | |||||||||||||||||||||||||||||||||||||||
POSITION | NAME | SIGNATURE | DATE | ||||||||||||||||||||||||||||||||||||
Reviewed by [HS Dept]: | |||||||||||||||||||||||||||||||||||||||
POSITION | NAME | SIGNATURE | DATE | ||||||||||||||||||||||||||||||||||||
Reviewed by [HS Dept]: | |||||||||||||||||||||||||||||||||||||||
POSITION | NAME | SIGNATURE | DATE | ||||||||||||||||||||||||||||||||||||
| Distribution and acknowledgment: | Project Manager | Construction Manager | QA/QC Engineer | Site Engineer | Distribution and acknowledgment: | Project Manager | Construction Manager | QA/QC Engineer | Site Engineer | Distribution and acknowledgment: | Project Manager | Construction Manager | QA/QC Engineer | Site Engineer | ||||||||||||||||||||||||
Distribution and acknowledgment: | |||||||||||||||||||||||||||||||||||||||
Project Manager | Construction Manager | QA/QC Engineer | Site Engineer | ||||||||||||||||||||||||||||||||||||
Distribution and acknowledgment: | |||||||||||||||||||||||||||||||||||||||
Project Manager | Construction Manager | QA/QC Engineer | Site Engineer | ||||||||||||||||||||||||||||||||||||
Distribution and acknowledgment: | |||||||||||||||||||||||||||||||||||||||
Project Manager | Construction Manager | QA/QC Engineer | Site Engineer |
PPE INSPECTION CHECKLIST (PERSONAL PROTECTIVE EQUIPMENT)
General Information | |||
Area/Location: | Date: | ||
Conducted By [HSE Rep]: | Signature: |
Description | |||||
S/N | ITEM | EVALUATION | |||
YES | NO | N/A | |||
1 |
Are PPE used as required? | ||||
2 |
Minimum PPE (i.e. helmet, safety boots, hi-visibility vest, safety glasses) provided to all employees and records maintained? | REMARKS
(Corrective action and recommendations) | |||
3 |
A copy of the PPE manufacturer manual is available? | ||||
4 |
Users trained on using, maintenance and storage of PPE? | ||||
5 |
Additional PPE have been provided as appropriate for those who are executing critical activities (e.g. fully body harness for working at height, full face mask breathing apparatus, etc.)? | ||||
6 |
PPE correctly selected based on the task risk assessment? | ||||
7 |
Regularly inspected, cleaned and maintained and replace when deemed necessary? | ||||
8 |
Safety glass complies with ANSI standard? | ||||
9 | Protective (cover) glass used for the person using eyeglasses? | ||||
10 |
Hearing protection being used for workers exposed to noise? | ||||
11 |
Head protection being used on hardhat area? | ||||
12 |
Are protective head gears in compliance with ANSI standard? | ||||
13 | Is protective footwear being used? | ||||
14 |
Do protective footwear meets the ASTM F2412? | ||||
15 |
Are high visibility vest being used on site? ) | ||||
16 |
Are high visibility vest complies with ANSI standards? | ||||
Note: Corrective and recommended actions must be implemented immediately. |
Reviewed by [HS Dept]: | |||
POSITION | NAME | SIGNATURE | DATE |
Distribution and acknowledgment: | |||
Project Manager | Construction Manager | QA/QC Engineer | Site Engineer |
VISITORS SITE BRIEFING CHECKLIST
Visitors name: | |||
Area/Location: | Date: | ||
Conducted By [HSE Rep]: | Signature: |
Topics to be discussed | |||||||
S/N | Description | EVALUATION | REMARKS | ||||
YES | NO | N/A | |||||
1 | SITE SAFETY TOOLS | ||||||
2 | PPE | ||||||
Smoking | |||||||
4 | Consumption of Food and Drinks | ||||||
5 | Access and Safe Walk Area | ||||||
6 |
Vehicle Speed Limit | ||||||
7 |
Safety and Advisory Sign | ||||||
8 | SITE HAZARDS | ||||||
9 | Ongoing Activity | ||||||
10 | Vehicle Movement | ||||||
11 | SITE MAP | ||||||
12 | Site Offices | ||||||
13 | Welfare Facility | ||||||
14 | Emergency Muster Station | ||||||
Signature and Remarks | |||||||
|
Visitor’s Signature |
Visitor’s Signature |
Visitor’s Signature | Remark: | |||
Visitor’s Signature | |||||||
Visitor’s Signature | |||||||
Visitor’s Signature | |||||||
Conducted by: | Job Title: | Signature: | |||||
Reviewed by [HS Dept]: | |||||||
POSITION | NAME | SIGNATURE | DATE | ||||
Note: Corrective and recommended actions must be implemented immediately. (EM385-1-1 references in parenthesis) |
Sample Environment, Health, and Safety Policy
Kalyani Forge Limited’s EHS Policy |
We, at Kalyani Forge Limited, are committed for continual improvement to achieve Safe, Healthy and Environmental friendly working conditions Through…..
