SAFETY DEPARTMENT REQUEST FOR INSPECTION
Department Head Subcontractor Date Time Location Equipment to be inspected
Participant
Requester
Inspected / Approved By
Acknowledge By
H.O.D, Subcontractor
Maintenance Depart.
Safety Depart.
Name Signature
Date Inspection Results : Inspection passed – Machine allowed to use. Inspection Failed – Machine was rejected & not allows using. Inspection accepted – Machine allowed using but comments need to be rectified & comply. Date Line
- From ______________ until ________________ ________________ (Close date : _________ _________ )
Remarks / Comments: ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________
* Please attach copies of :a. c. d.
PMA / PMT PMT b. Competenc Competency y Certific Certificate ate Certificate of Registry Crew List
e. Safety Safety Constr Construct uction ion Certif Certifica icate te f. Insurance Insurance Certific Certificate ate g. Others
* Whichever applicable
Fr ,Rev 0,01.02.2009
SAFETY DEPARTMENT
YNESB/OSHEF/03
DAILY PLANT SAFETY INSPECTION CHECKLIST S.No 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
Description Forem remen on job area All All emplo employee yees s weari wearing ng prope properr eye/h eye/hea ead d prot protec ectio tion? n? All All wea wearin ring g hea hearin ring g prot protect ectio ion n whe where re neces necessar sary? y? All All weari wearing ng protec protectiv tive e clo clothi thing ng where where nece necessa ssary. ry. All All weari wearing ng respir respirato atory ry prot protec ectio tion n where where nece necessa ssary? ry? All All weari wearing ng ade adequ quat ate e safe safety ty sho shoes es/g /glo love ves? s? All All overhe overhead ad work workers ers usin using g safet safety y belts belts? ? Line Line? ? If req requir uired ed? ? Is prop proper er perm permit it at job job sit site e att attai aine ned? d? All All pro provi visi sion ons s on on perm permit it sati satisf sfie ied? d? All All hot hot wor work/ k/en entry try perm permit its s as as req requi uire red? d? Is fire fire watch watchma man n on duty duty ale alert rt & kno knowle wledg dgea eable ble of duty duty? ? Equi Equipm pmen entt prope properl rly y lock locked ed out out /ta /tagg gged ed out out? ? Elect Electric rical al conne connecti ction ons/c s/cord ords, s, prope properr twist twist lock conn connect ection ions? s? Weld Welding ing machi machine nes, s, sand sand blus bluster ters s etc etc prop properl erly y groun grounde ded? d? All All nece necess ssar ary y blin blind d inst instal alle led/ d/bl blin ind d list list ok? ok? Has Has sho shori ring ng been been done done as nece necess ssar ary? y? Have Have unde undergr rgrou ound nd draw drawing ing bee been n check checked ed for for safe safe excav excavati ation on? ? Road Roads s pro prope perl rly y blo block cked ed if nece necess ssar ary? y? Scaf Scaffo fold ldin ing g prope properl rly y inst instal alle led? d? Ladders prop roperly rly used sed? Tools pr properly rly us used? Prop Proper er lift liftin ing g meth method od s/m s/mat ater eria iall hand handli ling ng? ? Prop Proper er/a /app ppro rove ved d ligh lighti tin ng in use use? ? Reta Retain iner er pin pin or or air air hose hose/t /too ools ls con conne nect ctio ions ns? ? Hose Hose ree reels ls or or hose hoses s used used prop proper erly ly? ? Comp Compre ress ssed ed gas gas cyl cylin inde ders rs secu secure red d upri uprigh ght? t? Good house keeping Spec Specia iall war warni ning ng post posted ed if nece necess ssar ary y Labe Labels ls aff affix ixed ed to chem chemic ical al cont contai aine ner. r.
Yes
No No
N. N.A
Other Items /Comments
Supervisor : _________________
Safety Officer : _________________
Name
: _________________
Name
: _________________
Date
: _________________
Date
: _________________
Signature : _________________
Signature : _________________
SAFETY DEPARTMENT
YESB/OSHEF/04/01
Fr ,Rev 0,01.02.2009
LOCATION: Items Inspected
WEEKLY PLANT INSPECTION CHECKLIST
1. Housekeeping a. Access b. Stairways c. Signs d. Lighting e. Waste Disposal
Items Inspected 2.Hazardous 2.Hazardous Material a. MSDS Available b. Register Available c. Signboards Posted d. Proper Storage e. Labeling g. Fire Protection
3. PPE a. Safety Helmet b. Safety Boots c. Eye Protection d. Ear Protection e. Gloves f. Overall/Apron g. Filter/Dust mask
4. Work At Height a. Working Platform b. Safety harness c. Lifeline d. Tools Secured e. Barricade area below f. Fall Arrest Equipment g. Access
5. Lifting Activity a. Crane b. Lift Permit/Prelift Check c. Barricade/Signs d. Signalman e. Taglines g. Vehicle Entry Permit
6. Confined Space a. Permit Obtained b. Gas Test Done c. Standby Person d. Proper Ventilation e. Lifeline g. Explosion-proof Lights h. BA (if necessary)
h. Supervision 7. Equipments (W/Set, Generator, Compressor) a. Guards b. Emergency Stop c. Fire Extinguisher d. Oil Leaks e. PMT f. Earthing g. Leads/Cables h. Oil/Fuel/Radiator Cap
Tick Yes No
Remark
Tick Yes No
Remark
8. Work Areas a. Housekeeping b. Ladders/Platforms c. Hand Tools d. Obstruction e. Access f. Floor Opening g. Overhead Works h. Emergency Exits
9. Electrical a. ELCB Functional b. Industrial Cable c. Proper Connections d. Correct Plugs e. BD Condition f. Cable Management
SAFETY DEPARTMENT LOCATION:
YNESB/OSHEF/04/02 YNESB/OSHEF/04/0 2
WEEKLY PLANT INSPECTION CHECKLIST
Fr ,Rev 0,01.02.2009
Items Inspected
Tick Yes No
Comments
Items Inspected
Tick Ye s No
11.Weld/Cut/Grind a. Cylinder Secured b. Flash-back Arrestor c. Regulator/Hose/Torch d. Fire Extinguisher e. Hand Tools f. PPE g. Hot Work Permit h. Housekeeping
12.Scaffolding a. Tagging Available b. Access c. Walkways d. Working Platforms e. Handrails/Guardrails f. Toe-boards g. Tie-back/Bracing h. Ground Condition
13.Machinery a. Inspection Certificate b. Noise c. Oil Leakage d. Smoke Emission
14.Fire Equipment a. Extinguisher(type/qty) b. Hydrant/Hose/Nozzle c. Smoke/Heat Detector d. Suppression System
15.First Aid a. First Aid Box b. Signage c. Adequate Stock d. Readily Accessible
16.Hygiene/Welfare a. Toilet Facilities b. Drinking Water c. Canteen d. Garbage Disposal e. Housekeeping f. Rest Area/Surau
17.Radiography a. Area Barricaded b. Warning Lights c. Worker Competency d. Storage of Isotape e. Work Permit
Comments
Audit Conducted by : 1. 2.
