SW/HSE/CL001 REV:00

CHECK LIST FOR HYDROLIC ROTTARY RIG

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Check the Derrick Pulleys for damages and pin locking.

2 Working condition of the auxiliary winch Hoist limit switch.

3 Working condition of the Kelly Bar Limit Switch on the Mast.

4
Check the wire sling connections on the Kelly Bar for loose or damaged
U bolts and broken wires.
5
No oil leak in hydraulic parts.

6
Kelly Movement and working condition (damage, crack and jamming
while extending).
7 Working condition of the Emergency Lever in the Operator Cabin.

8 Wire ropes shall be free from Damages (No Kinks and broken wires).

9 Rotary Head support Connecting Pins to the mast (Crack, Damage).

10 Fire extinguisher provision in the operator cabin.

11 Availability of the Head and tail lamps (for night working).

12 Provision of rear view mirrors, front and reverse horn.

13
Operator should pose a valid license.

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL002 REV:00

CHECK SHEET FOR BAR BENDING MACHINE

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Erected in a firm base concrete platform.

2
Machine is grouted properly/ Base wheel stopper provided

3 Body Earthing is provided

4 D.B box connected with the machine is equipped with MGB and ELGB.

Emergency switch is available in working condition ( Front side and back side of the
5
m/c)

6 Power on & off switch with indicator light are available in working condition.

7 Belt and other internal moving parts are covered/Guarded.

8 No oil leakage

9 Both side hand guard is available.

10
Limit switch (Both Side,below the job plate) are in working condition

11 Availability of standard limit switch pin.

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL003 REV:00

CHECK LIST FOR CONCRETE MIXER

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Condition of the base

2 Presence of the mixer round handle stopper

3 Condition of the m/c stand with wheel

4 Presence of guard for rotating parts(pulley & chain)

5 Condition of the sling of the feeder/hopper (free from damage)

6 Cover of the starter

7 Condition of radiator

8 Wire rope/sling of the hopper fixed with the guide only by 'D' clamp.

9 Condition of belt

10 Diesel leakage from the diesel tank

11 Condition of chain

12 Guarding of revolving parts

13 Ensure barricading on both sides of the hopper when the machine in operation

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL004 REV:00

CHECK LIST FOR MINI DUMPER

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Physical damage in body of the vehicle and in the bucket

2 Working condition of the vehicle forward and reversed gear

3 Working condition of the hydraulic brakes (4 wheels)

4 Oil leakage from the hydraulic cylinder and from the diesel tank.

5 Starter shaft covered by guard

6 No Damage in Tire ( Crack, cut, air pressure etc).

7 Driver seat hood is available and no damage

8 Head and tail lamps (for night working).

9 Exhaust pipe is bended outside (Not faced on operator)

10 Operator license.

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL005 REV:00

CHECK LIST FOR TRACTOR

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Protection (canopies, screens) is provided to shield operator from falling objects.

2 Effective, working horn and reverse alarm

3 Moving parts, shafts, sprockets, belts, etc.are guarded.

4 Protection against contact with hot surfaces, exhaust, etc.is provided.

5 Safe means of access (steps, grab bars, non-slip surfaces) to the cab is provided

6 No Damage in Tire ( Crack, cut, air pressure etc).

7 No Leakage of oil from the vehicle and vehicle oil tank.

8 Vehicle rear view mirror

9 Head light,Tail lamp are in working condition (for night work)

10 Brake, accelerator, clutch are in good working condition

11 Lock of the back door (traile) in good condition

12 Inter locking system between the tractor and the trailer

13 Operator license (LMV atleast) & I.D card.

14 Vehicle valid insurance

15 Visualization of Check sheet and Operator details with photo in the vehicle itself.
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL006 REV:00