|
METAL PRODUCTS COMPANY’s IMS Policy |
METAL PRODUCTS COMPANY is committed to:
|
WEEKLY SAFETY REPORT
Contract No | Project Name | Location | Date | |||
From: | To: |
Description | |||||
JOB SAFETY ACTIONS/SAFETY INSPECTIONS | CONDUCTED | REMARKS | |||
YES | NO | N/A | |||
Was the Job Safety Meeting Held? | |||||
Were there lost time Accidents? | Reported to: | ||||
Miscellaneous Incidents? | IR Submitted: | ||||
Trench/Excavations: Competent Person daily inspection performed? | |||||
Scaffolding: Competent Person daily inspection performed? | |||||
Confined Space: Competent Person pre-entry inspection performed? |
Safety/QC Meetings/Inspections Conducted (List): |
Field Activities: |
Safety Findings & Corrective Actions: | |
Safety Findings | Corrective Actions |
Prepared by [HSE Rep]: | Reviewed by [HS Dept]: | ||
Signature: | Signature: |
For Head Office use only: | ||
Operations Manager | Project Director | Others |
Risk Register
Risk description |
“Likelihood |
“Severity |
“Risk level |
Risk Mitigation |
Responsibility |
Deadline |
Evaluation date |
Evaluation result |
Opportunity Register
Opportunity description |
“Likelihood |
“Benefit |
“Opportunity Factor |
Opportunity Pursuit Plan |
Responsibility |
Deadline |
Evaluation date |
Evaluation result |
Noncompliance Notice
Employee Information | |||||
Employee Name: | Job Title: | Date: | |||
Organization: | Supervisor Name: |
Type of Notice | |||||
First Notice | Second Notice | Final Notice | |||
Classification | |||||
Failure to use PPE Properly | Inadequate Guards/Barriers | Inadequate Warning System | |||
Defective tools/Equipment/Materials | Poor Housekeeping/Disorder | Violation of Safety Rules | |||
Other: |
Details | |||
Description of Noncompliance: |
|
| |
Non-Compliance Picture: | |||
Violation Photo | |||
Immediate Action Taken: |
| ||
Close-Out Picture: | |||
Correction Photo | |||
Recommended Corrective Action: | |||
Acknowledgment: | ||
By signing this form, you confirm that you understand the information in this warning. You also confirm that you and your Supervisor have discussed the issue and a plan for improvement. Signing this form does not necessarily indicate that you agree with this warning. | ||
Employee Name | Signature | Date |
Supervisor Name | Signature | Date |
Witness Name & Signature (if the employee understands warning but refuses to sign) | Date |
Prepared by [HS Dept]: | |||||
Job Title: | Name: | Signature: |
TOOLS INSPECTION CHECKLIST
General Information | |||||
Area/Location: | Type of Tools: | ||||
Conducted By: | Signature: | Date: |
Description | |||||
S/N | ITEM | EVALUATION | REMARKS
(Corrective action and recommendations) | ||
YES | N/A | ||||
1 | Tools checked and inspected before use? | ||||
2 |
Guards are fitted, adjusted, and tools in good condition? | ||||
3 |
Nonsparkling tools used near source ignition area? | ||||
4 |
No loose and frayed clothing while working with power tools? | ||||
5 |
Are floor and bench mounted power tools anchored or securely clamped to a firm foundation? | ||||
6 |
Grinder and abrasive machinery with the guard? | ||||
7 |
Damaged or cracked abrasive wheel? | ||||
8 |
Has circular saw equipped with guard and kickback device? | ||||
9 |
Are safety clips and retainers installed and maintained on pneumatic tools? | ||||
10 |
Is the explosive actuated tool operator trained and qualified? | ||||