NAME
DESIGNATION
SIGNATURE / DATE
DESIGNATION
SIGNATURE / DATE
Audit Attend by : Contractor/ H.O.D 1. 2. 3. 4. 5. 6.
NAME
SAFETY DEPARTMENT YNESB/OSHEF/05 CRANE / SKY LIFT INSPECTION CHECKLIST (INITIAL / QUARTERLY) Contractor
Crane Operator
Inspection Date
Fr ,Rev 0,01.02.2009
Crane Type DOSH Reg. No. S/No
Crane No. PMA No Item Description
Tick Yes
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
Rated Capacity PMA Expiry Remarks No
Tire Tires s in in goo good d con condi diti tion on and and inf infla late ted d All All whe wheel els s off off the grou ground nd Oil leakages Lift Liftin ing/ g/Ri Rigg ggin ing g equi equipm pmen ents ts acc accep epta tabl ble e Horn Horn/b /buzz uzzer er/h /haz azar ard d lig light hts s fun funct ctio iona nall Val Valid Road Road Tax/ Tax/ Insur nsuran ance ce Ligh Lights ts/s /sig igna nals ls in worki working ng cond condit itio ion n Any Any dam damage age to wire wire rope ropes s Oper Operat ator or regi regist ster ered ed with with DOSH DOSH Valid PMA Fire Fire exti exting ngui uish sher er avai availa labl ble e Load Load char chartt av availa ailabl ble e Any Any weld welds/ s/vi visi sibl ble e crac cracks ks on on the the boom boom Outrig Outrigger gers s fully fully extend extended ed and and pads pads availa available ble Nois Noise/ e/sm smok oke e leve levell acce accept ptab able le Exte Extens nsio ion n jib jib safe safely ly secu secure red d Heig Height ht limi limitt ala alarm rm func functi tion onin ing g Hois Hoistt bra brake kes s fun funct ctio ioni ning ng View View from from operat operator or cabin cabin not restric restricted ted Boom Boom angl angle e ind indic icat ator or accu accura rate te Liftin Lifting g blocks/ blocks/hoo hooks ks in good good condit condition ion Safe Safety ty latc latche hes s in in goo good d cond condit itio ion n Barr Barric icad ades es and and sig signs ns inst instal alle led d Tagl Taglin ines es avail vailab ablle Sign Signal alm man av availa ailabl ble e Operat Operator/ or/Sig Signal nalman man famili familiar ar with with sign signals als Cran Crane e cre crew w saf safet ety y bri brief efed ed
Attached are true copies of:Valid PMA
Load Chart
Operator’s Competency Cert. (DOSH/JPJ License)
Inspection Result
NAME & SIGNATURE CRANE SUPPLIER
Contractor
:
PASSED
Road / Insurance Tag Reg.
FAILED
ACCEPTED WITH COMMENT
DATE LINE: …………
NAME & SIGNATURE SAFETY OFFICER
NAME & SIGNATURE YARD MANGER
SAFETY DEPARTMENT YNESB/OSHEF/06 CRANE / SKY LIFT INSPECTION DAILY CHECKLIST Crane Inspection Operator Date
Fr ,Rev 0,01.02.2009
Crane Type
Crane No. PMA No
DOSH Reg. No. S/No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
Item Description
Tick Yes No
Rated Capacity PMA Expiry Remarks
Tire Tires s in in goo good d con condi diti tion on and and inf infla late ted d All whee heels off th the gr groun ound Oil leakages Lift Liftin ing/ g/Ri Rigg ggin ing g equi equipm pmen ents ts acce accept ptab able le Horn Horn/b /buz uzze zer/ r/ha haza zard rd lig light hts s func functi tion onal al Valid Road Tax Tax// In Insura urance nce Ligh Lights ts/s /sig igna nals ls in work workin ing g con condi diti tion on Any damage to wir wire e rope opes Opera perato torr reg regis iste tere red d wit with h DOS DOSH H Valid PMA Fire Fire exti exting ngui uish sher er avai availa labl ble e Loa Load chart hart avai availa labl ble e Any Any vis visib ible le crac cracks ks on the the boo boom m Outri Outrigge ggers rs fully fully exten extended ded and and pads pads available Nois Noise/ e/sm smok oke e leve levell acce accept ptab able le Exte Extens nsio ion n jib jib safe safely ly secu secure red d Heig Height ht lim limit it ala alarm rm fun funct ctio ioni ning ng Hois Hoistt brak brakes es func functi tion onin ing g View View from from ope operat rator or cabi cabin n not not rest restric ricted ted Boom Boom ang angle le ind indic icat ator or acc accur urat ate e Liftin Lifting g bloc blocks ks/ho /hooks oks in good good cond conditi ition on Safe Safety ty lat latch ches es in in good good con condi diti tion on Barr Barric icad ades es and and sig signs ns ins insta tall lled ed Tagline lines s ava availa ilable Sig Signalm nalma an avail vailab able le Opera Operator tor/S /Sign ignalm alman an fam famili iliar ar with with sign signal als s Cran Crane e cre crew w safe safety ty brie briefe fed d
Remark :
SAFETY DEPARTMENT
YNESB/OSHED/07
Date : ___________ DAILY WELDING & CUTING MACHINE CHECKLIST NO 1
DESCRIPTION
YES
NO
N/A
REMARKS
STAR STARTE TER R & WIRI WIRING NG SYSTE YSTEM M IN GO GOOD OD COND CONDIT ITIO ION N
Fr ,Rev 0,01.02.2009
2
GAS GAS HOS HOSES ES AND CO COUPLIN LING IN IN GOO GOOD D CO CONDI NDITION ION
3
FIRE EXTINGUISHER IN PLACE