CHECK SHEET FOR EXCAVATOR

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Front & reverse horn

2 Head & tail lamps(for working at night)

3 Lakage of oil(in hydraulic & pneumatic systems)

4 Loose bolts /connecting pins(bucket)

5 Back view mirror

6 Roller-crawler / tyre condition (check for damaged / missing idle rollers)

7 Structure beem condition(damage,cut,crack)

8 Diesel, oil and grease spillage.

9 Licensed operator (heavy licence)

10 Fire extinguisher in operator cabin

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL007 REV:00

CHECK LIST FOR JCB

PROJECT: LOCATION: DATE:

7
1
10
4
5
6 3

SL NO CHECK ITEMS Y N

1 Head & tail lamps(for working at night)

2 Front & reverse horn
3 Leakage of grease or oil(in hydraulic & pneumatic systems)
4 Clutch / brake / Hand brake
5 Back view mirror
6 Tyre condition
7 Seat Belt
8 Operators fitness
9 Licensed operator (heavy licence)
10 Fire extinguisher in operator cabin
11 Any other Points
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL008 REV:00

CHECK LIST FOR HYDROULIC ROTARY MIXER

PROJECT: LOCATION: DATE:

3 10
8
6

5 7

SL NO CHECK ITEMS Y N

1 Operator should pose a valid license.

2 Driver has completed site-specific induction

3 Hose – any leakage

4 Engine & Chassis Condition

5 No oil leak in hydraulic parts.

6 Fire extinguisher fitted any fully operational

7 Working condition of the Emergency Lever in the Operator Cabin.

8 Guarding of revolving parts

9 Warning horn fully operational

10 No cracks in windscreen

11 Availability of the Head and tail lamps (for night working).

12 Signal man
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL009 REV:00

CHECK LIST FOR MOBILE CRANE ( F-15)

PROJECT: LOCATION: DATE:

2
1
8 10

11
3

9
6

SL NO CHECK ITEMS Y N

1 Safety latch in hook.

2 Hoist limit switch (Or presence of plate).

3 SWL marked in crane.

4 Automatic safe load indicator

5 Wire rope and slings free from tolerable damage( No kinks, broken wires more than 10% is N.G).

6 No oil leak in hydraulic parts (piston drums).

7 No Damage in Tire ( Crack, cut, air pressure etc.).

8 Head and tail lamps (for night working).

9 Front and reverse horn.

10 Four outrigger are in good working condition

11 Fire extinguisher in operator cabin.

12 Operator license (heavy duty).

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL010 REV:00

CHECK LIST FOR MOBILE CRANE

PROJECT: LOCATION: DATE:

11

SL NO CHECK ITEMS Y N

1 Safety latch in hook.

2 Hoist limit switch (Or presence of plate).

3 SWL marked in crane.

4 Wire rope and slings free from tolerable damage( No kinks, broken wires more than 10% is N.G).

5 No oil leak in hydraulic parts (piston drums).

6 No Damage in Tire ( Crack, cut, air pressure etc).

7 Head and tail lamps (for night working).

8 Front and reverse horn.

9 Boom structure condition while full expansion (damage, crack and jamming while extending).

10 Fire extinguisher in operator cabin.

11 Four outrigger and flotpat are in good working condition

12 Automatica safe load indicator

13 Third party certificate(Form 32)

14 Operator license (heavy duty).

15 Vehicle valid insurance

16 Road tax document

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL011 REV:00

CHECK SHEET FOR CHERRY PICKER (BOOM LIFT)

PROJECT: LOCATION: DATE:

10 3

4
5
9

7
1
10
6
2

SL NO CHECK ITEMS Y N

1 No Damage in Tire ( Crack, cut, air pressure etc).

2 Platform is securely fastened to platform support.

3 All member in the platform have safety belt

4 Foot pedal in the bucket is in working condition.

5 Outriggers & extendable axles are in smooth working condition.

6 High engine and height drive cutout is in working condition.

7 Any oil leakage in the Hydraulic systems.

8 Warning lamp is in working condition.

The cherry picker movement/ work area is leveled ,compacted and free from all
9
obstructions
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 RGP ELECTRONICS INDIA PVT.LTD
CHECK SHEET FOR SCISSOR LIFT
PROJECT: RENEWSYS HC-3 LOCATION: SREENAGAR (VILL) DATE:

SL NO CHECK ITEMS PHOTOS Y N

Level adjustment is
4 in good working
condition

Access lader to the

platform is with out
5 any
defects,missing
rungs.