11 |
Is proper safekeeping power actuated tool being followed? | ||||
12 |
Is manufacturer instruction is available and being followed? | ||||
13 |
All hoses, coupling, and fittings of the correct rating and inspected and maintained regularly? | ||||
14 |
Tools secured to the hose by positive means to prevent disconnection? | ||||
15 |
Air supply line protected from drainage, maintained and inspected regularly? | ||||
16 |
The safety device is provided for air hose with large diameter? | ||||
17 |
Home-made tools are not used and tools being used fit for the job? | ||||
18 |
Suitable PPE provided for any type of job using portable tools? |
Reviewed by [HS Dept]: | |||
POSITION | NAME | SIGNATURE | DATE |
Distribution and acknowledgment: | |||
Project Manager | Construction Manager | QA/QC Engineer | Site Engineer |
JOB HAZARD / SAFETY ANALYSIS
Job Hazard/Safety Analysis (JHA/JSA) REVIEWS | ||
Reviewed & Approved by: | Reviewed & Approved by: | Reviewed & Approved by: |
Signature & date: | Signature & date: | Signature & date: |
All signature blocks completed indicate authorization to perform identified Activity’s. | ||
Drawings Attached: Yes No |
Definable Work Activity: | Revision No: | Date: | |||
Work Task | Potential Hazard(s) | Control Measure (s), Required Training, -required Permits or Plans, and Competent Person (s) | |||
Equipment to be Used | Required Inspections | Required Training |
JHA REVIEW/Pre-Job Brief attendance roster | |||||
By signing below, I agree to the following: § I agree to follow the work steps and implement the controls as written. § I agree to stop work when conditions or hazards change or when I encounter unexpected conditions during the execution of work, or when work cannot be performed as written, or instructions become unclear during execution. § I confirm that I am authorized, qualified and fit to perform the work. | |||||
Name | Signature | Date | Name | Signature | Date |
Instruments Calibration history chart
Description: | Location: | |||||||
Identification no: | Specification: | |||||||
Acceptance criteria: | Cal. Frequency: | |||||||
Sr no. | Calibration Date | Calibration.Agency | Certificate. No. | Calibration Status | Cal.Due On | Inspected By | Approved By | REMARKS |
Calibration Schedule
Sr.No | Device ID NO. | Description | Calibration Frequency | Calibration Done on (Date) | Next Calibration Due on (Date) | REMARKS |
Lessons Learnt log
ID | Date | Entered By | Subject | Situation | Recommendations & Comments |
Communication Plan
Communications item | what | Who | Who Attends | When | When Format |
TRAINING NEEDS IDENTIFICATION
TRAINING NEEDS IDENTIFICATION FOR THE YEAR Jan-2018 TO Dec-2018 | |||||||
DEPARTMENT: | |||||||
Sr.No. | Name of Employee | Emp No | Training Topics | ||||
NOTE – MARK ” √ ” if particular employee needs training of specified topic | |||||||
HOD Name & Signature: |
SERVICING OF FIRE EXTINGUISHER
Sr. No | F.E. No | Location | Type of Fire Extinguisher | Capacity | H.P. tested on | H.P test due date | Refilled on | Refilling Due date: | Defect / Required spare | Remarks/ Corrective action |
VERIFIED BY: Dept Head CHECKED BY: HR. IR & ADMIN |
TRAINING ATTENDANCE SHEET
Theme : | |||
Trainer / Faculty : | Date : | ||
Venue : | Time : | ||
Sr.No | Name of Employee | Emp .No | Sign. |
1 | |||
2 | |||
3 | |||
4 | |||