4
FREE FR FROM CO COMBUSTIBLE MATERIAL
5
WELDING MACHINE INSPECTED
6
IS THE MA MACHINE EA EARTHED
7
IS THE GA GAS CYL CYLIN IND DER UP UPRIGH IGHT AN AND SE SECURED
8
IS FL FLASH-BACK AR ARRESTOR AV AVAILABLE
9
10
RESP RESPON ONSI SIBL BLE E PERS PERSON ON FOR THE THE INSP INSPEC ECTI TION ON OF WELDING MACHINE AND EARTHING : NAME:____________________ ____ DESIGNATION:_____________ ____ ARE THESE PPE PROVIDED: SAFETY GLASSES FACE SHIELD GLOVES
11
ARE ARE THE THE HAND HAND TOO OOLS LS IN GOO OOD D CON CONDI DITI TION ON
12
ARE ARE THE THE ELEC ELECTR TRIC ICAL AL CON CONNE NECT CTIO IONS NS SAFE SAFE
13
ARE ARE THE THE LEAD LEADS S / CABL CABLES ES IN GO GOOD OD COND CONDIT ITIO ION N AND AND PLACED OVEREAD
14
ARE SCREENS IN PLACE
16
CUT CUT OFF OFFS S REM REMOV OVED ED AND AND PLA PLACE CED D IN IN DRU DRUMS MS
17
HOUS OUSEKEEPIN EPING G ACC ACCEPTABLE
18 IS COMP COMPLE LETE TED D AND AND APPR APPROV OVED ED JSA JSA AVA AVAIL ILAB ABLE LE REMARKS
Responsible Person On site :
_______________ Name
_________________________ Signature
SAFETY DEPARTMENT
___________ Date
YNESB/OSHEF/08
Date : ___________ QUARTERLY WELDING & CUTING MACHINE CHECKLIST NO
DESCRIPTION
1
STARTE RTER & WIRI WIRIN NG SY SYSTEM TEM IN IN GOO GOOD D CON CONDI DITI TION ON
2
GAS GAS HOS HOSES ES AND COUP COUPLI LIN NG IN IN GO GOOD COND CONDIITION TION
3
FIRE EX EXTINGUISHER IN IN PL PLACE
YES
NO
N/A
REMARKS
Fr ,Rev 0,01.02.2009
4
FREE FROM COMBUSTIBLE MATERIAL
5
WELDING MA MACHINE IN INSPECTED
6
IS THE MA MACHINE EA EARTHED
7
IS THE THE GAS GAS CYLI CYLIND NDE ER UPR UPRIIGHT GHT AND AND SECURE CURED D
8
IS FL FLASH-BACK AR ARRESTOR AV AVAILABLE
9
RESP RESPON ONSI SIBL BLE E PER PERSO SON N FOR FOR THE THE INS INSPE PECT CTIO ION N OF OF WEL WELDI DING NG MACHINE AND EARTHING : NAME:________________________ DESIGNATION:_________________
10
ARE THESE PPE PPE PROVIDED: SAFETY GLASSES FACE SHIELD GLOVES
11
ARE ARE THE THE HAND HAND TOOL TOOLS S IN GO GOOD OD COND CONDIT ITIO ION N
12
ARE ARE THE THE ELEC ELECTR TRIC ICAL AL CONN CONNEC ECTI TION ONS S SAF SAFE E
13
ARE ARE THE THE LEAD LEADS S / CAB CABLE LES S IN GO GOOD OD COND CONDIT ITIO ION N AND AND PLAC PLACED ED OVEREAD
14
ARE SCREENS IN PLACE
16
CUT CUT OFFS OFFS REMO REMOVE VED D AND AND PLAC PLACED ED IN DRUM DRUMS S
17
HOUSEKEEPING AC ACCEPTABLE
18
IS COMP COMPLE LETE TED D AND AND APPR APPROV OVED ED JSA JSA AVA AVAIL ILAB ABLE LE
REMARKS
Checked by :
Area :
Name :
Responsible Person On site :
Signature : Acknowledged By :
_______________ Name
_________________________ Signature
SAFETY DEPARTMENT
___________ Date
YNESB/OSHEF/09
Date: ____________ QUARTERLY CHECKLIST FOR LIFTING SLING, CHAIN AND WIRE ROPE
Statutory and licensed equipment/machinery Location : Colour code: Inspected item
Non -statutory and licensed equipment/machinery Department/section Visual inspection
Remarks
Fr ,Rev 0,01.02.2009
Ye s
No
N.A
a. Is lifting chain/sling/wire in good working order(visual check)? b. Is safe working load clearly labeled on individual lifting chain/sling/wire? c. Is there a register to encompass all lifting chains/slings/wires? d. Any signs of worn or frayed slings/wires? e. Is standard operating procedure for using lifting chains/slings/wires? f. Is there clear access to retrieve or return lifting chains/slings/wires? g. Any signs of excessive corrosion on lifting chains/wires? h. All fastening devices intact? i. Is there any proper storage for lifting chains/slings/wires? j. Is there a record a proper functional and load testing on lifting chains/slings/wires? k. Is there any signs of proper maintenance of lifting chains/sling/wires? l. Is there any sign-in or signed-out procedure of retrieving/returning retrieving/returning lifting chains/sling/wires? m. Are lifting chain/slings/wires appropriate for their use? Note : Responsible persons must record and maintain the monthly checklist for 24 months Checked by :
Area :
Name :
Responsible Person On site :
Signature : Acknowledged By :
_______________ Name
_________________________ Signature
SAFETY DEPARTMENT
___________ Date
YNESB/OSHEF/10
Date : ____________ DAILY CHECKLIST FOR LIFTING SLING, CHAIN AND WIRE ROPE
Statutory and licensed equipment/machinery Location
Non -statutory and licensed equipment/machinery Department/section
Fr ,Rev 0,01.02.2009
Inspected item
Visual inspection Ye s
No
Remarks
N.A