Availability of limit
6 switch for the
platform extension

Mechanical stoper
7 for the platform
lifter is in

SL NO CHECK ITEMS PHOTOS Y N

Operator and
Scissor lifter working
scissor lifter
platform is provided
1 8 capacity details
with hand rail and
displayed in the
midrail
liftefr.

Availability of four All hazards signs

outrigger in four and operating
2 9
sides (Depends on instruction
type of lifter) displayed .

3
All wheels are in
good

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL013 REV:00

CHECK LIST FOR FORK LIFT

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Front & reverse horn

2 Head & tail lamps(for working at night)

3 Leakage of oil(in hydraulic & pneumatic systems)

4 Loose bolts /connecting pins(bucket)

5 Back view mirror

6 Tyre condition

7 Structure beem condition(damage,cut,crack)

8 Diesel, oil and grease spillage.

9 Licensed operator (heavy licence)

10 Fire extinguisher in operator cabin

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL014 REV:00

CHECK LIST FOR GENERATOR (DG)

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Guard provided for any rotating parts.

2 Hot surface is provided with guard.

3 Rubber mat is provided in operator standing area.( around the D.G)

4 No oil leakage from the oil tank & other parts of the m/c.

5 Wheel stopper in case of vehicle mounted D.G

6 Proper access to the D.G control panel

7 Exhaust smoke pipe faced upwards & outside of D.G shelter.

8 Dip tray for any oil leakage.

9 Drive belt is in good condition (any cut,dent or damage)

10 Adequate ventilation in case of indoor generator

11 Presence of fire extinguisher (ABC type)

Presence of damage free operating switch,Voltage and temperature

12
meter,circuite breaker,Oil level indicator, Emergency switch

13 Earthing is provided with standard earthing pit.

In case of mobile gen set, confirmation of inbuilt acoustic system. (If sound is
14
more than 85 dB)
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL015 REV:00

CHECKSHEET FOR DISTRIBUTION BOARD / PANEL BOARD

PROJECT: LOCATION: DATE:

2 4

3 8

9 14

5 7
1
6
15
13

Y N
SL NO CHECK ITEMS

1 Firm Base with grouting & Easily accessable panel (height of the leg is equal to 1m)

2 The Housing & connections of D.B is weather proof. (minimum of IP 44 type)

3 Authorized Operator Name Photo, Contact No.on DB panel (Confirmation)

4 Visualization of voltage, current and type of tools to be used in the socket & Panel.

5 Identification of input and output cables

6 Confirmation of LOTO availability

7 Separate MCB for every socket

8 Safety sign / isolate flammable Fire Hazard

9 Double Earthing System of MDB / DB panel with Std earthing pit

10 Separate ELCB with tripping current of 30 mA & in working condition.

11 Hylem sheet to be provided over live bus bars

12 Presence & Condition of Bus bar/ Terminal

13 Condition of Cable,Power Socket and Plug without damage

14 Color coding to be followed (RYB) for all cables/wires

15 Presence of rubber mat infornt of the D.B (Operator standing Location)

16 Plug-Socket should be Industrial type (IP 44 type)

Comments If any:

Signature of site safety incharge Signature of site engine

 RGP ELECTRONICS INDIA PVT.LTD
CHECK LIST FOR LADDER

PROJECT: LOCATION: DATE:

9
2
1
3 4 0
16
6

4
4
1
15 0
20 21 22
Extension 1
Ladder 14
10 8

SL NO CHECK ITEMS Y N

1 All the rungs, cleats, or steps are in good condition (Broken,missing,bend rungs)
2 Side rails is intact without any cracks, bends, or breaks.
3 The rungs, cleats, or steps is fit into the side rails without damage.
4 Ladder is free from corrosion.
5 Side rails and steps are free of oil or grease.
6 Rungs are placed at regular intervals (30 cm gap between two rungs)
7 Projection of loose nails, screws, bolts, or other metal parts
8 At the time of using, the ladder should be placed at 65-75 degree angle (1:4 ratio)
9 Ladder is extended at least 1 m above the landing platform (3 Rungs)
10 Ladder is secured either at top or at the bottom
11 Ladder rungs should not be painted.
12 Reinforcement rod should not be used as ladder rungs
13 The surface of the rungs should not be smooth
14 Rubber feet for firm grip (in case of Aluminum ladder)
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 RGP ELECTRONICS INDIA PVT.LTD
CHECK LIST FOR DRILLING MACHINE

PROJECT: LOCATION: DATE:

Comments If any:

Signature of site safety incharge Signature of site engineer/inch

 RGP ELECTRONICS INDIA PVT LTD
CHECK LIST FOR FIRE EXTINGUISHER

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Condition of the extinguisher (Clean and Tidy)

2 Physical appearance for corrosion.

3 Safety pin in position

4 Condition of discharge nozzole (any blockage/damage)

5 Condition of hose (any leakage/broken)

6
Weight of the extinguisher (Should be match with actual weight written
in the body)
7 Availability of visual board.

8 All the indicator gages (where fitted) in green segment (not to be red)

9 Extinguisher is not expired or refilled before refilled date

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL019 REV:00

CHECK LIST FOR DRILLING MACHINE

PROJECT: LOCATION: DATE:

2
5 1

4
3
6

7 4

Y N
SL NO CHECK ITEMS

1 Fore handle in good operating condition

2 Presence of Cord strain reliever (glands).

3 Presence of Drilling trigger switch lock.

4 Drilling Bit should be in good condition.

5 Electric wire without cuts and joints.

6 Condition and presence of the On/off switch

7 Monthly inspection sticker

8 Presence of dust cleaning brush near the equipment

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 RGP ELECTRONICS INDIA PVT. LTD
CHECKLIST FOR CUT OFF MACHINE

PROJECT: LOCATION: DATE:

2
5

1 7 4 3

SL NO CHECK ITEMS Y N

1 Crack & Damage of the Cutting plate

2 Presence of Cutting plate guard

3 Presence of locking system for the plate & Guard

4 Presence of job clamp and its condition

5 Presence of handel and its condition

6 Cable condition(Any cut,wear etc) and presence of wire top plug

7 Presence cutting dust guard

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 RGP ELECTRONICS INDIA PVT.LTD
CHECK LIST FOR PORTABLE GRINDING MACHINE

PROJECT: LOCATION: DATE:

2 1
1
4
4
5 5

6
7 8 7

2
3 8 6
3

SL NO CHECK ITEMS Y N

1 Fore handle without damage.

2 Wheel guard (covering 3/4th area).
3 Grinding wheel without any crack.
4 Rear handle without any damage.
5 Presence of Cord strain reliever (glands).
6 Trigger switch without damage.
7 Presence of Switch lock.
8 Electric wire without cuts and joints.
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL022 REV:00

CHECK LIST FOR GAS CUTTING SET

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

Protective valve cap firmly fixed for both cylinder(Check for

1
damage/crack in the valve cap)
Pressure gauges two for each cylinder(inlet & out)are in working
2
condition(both Oxygen & Acetylene gas)
3 Flash back arrestor (FBAs) is provided for acetylene & oxygen cylinders
Non return valves (NRVs) is provided for both acetylene & oxygen
4
cylinders.
5 Tight Crimping of hoses with jubilee clamps.

6 Hose free from damage(cut and cracks )

7 Cylinder secured by chain to the trolley.

8 Trolley tire shall be free from damages.

Availability of industrial type lighter (no match box / commercial
9
lighters).
10 Cutting area Should be barricaded and warning boards to be displayed.