5 | |||
6 |
Document Matrix
Sr.No. | Document Name and Identification | Location | Responsibility | Revision | Document Type | Protection | Retrieval | Retention Time | Disposition |
(Soft/ Hard/ Both) | |||||||||
Example of Report of Mock drill
Scenario: Oily rags used in the shop floor are removed outside and thrown in the storage area where they catch fire due to welding activity. Dried grass present around gets ignited resulting in a wildfire. |
11:00 am: Smoke coming out from the back of the Press shop is seen by the security guard Mr. P. P. Deshmukh who was on a patrol round. 11:02 am: Mr. P. P. Deshmukh immediately reached on the spot to find that there was a fire in an incipient stage due to the welding activity going around and the sparks flying out of it. 11:03 am: Mr. P. P. Deshmukh immediately stopped the welding activity and alerted the contractor person working around who did not keep any water or sand bucket or any water fire extinguisher with him while working. 11:04 am: Mr. P. P. Deshmukh immediately called up Gate office/Emergency Control Centre and Security supervisor Mr. M. N. Jorvekar who in turn called up Asst. Safety Manager Mr. Santosh Kasalkar, Site Controller Mr. Sunilkumar Shinde and Incident Controller Mr. J. G. Swami. 11:05 am: Mr. Kasalkar and Mr. Jorvekar rushed to the spot to find that the fire had grown wild due to the surrounding dry grass. Mr. Kasalkar immediately informed Mr. Sunilkumar Shinde about the situation who inturn declared it an emergency and ordered the Main Gate to be closed and the wailing emergency siren to be sounded. 11:07 am: Fire fighting team members rushed on to the spot with ABC fire extinguishers and the garden pipe was also started. 11:10 am: Fire was completely extinguished with the help of ABC fire extinguishers and the garden hose. The all-clear siren was sounded. Following were the Observations made: Following Corrective actions are taken. 1) All welding activity will be done under the supervision of the contractor and the concerned dept supervisor. Prepared By: Approved By: |
Nonconforming Service Report (NSR)
Date: | Reported by: | Recorded by: |
Summarize the reported service nonconformity. Attach or reference applicable documentation (emails, etc.) | ||
Initial Review: | ◙ Nonconformity affirmed, proceed with the investigation | |
◙ Nonconformity could not be affirmed or replicated; stop and monitor for further occurrences. | ||
◙ No nonconformity; stop. | ||
Initial Review by: | Date: | |
Root cause analysis: | ||
Disposition (check all that apply) | ◙ Issue Refund | |
◙ Provide corrected service. Details: | ||
◙ Provide new services. Details: | ||
◙ File [CAR Form Abbreviation]; reference [CAR Form Abbreviation] #: | ||
◙ Customer waiver. Details: | ||
◙ Other action. Details: | ||
Remark: | ||
Disposition Approval by: | Date: | |
Customer Approval by: |
List of Internal Auditor
Sr. No. | Name of Internal Auditor | Designation | Reporting to |
Criteria for selection of Internal Auditor w.r.t. experience & skill – |
NCR Status Log.
S No. | NCR No | NCR issued to | Date | Action completion date | Proposed follow-up date | Date NCR closed | Remarks | MR (Sign) |
Hi, I went through the docs for EHS from your post in LinkedIn group. Can you send it to me through mail ? Let me know
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