a. Is lifting chain/sling/wire in good working order(visual check)? b. Is safe working load clearly labeled on individual lifting chain/sling/wire? c. Is there a register to encompass all lifting chains/slings/wires? d. Any signs of worn or frayed slings/wires? e. Is standard operating procedure for using lifting chains/slings/wires? f. Is there clear access to retrieve or return lifting chains/slings/wires? g. Any signs of excessive corrosion on lifting chains/wires? h. All fastening devices intact? i. Is there any proper storage for lifting chains/slings/wires? j. Is there a record a proper functional and load testing on lifting chains/slings/wires? k. Is there any signs of proper maintenance of lifting chains/sling/wires? l. Is there any sign-in or signed-out procedure of retrieving/returning retrieving/returning lifting chains/sling/wires? m. Are lifting chain/slings/wires appropriate for their use? Note : Responsible persons must record and maintain the daily checklist for 24 months
Checked By : _____________________ Name
___________________ Signature
__________________ Date
BARBENDING,ROLLING BARBENDING,ROLLI NG & CUTTING MACHINE QUARTERLY INSPECTION CHECKLIST Company : Supervisor : Date :
Type : Model : Series No:
Inspection By : Next Inspection :
Tag No :
Fr ,Rev 0,01.02.2009
Item Description
Yes
No
N/A
Remarks
1. Body & Engine Condition 2. Starter & Wiring System 3. Noise 4. Leakage of Oil 5. Radiator & Fuel Cap 6. Belting damage, safety guard 7. Emergency Stop Button 8. Any Modification 9. Rotating part guard & protected 10. Condition of bending & cutting machine 11. Condition of bending & cutting table 12. Surrounding area cleanliness & obstructed 13. Used by trained / competent workers 14. Necessary PPE provided 15. Operating manual provided 16. Manufacturing stickers 17. Series / model stickers 18. Material proper store
Company :
Checked by :
Area :
Name :
Responsible Person On site :
Signature :
Acknowledged By :
_____________ Name
_________________ Signature
___________ Date
SAFETY DEPARTMENT
YNESB/OSHEF/12
BARBENDING, ROLLING & CUTTING CUTTING MACHINE DAILY INSPECTION INSPECTION CHECKLIST Company : Supervisor : Date :
Type : Model : Series No:
Item Description
Yes
No
N/A
Remarks
Fr ,Rev 0,01.02.2009
1. Body & Engine Condition 2. Starter & Wiring System 3. Noise 4. Leakage of Oil 5. Radiator & Fuel Cap 6. Belting damage, safety guard 7. Emergency Stop Button 8. Any Modification 9. Rotating part guard & protected 10. Condition of bending & cutting machine 11. Condition of bending & cutting table 12. Surrounding area cleanliness & obstructed 13. Used by trained / competent workers 14. Necessary PPE provided 15. Operating manual provided 16. Manufacturing stickers 17. Series / model stickers 18. Material proper store
Checked By : _____________________ Name
___________________ Signature
__________________ Date
SAFETY DEPARTMENT YNESB/OSHEF/13 WRITTEN WARNING FOR SAFETY MISCONDUCT REPORT NO :
DATE :
NAME : DESIGNATION:
Fr ,Rev 0,01.02.2009
AFTER ISSUING VERBAL WARNING FOR CONTINUOS VIOLATION OF SAFETY REGU REGULA LATI TION ONS, S, IT HAS HAS BE BEEN EN DEEM DEEMED ED NECE NECESS SSAR ARY Y TO NOW NOW ISSU ISSUE E AN OFFICIAL WRITTEN WARNING ANY FURTHER VIOLATIONS WILL RESULT IN IMMEDIATE REMOVAL OF YOURSELF FROM SITE AND DISMISSAL FROM THE COMPANY.
REASON FOR ISSUING OF WARNING.
SAFETY OFFICER :
YARD MANAGER :
EMPLOYEE :
SAFETY DEPARTMENT YNESB/OSHEF/14 NOTIFICATION OF OVERTIME AND REST DAY/PUBLIC HOLIDAY WORK CONTRACTOR: Fill the appropriate row
DATE:
Overtime Works On :
_____/_______/_______
Time : From_________To_______ From_________To_________ __
Rest Day Works On :
_____/_______/_______
Time : From_________ To_________
Public Holiday Works On :
_____/_______/_______
Time : From _________To_________
Specific Location of Work Area :
Supervisor in charge
Fr ,Rev 0,01.02.2009
Specific Work To Be Carried Out :
No Of Persons
: ______________________ (Name)
Signature ________________
Contractor’s Safety Safety Personnel On Duty : ______________________ (Name)
________________
Contractor’s Authorized Personnel
________________
Contractor On Duty
: ______________________ (Name)
Approved by (YNESB PERSONALS)
Signature
Production Manager : __________________________(Na __________________________(Name) me)
________________
Safety officer
________________
: __________________________(Na __________________________(Name) me)
Safety Instructions: # To standby vehicle for Emergency Use throughout the working duration Note : # Normal day overtime work notification to be submitted to OSHED by or before 1700 hours on the intended working day # Rest day/Public Holiday work notification to be submitted to OSHED one (1) day prior to the intended working day
SAFETY DEPARTMENT
YNESB/OSHEF/15 Date :
HEAVY LIFTING PERMIT SECTION 1
DEPT/CONTRACTOR
LOCATION
DESCRIPTION OF WORK
SECTION 2
Item Description A. Normal lift <6 metric tons B. Lifting between 6-12metric tons C. Critical lift exceeding 12 metric tons (Attach sketch & capacity calculation) D. Multiple crane lifting (wt................ (wt.................. ..