11 Cutting area shall be free from debris and flammable materials.

12 Availability of PPE (Cutting Goggles, Leather gloves Etc.)

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL023 REV:00

CHECK LIST FOR ARC WELDING MACHINE

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

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

9 Fire extinguisher and fire bucket with sand availability

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL-024,REV:00

CHECK LIST FOR AIR BLOWER

PROJECT: LOCATION: DATE:

3
5
2

Y N
SL NO CHECK ITEMS

1 Is plug is in proper condition?

2 Is cable is in proper condition?

3 Is operating switch is in proper condition?

4 Is there is damage / crack in air blower body?

5 Connection between air blower body & air horn is in good condition?
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL-025 REV:00

ELECTRICAL SAFETY INSPECTION CHECKLIST

PROJECT: LOCATION: DATE:

Sr. No Contents Yes / No Remarks

A Cable
1 Whether the condition of Cable is checked?
Are cables received from other site checked for insulation resistance
2
before putting them into use?
3 Are all main Cables taken either underground/ overhead?
4 Are welding cables routed properly above the ground?
5 Are welding & electrical cables overlapping?
6 Is any improper joining of cables-wires prevailing at site?
B DBs/ SDBs
1 Is earth conductor continued upto DB / SDB?
2 Whether DBs & extension boards are protected from rain / water?
3 Is there any over loading of DBs / SDBs?
Are correct / proper fuses & CB’s provided at main boards & sub-
4
boards?
Is energised wiring in junction boxes, CB panels & similar places
5
covered all times?
C ELCB
1 Whether the connections are routed through ELCB?
2 Is ELCB sensitivity maintained at 30 mA?
Are the ELCB numbered & tested periodically & test results recorded
3
in a logbook countersigned by competent person?
D Grounding
Is natural earthing ensured at the source of power (main DB at
1
Generator or Transformer)
2 Whether the continuity & tightness of earth conductor are checked?
3 Mention the gauge of earth conductor used at site.
4 Mention the value of Earth Resistance.
E Electrically Operated Machines / Accessories
1 Whether the plug top provided everywhere?
Are all metal parts of electrical equipment & light fittings /
2
accessories grounded?
3 Is there any shed / cover for welding machines?
4 Are Halogen lamps fixed at proper places?
5 Are portable power tools maintained as pr norms?
6 Any other information

Signature of site safety incharge Signature of site engineer/incharge

 SW/HS

CHECK LIST FOR EXCAVATION

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS

1 Whether soil stability and load bearing strength is adequate?

2 Whether necessary precaution is taken for underground pipes, sewer, and cable?

3 In case of loose soil whether proper shoring for the excavation is provided to prevent cave in?

4 Whether proper slope usually 450 & suitable benches of 0.5 m width at each 1.5 m depth are provided?

5 Whether proper foot step, slope or ladder provided for safe access / egress of man and equipment?
Whether barrication of 1m height with caution tape provided for excavation having depth < 1 m and
6
hard barrication for depth > 1 m?
7 Whether excavated earth is placed beyond 1.5 m of the edge of the trench?

8 Whether separate area is identified for storage of excavated earth or debris if required for back filling?

9 Whether heavy vehicle movement is restricted to come 2m of the edge of the excavation?

10 Whether proper dewatering arrangement has been made if required?

11 During rains whether the excavation is done with extra precaution to prevent cave in?
Whether caution board is provided for do’s and don’ts like ‘Caution – Deep Excavation’ & ‘Nobody to
12
enter within one meter of extreme reach’ etc.
13 Others if any
Comments If any:

Signature of site safety incharge Signature of site engineer/inch

 SW/HSE/CL026 REV:00

DATE:
Y N

ble?

o prevent cave in?