Purpose of Lift
Special Work Instruction
Fr ,Rev 0,01.02.2009
E. Use of overhead crane (wt................. (wt................. F. Lifting over unprotected/live equipment G. Removal or installation of equipment H. Overhead lift (sling not made of wire rope) I. Using more than 4 legged sling J. Lifting inside confined space
Originator/User...................................Designation..............................................Signature........................................ Name of crane operator Signalman................ Signalman.. ............................ ........................... .............
Signature............... Signature. ............................ ....................... .........
SECTION 4 : WORKSITE PREPERATION
PRECAUTIONS A. Valid PMA B. Crane inspected (safe for use) C. Competent crane Operator / Signalman D. Rigging equipments in good condition E. Load weight ascertained F. Ground condition firm and level (use steel plates plates if reqd) G. Pre-job meeting carried out H. Overhead obstruction/ services checked
Yes / No
Initial by S’visor
SLING SPECIFICATION A. Sling test date B. Sling Assy. SWL C. Load wt. (mt) D. Sling ID No E. Size of wire rope G. Size of shackle
H. Shackle SWL I. No of shackle used
SECTION 5 : PERMIT VALIDATION
Approved By : Name Signature
Lift Permit No: Position
Date
Time
From To
SECTION 6 : WORK COMPLETION / SUSPENSION
The work has been completed/suspended completed/suspended on................... on.............................. ...........(date) (date) at................... at......................(hrs) ...(hrs) Reason for suspension (if any).................................................................................................................................... ........................................................................................................................................................................................... ................................
SAFETY DEPARTMENT PERMIT TO WORK Work Activity (delete as applicable)
Hot Work
Lifting Work
Repair/ Maintena nce Machine
YNESB/OSHEF/16
Confined Space Entry
Blocking Access
OTHERS
A. Application ( to be completed by H.O.D, Contractor, ) Requesting Dept/Cont Plant Area
Request by
Date
Description of work (attach drawing / sketch as ne n ecessary)
Time
Date
To
Time
Date
Fr ,Rev 0,01.02.2009
Permit is required From: B. Precautions to be taken prior to commencement and during the work (delete/add as appropriate) Hot Work Is Approved Method Statement and Risk Assessment available Area cleared of Flammable Waste Fire Extinguisher available Overhead work to have area below barricaded Pipelines etc free of g as/liquid Fire blanket provided to arrest spark / flame Welding screens in use to protect others Appropriate PPE available Cylinders secured & flash-back arrestor fitted
Lifting Work No lifting machine shall be operated except by an authorized person. All lifting equipment must be examined by the supervisor and operator before use. Protect wire rope or chain sling from sharp edges and corner with padding. The centre of gravity for the load must be determined for proper balancing of the load. The chain opening angle shall not exceed 60%.Stay clear from any suspended load.
Repair/Maintenance Machine
Is Approved Method Statement & Risk Assessment available, PPE available. Log In and Log Out sign display.
C. REQUEST (PRODUCTION TEAM)
Permission is given for the work to proceed subject to the conditions specified above Signed ( Permit Controller)
Sign
Print
Date
Time
Company
D. Performing Authority Acceptance (SAFETY PERSONAL)
I certify that I have read and understood this permit and that the work will be carried out in accordance with the requirements Signed :
Sign
Print
Date
Time
Company
E. Completion of work (PRODUCTION TEAM)
I hereby declare that all work for which this permit was issued has been complete, all personnel under my control have been withdrawn and the work area and all associated equipment has been left in a safe condition. Signed :
Sign
Print
Date
Time
Company
Print
Date
Time
Company
F. Cancellation (SAFETY PERSONAL)
This permit is cancelled Signed :
Sign
SAFETY DEPARTMENT
YNESB/OSHEF/17
ELECTRICAL TOOLS / EQUIPMENT QUATERLY INSPECTION CHECKLIST Company :
Type :
Supervisor :
Model :
Date :
Series No:
Inspection By :
Tag No :
Next Inspection : Item Description B O D Y P
Yes
No
N/A
Remarks
1. Casing – damage / crack 2. Handle – installed securely 3. Handle – damage / crack
Fr ,Rev 0,01.02.2009
A R T
4. Switch – damage / no function 5. Trigger lock – faulty / damage 6. Main dead switch – faulty / damage 7.Power cord defect – cracking / frying 8. On / Off switch – faulty / damage 9. Guardrail / shield / hazard part protection provided
C A B L E / W I R E
10. Damages of wire 11. Proper Connection 12. Earth, properly grounded 13. Plug – crack, loose, missing 14. Use 3 prong plug (faulty prongs) 15. Check earth leakage
/ P L U G O T H E R S
16. Broken wire insulated 17. Wire cable / quality 18. Used by trained / competent workers 19. Necessary PPE provided 20. Operating manual provided 21. Manufacturing stickers 22. Series / model stickers 23. Proper store
NAME & SIGNATURE MAINTENANCE/ MAINTENANCE/ FACILITY DEPT.
NAME & SIGNATURE SAFETY PERSONAL
NAME & SIGNATURE STOR SUPERVISOR
SAFETY DEPARTMENT
YNESB/OSHEF/18
ELECTRICAL TOOLS / EQUIPMENT DAILY DAILY INSPECTION CHECKLIST CHECKLIST Company :
Type :
Supervisor :
Model :
Date :
Series No:
Inspection By :
Tag No :
Next Inspection : Item Description B O D Y P A R
Yes
No
N/A
Remarks
1. Casing – damage / crack 2. Handle – installed securely 3. Handle – damage / crack 4. Switch – damage / no function
Fr ,Rev 0,01.02.2009
T
5. Trig Trigge gerr loc lock k – fau fault lty y / dam damag age e 6. Main dead switch – faulty / damage 7.Power cord defect – cracking / frying 8. On / Off switch – faulty / damage 9. Guardrail / shield / hazard part protection provided
C A B L E / W I R E
10. Damages of wire 11. Proper Connection 12. Earth, properly grounded 13. Plug – crack, loose, missing 14. Use 3 prong plug (faulty prongs) 15. Check earth leakage
/ P L U G O T H E R S
16. Broken wire insulated 17. Wire cable / quality 18. Used by trained / competent workers 19. Necessary PPE provided 20. Operating manual provided 21. Manufacturing stickers 22. Series / model stickers 23. Proper store
Checked By : _______________________________ Name/
SAFETY DEPARTMENT
YNESB/OSHEF/19
GROUND EQUIPMENT INSPECTION CHECKLIST(INITIAL/ QUARTERLY ) Signature/ Date
( GENERATOR, WELDING MACHINE, AIR COMPRESSOR, ETC)
Fr ,Rev 0,01.02.2009
Company :
Type of Inspection : INITIAL / QUARTERLY / RENEWAL Type of Equipment :
Serial / Equipment No :
Inspection Certificate No.:
PMT No.(air compressor) : Expiry Date :
Expiry Date : Item Description
Yes
No
N/A
Remarks
A. Is wiring in good condition B. Is insulation in good condition C. Is information plate visible D. Is ELCB in good condition E. Is safety guard in place F. Is radiator cap fired G. Is fuel cap fitted H. Is exhaust spark arrestor fitted I. Is air induction control valve fitted J. Is drive belt cover fitted K. Is there any evidence of fuel leakage L. Are pressure regulators in good condition M. Are gauges in good condition N. Are the leads and hoses in good condition P. Is Emergency Stop button available and clearly marked Q. Is earthling system available R. Is equipment fitted with fire extinguisher S. Is copy of PMT displayed on the equipment
NAME & SIGNATURE MAINTENANCE SUPERVISOR
NAME & SIGNATURE SAFETY PERSONAL
NAME &SIGNATURE STOR SUPERVISOR
GROUND EQUIPMENT DAILY INSPECTION CHECKLIST
Fr ,Rev 0,01.02.2009
Company :
Type of Equipment :
Serial / Equipment No :
Inspection Certificate No.:
PMT No.(air compressor) : Expiry Date :
Expiry Date : Item Description
Yes
No
N/A
Remarks
A. Is wiring in good condition B. Is insulation in good condition C. Is information plate visible D. Is ELCB in good condition E. Is safety guard in place F. Is radiator cap fired G. Is fuel cap fitted H. Is exhaust spark arrestor fitted I. Is air induction control valve fitted J. Is drive belt cover fitted K. Is there any evidence of fuel leakage L. Are pressure regulators in good condition M. Are gauges in good condition N. Are the leads and hoses in good condition P. Is Emergency Stop button available and clearly marked Q. Is earthling system available R. Is equipment fitted with fire extinguisher S. Is copy of PMT displayed on the equipment
( GENERATOR, WELDING MACHINE, AIR COMPRESSOR, ETC)
NAME
POSITION
SIGNATURE / DATE
SAFETY DEPARTMENT YNESB/OSHEF/21 MONTHLY CHECKLIST - FIRE EXTINGUISHERS Statutory and licensed equipment/machinery
Non -statutory and licensed equipment/machinery
Location
Department/section
Fr ,Rev 0,01.02.2009
Visual inspection and functional test
Inspected item
Yes
No
Remarks
N.A
Is fire extinguisher conspicuously located? .Is there any proper space demarcation for fire extinguisher. Is trigger pin intact? Is wire seal of fire extinguisher unbroken? Is standard operating procedure for using fire extinguisher displayed? Is there clear access to fire extinguisher? Is discharge hose and horn in good working condition and free from cracks and surface grazing? Is pressure indication gauge within the green zone? Is the body of fire extinguisher free from corrosion? Is the fire extinguisher close to hazard area (i.e 1.5 m apart at high fire hazard area) Is the fire extinguisher affixed with approved labels? Is the fire extinguisher inspected by licensed fire extinguisher contractor annually? Is the fire extinguisher appropriate for the area served? Note : Responsible persons must record and maintain the monthly checklist for 36 months Inspected By :
NAME
POSITION
SIGNATURE / DATE
SAFETY DEPARTMENT YNESB/OSHEF/22 QUATERLY CHECKLIST - EXIT LIGHTS Statutory and licensed equipment/machinery
Non -statutory and licensed equipment/machinery
Location
Department/section
Inspected by
Date of inspection
Fr ,Rev 0,01.02.2009
Area manager in-charge
Reviewed by and date Visual inspection and functional test
Inspected item
Yes
No
Remarks
N.A
a. Batteries of exit lights properly charged b. Exit lights are ‘No’ when conducting inspection. c. Light bulbs are intact and working order. d. Supplementary electricity supply to exit lights is intact and normal. e. Any signs of missing or damaged hardware, such as, wires, screws and lamps. f. Any sign of obstruction to lamps. g. Any signs of worn or frayed cables. h. Any sign of improper support to exit lights i. Any inventory of all exit lights in the facility. j. Any obstruction to gain access to exits? Note : Responsible persons must record and maintain the quarterly checklist for 36 months Inspected By :
NAME
POSITION
SAFETY DEPARTMENT
SIGNATURE / DATE
YNESB/OSHEF/23
QUATERLY CHECKLIST - FIRE DOORS
Statutory and licensed equipment/machinery
Non -statutory and licensed equipment/machinery
Location
Department/section
Inspected item
Visual inspection Yes
No
Remarks
N.A
a. Are fire doors conspicuously located? b. Is there any proper space demarcation for fire doors? c. Are rivets, bolts or screw intact?
Fr ,Rev 0,01.02.2009
d. Are wires (Connected to counter weights)disconnected or broken? e. Are warning sign “Not to damage fire door “ printed on fire doors? f. Are fusible links intact? g. Is there any signs of cracks or dents on fire doors? h. Is there any “ fire rating” sign on fire doors? i. Are fire doors free free from oil and grease? j. Is any standard operating procedure on operating fire door displayed near the affected area? k. Is there an inventory of all fire doors? l. Are fire doors free from obstruction? m. Is fire door/fire shutter closed completely during functional testing? n. Is there any warning signal or audio alarm associated with fire door/fire shutter when there is an activation?