1.5 m depth are provided?

f man and equipment?

having depth < 1 m and

f required for back filling?

e excavation?

t cave in?
Excavation’ & ‘Nobody to

Signature of site engineer/incharge

 SW/HSE/CL027

CHECK LIST FOR REFRIGERANT VACCUME MACHINE

PROJECT: LOCATION: DATE:

4 6

5
3

2
8

1
9

SL NO CHECK ITEMS

1 Fore handle in good operating condition

2 Check Oil for normal level as per marked

3 Check Oil inlet port in good condition and proper tighting

4 Vaccume out let pipe / Handle in good condition

5 Electric connector and wire good condition and without cuts and joints.

6 Condition and presence of the On/off switch

7 Monthly inspection sticker

8 Check Service valve in good conditions

9 Check the pump base is in good condition

Comments If any:
Signature of site safety incharge Signature of site engineer/inch
SW/HSE/CL027 REV:00

DATE:

Y N
ure of site engineer/incharge
 SW/HSE/CL028 REV:00

CHECK LIST FOR REFRIGERANT RECOVERY MACHINE

PROJECT: LOCATION: DATE:

7
6
8
9
5

10
4

11 Y N
SL NO CHECK ITEMS

1 Check Overall Condition of Machine and Cylinders

2 Check Charging line and its connector in good condition

3 Check Electrical Cable with out joint and good condition

4 Check operating/ Selector knob is in good condition and correct position

5 Check the Pressure gauges are at zero position and correct reading (Calibrated)

6 Condition and presence of the On/off switch

7 Check Inlet valve are in good condition / proper closing

8 Check Charging / outlet valve are in good condition / proper closing

9 Check Cylinder shut off valve for damage

10 Check operating/ Selector knob is in good condition and correct position for type of refrigerant

11 Check Charging hose for damage

Comments If any:

Signature of site safety incharge Signature of site engineer/incharg

 SW/HSE/CL

CHECK LIST FOR PRESSURIZE WATER PUMP

PROJECT: LOCATION: DATE:

3
2

SL NO CHECK ITEMS

1 Fore handle in good operating condition

2 Check adapter in good condition

3 Check additional Water filter in working condition

4 Pressure Gun operating switch in good condition

5 Water Pipe without cuts and joints, connecting part in good condition

6 Condition and presence of the On/off switch

7 Check Inlet Solinoide Valve in working condition

8 Additional Nozals must be good condition

9 Check Discharge Water Port must be clean and good condition of thread

10 Check Power supply cable is uncut / without joint & good Condition

Comments If any:
Signature of site safety incharge Signature of site engineer/i
 SW/HSE/CL029 REV:00

MP

DATE:

17

Y N
Signature of site engineer/incharge
 RGP ELECTRONICS INDIA PVT. LTD

CHECK LIST FOR ALUMINIUM MOBILE SCAFFOLDING

PROJECT: RENEWSYS HC-3 LOCATION: SREE NAGAR ( Viil) DATE:

Y N
SL NO CHECK ITEMS

1 Only Caster wheel are installed

2 Proper locking machenism is available and in working condition

3 Ladder from inside the scaffold and inclined at 75 degree angle

4 Support provided from all sides and placed on ground

5 Handrail at haight1100 mm and midrail 550 mmfrom platform

6 Toe board of height 150mm to prevent fall of any material from platform

7 Base and height ratio is maintained as 1:3

8 Cross bracing and railing for ladder/ access is provided

9 Working platform is fully covered

10 Scaffolding status displayed through Tag

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL031 REV:00

CHECK LIST FOR SOIL COMPACTOR

PROJECT: LOCATION: DATE:

3
7
1

CHECK ITEMS Y N
SL NO

1 Tires,wheels,Lug Nuts,steam cap- If any Inflation.leaks,damage,wear

2 Drum Scrapers-Excessive wear,Damage

3 Vibratory support in Good Condition

4 Steering and Breaking system are in good Condition

5 Steps and handholds-Condition,cleanliness

6 Any oil leaks from the equipment

7 All hoses-Crack,wear spots,leaks

8 Codition of operator seat - Damage

9 Horn,light,indicator light, front & Rear Mirror -Proper functioning

10 Presence of fire extinguisher and its condition inside the cabin.

11 Presence of vehicle R.T.O document and driving license of the driver

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECK LIST FOR HAND PALLET TRUCK

PROJECT: MYLAN-VKSF DATE:

SL NO CHECK ITEMS OK NA

1 Checkload capacity plate is fitting legible and correct

2 Inspect forks for damage

3 Check wheels are in good condition

4 Check hydraulic jack cylinder for any leaks

5 Check lowering handle

6 Check handle is secure

7 Check operation hold and lowering

8 Check blade rollers

9 Any other visible damage and defects (mite details below)

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL032 REV:00

CHECK LIST FOR TRUCK

PROJECT: LOCATION: DATE:

4
3

CHECK ITEMS Y N
SL NO

1 Head and tail lamps & Indicators are in good condition

2 No Damage in Tire ( Crack, cut, air pressure etc).

3 Rear view mirror

4 Steering and Breaking system are in good Condition

5 Wind shield with wipe

6 Any oil leaks from the truck

7 Front and reverse horn are in good condition

8 Truck should not be overloaded

9 Presence of fire extinguisher and its condition inside the cabin.

10 Presence of vehicle R.T.O document and driving license of the driver

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL-033 REV:00

CHECKLIST FOR SCAFFOLDING

PROJECT: LOCATION: DATE:

Sr. No Description Yes No Remarks

1 Design tall scaffold
2 Provide scaffold of sound material
For tubular scaffold, diameter should not less than 48mm and wall thickness
3
less than 2.3mm
Check whether each scaffold is securely supported or suspended and properly
4
strutted or braced
Check whether all scaffold and working platform are securely fastened to the
5
building or structure and braced or guyed properly
Provide a regular plank stairway wide enough for 2 persons to pass and
6
provide hand rail on both sides
7 The length of the ladder should not be more than 4 meters
8 Check for all of loose material, bracing and other parts off scaffold
Check whether Un-insulated electrical wires exist near working platform,
9
gangway etc of scaffold
10 Check any other safety issues

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL-034 REV:00

CHECKLIST FOR LABOUR COLONY

PROJECT: LOCATION: DATE:

Sr. No. CHECK POINTS YES/ NO

ACCESS & EGRESS
1. Are the entry roads / walkways / passages to colony kept clear?
2. Are the walkways & roads are even and free from water logging?
3. Is the entry inside workmen colony restricted?
4. Is Illumination level OK in access / egress?
GENERAL
1. Are wastage bin kept in appropriate place?
2. Is garbage disposed regularly?
3. Are the drinking water facilities satisfactory?
4. Is there any emergency communication system in place?
5. Is the Workmen colony constructed with Non-Fire Hazard Material?
Is the workmen colony constructed with materials, which are not readily
6.
flammable?
7. Is fire risk prevention system in place?
8. Are First-aid boxes kept in appropriate places?
9. Whether disinfection activities carried out on weekly basis?
LIVING AREA
1. Whether Cement Flooring provided?
2. Condition of the Side walls / Roof Sheet
3. Is shelter strong enough to with stand wind pressure?
4. Whether the electrical connections provided are 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?
8. Is the general hygienic condition of the rooms adequate?
KITCHEN
1. Are kitchens kept clean and tidy?
2. Is the water supply adequate for cooking?
3. Is the garbage of kitchen being disposed off every day?
4. Are the utensils are being cleaned on regular basis?
Are gas cylinders & other flammable materials kept in safe area
5.
(away from fire)?
6. Are suitable regulator, Connecting tube & connections with the cylinder O.K
7. Are fire extinguishers kept out side kitchen?
UTILITIES AREA
1. Is the Wash area - Water tanks constructed as per the Design Drawing?

2. Are adequate toilets available?

3. Are the toilets are being cleaned on regular basis?

4. Is there adequate water facility available for toilet and bath?

5. Are the septic tanks and soak pit working properly?

6. Is area around bathrooms cleaned & kept dry and non slippery?

7. Is proper drainage provided?

8. Is drinking water available?

9. Is water tank tap not leaking?

10. Is water tank cleaned regularly?

Signature of site safety incharge Signature of site engineer/incharge

 SW/HSE/CL-034 REV:00

DATE:

REMARKS
er/incharge
 RGP ELECTRONICS INDIA PVT.LTD
CHECKLIST FOR HOUSEKEEPING
PROJECT: LOCATION: DATE:

Sr. No. CHECK POINT YES/NO REMARKS

1 Worksites clean and orderly?
2
Work surfaces kept dry or appropriate means taken to assure the
surfaces are slip-resistant?
3 All spilled materials or liquids cleaned up immediately?
4
Combustible scrap, debris and waste stored safely and removed
from the worksite promptly?
5 Metallic scrap removed from site promptly?
6 Work areas adequately illuminated?
7
Separate house-keeping team engaged as per the site
requirements?
8
The walkways and roadways maintained cleanly without any
obstruction?
9
Whether materials stacked properly in stores to protect from rain
water?
10 Whether stacking height maintained at chest level?
11 Appropriate signages and safety posters displayed at sites?

Signature of site safety incharge Signature of site engineer/incharge

 RGP ELECTRONICS INDIA PVT.LTD
CHECKLIST FOR WORKING AT HEIGHT
PROJECT: RENEWSYS HC-3 LOCATION:SREENAGAR (VILL) DATE:

Sr. Location- Location-

Check Points
No.
Yes No Yes No
1 Whether the work is performed at a heig more than 1.8 meters?
2 Is the work at height permit Required? Is obtained?
Ladder:
Whether ladder/scaffolding pipe/clam etc used are in good condition
3
havin marking of inspection?
4 Whether ladder is placed at solid an leveled surface?
5 Whether ladder is placed with an angl with horizontal ground > 75 0
Whether the ladder used is OK?
6 No broken rung,
The rung spacing ≤ 12” etc
When one person is climbing ladder, n material is in his hand and ladder
7
is hol by another person at bottom?
8 In case of rolling ladder its shoe brakes ar applied.
Is ladder tied up at upper end and its upp portion extended above 1 m
9
from platform.
While ascending and descending the ladd person faces toward the
10
ladder or not Does he maintain 3 point contact ?
11 Other observations for ladder:
Scaffold :
Is there any scaffold erection in progress? If yes whether only trained riggers
12 are employed for the job under competent supervision?
Whether scaffolding has been erected on rigid / firm / leveled surfaces only?
13 Are base plates provided for scaffolding posts?
14 Are the scaffolding in plumb and level?
Are all braces bearer and clamps secured all sections pinned or
15
appropriately secured ?
16 Are all the wheel / castors locked ?
Is there a safe and convenient means of access such as ladder ( i.e.
17
without climbing on cross brace)?
Are the gratings placed in order without undue gaps and secured
18
properly?
Is every work platform fitted with handrail (42” high), knee rail (21”
19
high)?
Are all compounds inspected for defects such as broken welds, corroded
20
members, and missing locks, bent or dented tube ?
21 Is the front / face of the scaffold within 14” of the work?
22 Does the scaffold have a height to base ratio of at least 4:1?
23 Is scaffold height above 6 mtr? If yes is it fastened with structure?
24 Is electrical safety distance maintained ?
Is the scaffold legs are under digged or on the edge of excavation or
25
above ground?
Are properly anchored safety belts being used while working on
26
scaffold?
In case any painting or insulation work carried out without properly
27
secured scaffold?
a Arrangement is made by providing life line (≥ 1” dia PP rope)?
b Do the workmen fasten their lanyard with life line ?
c Is there any ladder provided for access to work location?

Signature of site safety incharge Signature of site engineer/incharge

 W/HSE/CL-037 REV:00

ON SITE RADIOGRAPHY CHECKLIST

PROJECT: LOCATION: DATE:

SL.No Check Points Yes No Remarks

1 Radiography Permit available
2 Only authorized person engaged in the operation
Workmen Evacuated and Barrication provided at 50 mts.
3
periphery from the radiography source.
Radiation Hazard signs /Warning “No entry Danger” is in
4
place
5 Operators worn personal dose metre
6 Flashing Red / Amber light using during operations
7 Adequate illumination available
8 Calibrated survey meter available
9 Usage of required PPE
10 Information given to nearby personnel
11 Adequate supervisory surveillance
12 Emergency equipment in place

Signature of site safety incharge Signature of site engineer/incharge