Note : Responsible persons must record and maintain the monthly checklist for 24 months Inspected By :
NAME
POSITION
SIGNATURE / DATE
SAFETY DEPARTMENT
YNESB/OSHEF/24
QUARTERLY CHECKLIST - MAIN MAIN SPRINKLER SPRINKLER CONTROL AND HYDRANT
Statutory and licensed equipment/machinery
Non -statutory and licensed equipment/machinery
Location
Department/section
Inspected item
Visual inspection Ye s
No
Remarks
N.A
Are fire sprinkler control valve/hydrant isolation valves conspicuously located? Is there any proper space demarcation by hydrant isolation valve?
Fr ,Rev 0,01.02.2009
Is there a proper means of securing the main fire sprinkler control valves?(i.e straps & locks) Are straps and locks of sprinkler control valve intact. Is wire seal if hydrant isolation valve unbroken? Is there any standard operating procedure and drawing of operating sprinkler control valve intact. Is there clear access to sprinkler control valves. Are local alarms /bells of deluge control valve of sprinkler system in good working condition order and free from cracks of surface glazing Are pressure indication gauges and in good working conditions? Is there any ‘open or shut’ indicator for hydrant isolation valve? Is the body of sprinkler control valve or deluge valve free from corrosion? Are fastening bolts, nuts or gaskets for sprinkler control valve or deluge valve intact and in good working conditions? Are there signs of leaks of sprinkler valves/deluge valve/hydrant isolation valves? Is there an inventory of sprinkler control valves deluge valves/hydrant isolation valves? Note : Responsible persons must record and maintain the monthly checklist for 24 months Inspected By :
NAME
POSITION
SAFETY DEPARTMENT
SIGNATURE / DATE
YNESB/OSHEF/25
Rules and Regulations
1.
I have been been instru instructed cted and and underst understood ood the the OSHE OSHE rules rules and regula regulation tionss and agree to abide by them.
2.
I have been instructed and understood that if I have any questions or concerns then I should consult with my immediate supervisor. If he is unable to give a solution then I have a right to seek higher assistance from the Safety Personals.
Fr ,Rev 0,01.02.2009
Name of employee : ______________________________________________ Designation:
______________________________________________
Project badge no.: _________________________ ______________________________________________ _____________________ NRIC/Passport No. ______________________________________________ Employee signature:_____________________________________________ Date inducted:
_____________________________________________ _________________________ ____________________
SAFETY DEPARTMENT WORKER PARTICULAR Company
:________________________________________
Date
:________________________________________
Post
:________________________________________
Name Of Employee I/C No.
YNESB/OSHEF/26
:________________________________________ :_______________________________ _________ :________________________________________ :_______________________________ _________
(To be contacted during emergency)
Next Of Kin Address
:___________________________________________ :_______________________________ ____________ :___________________________________________ ____________________________________________
Fr ,Rev 0,01.02.2009
Tel No.
: ______________________________________ ____________________________________________ ______
H/P No.
:_____________________________________________ :__________________________________ ___________
I have been given the following P.P.E. Safety Helmet Safety Shoe Safety Goggles Gloves Dust Mask Welding Shield Grinding shiled
Incase any accident happen and being traced me not wearing the above P.P.E Provided to me than I shall not to blame the company as it will be considered as my own carelessness. Employee Signature
* I/C or Passport Passport photocopy attached attached ________________________
SAFETY DEPARTMENT
YNESB/OSHEF/27
MEDICAL HISTORY
_________________________________ NAME
__________________________ D.O.B
EMERGENCY CONTACT :
__________________ IC/Passport No.
_______________ AGE
MALE
/
FEMALE
___________________________________________________ ___________________________________________________ NAME PHONE#
Fr ,Rev 0,01.02.2009
ALLERGIES: ___________________________________________________________________________ ________________________________________________________________________________________ PAST MEDICAL HISTORY (ie,HEART,LUNG,LIVER , ETC.:APPENDECTOMY, TONSILECTOMY, HYSTERECTOMY, ETC. ) ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
MEDICATIONS TAKEN ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
IF NOT TAKING ANY MEDICATION OR DO NOT HAVE A PAST MEDICAL HISTORY NOT ALLERGIES, PLEASE WRITE IN N/A. ALL MEDICAL INFORMATION WILL BE CONFIDENTIAL. THIS IS TO BENEFIT YOU IN CASE OF AN EMERGENCY INJURY OR ILLNESS.
SAFETY DEPARTMENT
YNESB/OSHEF/28
BOOKING LIST FOR OSHE INDUCTION
Contractor Name Induction Date Booked S/N
Name
: ___________________ : ___________________ Time Booked : Passport/IC No.
Designation
__________________ Remarks Absent Present
1 2 3 4 5 6 7 8 9
Fr ,Rev 0,01.02.2009
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total For This Page :
Verified By
Submitted By
Received By
Name / Signature / Date
Name / Signature / Date
Name / Signature / Date
SAFETY DEPARTMENT
YNESB/OSHEF/29
WARNING FOR SAFETY VOILENCE
1ST WARNING 2ND WARNING 3RD WARNING
NAME
: ________________________________ _______
CONTRACTOR: _______________________________________
PLACE: _____________
VOILENCE
DATE: _____________
TIME: _____________
: __________________________________ ____________________________ ______________________________________________________________ ______________________________________________________________
FEATHER ACTION TAKEN
: ____________________________________ __________________________ ______________________________________________________________
Fr ,Rev 0,01.02.2009
DEMIRIT POINTS:
ACCUMULETE DEMIT POINTS: GIVEN BY:
NAMA
:____________________________________________
SIGNATURE:_____________________________________________ RECEVED BY:
NAME EMP. NO
: _________________________________ __________________ : __________________________________ _________________
DESIGNATION: _______________________________________________ SIGNATURE: _____________________________ DATE Cc:
•
: _____________________________ Mr. M.S.Han – Senior Manager Mr. Yusufirashim - Admin& HR Manager Mr. Samuel Wong –Yard Manager Sub- Contactor Picture as attached
SY S YSTEM ST EM DEM D EMERI ERIT T The demerit system provides penalties and disqualification for staff and workers who contravene safety rules within a three (3) month period.
1. PERSONAL PROTECTIVE EQUIPMENT 1.1 1.2 1.2 1.3 1.3 1.4 1.4 1.5 1.5 1.6 1.7 1.7
Working without safety helmet Worki orkin ng witho ithou ut safe afety shoe shoe Worki orking ng with withou outt eye eye prot protec ecti tion on Worki orking ng with withou outt ear ear prot protec ecti tion on Worki orking ng with withou outt hand hand prot protec ecti tion on Working without dust mask Work Workin ing g with withou outt safe safety ty harn harnes esss abov abovee 3 mete meters rs
10 10 10 10 10 10 30
2. UNSAFE ACTS AND CONDITION 2.1 2.1 2.2 2.3 2.4 2.5
Off Off all all elec electr tric ical al equi equipm pmen entt when when not not usin using g Absent from Tool Box Meeting Close all gases valve when not using Working without proper access Poor house keeping
10 10 10 10 20
Fr ,Rev 0,01.02.2009
2.6 2.7 2.8 2.8 2.9 2.9 2.10 2.10 2.11 2.12 2.12 2.13 2.13 2.14 2.15 2.16 2.17 2.18
Eating / sleeping during working hours at workshop Blocking emergency access or fire fighting equipments Dump Dumpin ing g of wast wastee or scra scrap p at unau unauth thor oriz ized ed area areass Fail Failur uree to repo report rt acci accide dent nts, s, near near miss misses es and and inci incide dent nt Smok Smokin ing g insi inside de plan plantt Th Throwing of tools Using Using matche matchess or lighte lighterr to light light cuttin cutting g torch torch Unaut Unauthor horize ized d person person doing doing heavy heavy liftin lifting g Violating gas cylinder procedures and incorrect storage Using foul language against superior Horseplay Misuse of fire fighting equipment Under Under influenc influencee of drug drug or alcohol, alcohol, gambl gambling, ing, fighting, fighting, stealing, stealing, vandalism vandalism,, illegal illegal workers.
20 20 20 20 20 20 20 20 20 20 25 25 50
3. TRAFFIC 3.1 3.2 3.3
Riding motorcycle to around workshop area without approval Speeding or dangerous driving around workshop area Parking unauthorized area
20 20 20
PENALTY
30 Points Suspension for 3 days 40 Points Suspension for 7 days 50 points above Dismissal and bar from entering factory Value of every one demerit point equal to RM 1.00. Penalty will be double for above foreman level. Prepared By:- S.ESWARAN - Safety Officer
Approved By:
______________________
Mr. S.K. SIAU Executive Director
______________________ MR.SADIR MOHAMMED Director
Effective Date: September 2008
C.C.
Mr K. C. Seow – General Manager Mr M.S.Han – Senior Manager Manager Mr. Yusufirashim - Admin& Safety Manager Mr. Samuel Wong –Plant Manager
Fr ,Rev 0,01.02.2009
Mr. They.H.S- Production Manager Mr. Mandy Lua – Account Manager All Dept. Heads and Sub- Contractors.
SAFETY DEPARTMENT
YNESB/OSHEF/03
Block : Work Shop : S.No 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
DAILY PLANT SAFETY INSPECTION CHECKLIST Description Foremen on job area All All emp employ loyee ees s weari wearing ng prope properr eye eye/he /head ad protec protectio tion? n? All All wea wearin ring g heari hearing ng protec protectio tion n where where neces necessar sary? y? All All wea wearin ring g prote protecti ctive ve clothi clothing ng where where neces necessar sary. y. All All weari wearing ng respir respirato atory ry protec protectio tion n whe where re nece necessa ssary? ry? All All wear wearin ing g adeq adequa uate te saf safet ety y shoe shoes/ s/gl glov oves es? ? All All overh overhea ead d worke workers rs usin using g safet safety y belts belts? ? Line Line? ? If requi required red? ? Equi Equipm pmen entt prop proper erly ly loc locke ked d out out /ta /tagg gged ed out out? ? Elect Electric rical al conn connec ectio tions ns/co /cords rds,, prope properr twist twist lock lock conne connecti ction ons? s? Weld Weldin ing g mach machin ines es ear earth th pro prope perl rly y conn connec ecte ted? d? Exte Extens nsio ion n cab cable les s is is pro prope perl rly y lay. lay. Gas Gas hose hoses s in good good cond condit itio ion? n? Flas Flash h bac back k arr arres esto torr ins insta tall lled ed? ? Gas Gas hose hoses s prop proper erly ly ins insta tall lled ed and and pro prope perl rly y lay. lay. Firefi Firefigh ghtin ting g equi equipm pmen entt in place place and and good good cond conditi ition on.. Road Roads s prop proper erly ly bloc blocke ked d if nece necess ssar ary? y? Any Any obs obstr truc ucti tion on on the the acc acces ess s way way? ? Scaff Scaffol oldin ding g prop properl erly y ins instal talled led? ? Prop Properl erly y tag taggin ging? g? Ladders pro prop perly us used? Hand to tools prop roperly rly us used? Prop Proper er lift liftin ing g meth method od saf safe e mate materi rial al han handl dlin ing? g? Over Ov er head head crane rane in good good cond condit itio ion? n? Lift Liftin ing g slin sling g in goo good d cond condit itio ion? n? Ins Inspe pect cted ed? ? Durin During g lifti lifting ng,, padd paddin ing g in use use cove coverr the the Sha Sharpe rpe edge edges? s? Rubb Rubbis ish h and and scra scrap p bin bins s in in pla place ce? ?
Yes
No
N. N.A
Fr ,Rev 0,01.02.2009
26 27
Good house keeping Spec Specia iall war warni ning ng post posted ed if nece necess ssar ary y Remark:
Supervisor : _________________
Safety Officer : _________________
Name
: _________________
Name
: _________________
Date
: _________________
Date
: _________________
Signature : _________________
Signature : _________________
Fr ,Rev 0,01.02.2009