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www.adm.gov.ae/hse - hse@adm.abudhabi.

ae
www.adm.gov.ae/hse - hse@adm.abudhabi.ae
The Municipality of abu Dhabi City invites all Consultant
Offces operating in the Building & Construction Sector
to observe the following:
All contractors are obliged to prepare and submit
Health, Safety & Environment (HSE) plans or their
projects.
HSE plans to be approved by the consultant.
HSE plans have to be added to the requisites of
obtaining permits for starting construction and
infrastructure works.
This requirement has been put into effect as of
26/12/2010.
The guidlines for Developing HSE Plans can be
downloaded from the website
(www.adm.gov.ae/hse).
For inquiries please contact us on: hse@adm.abudhabi
or call the Municipalitys toll-free number.
To all Building and Construction
Consultancy Offces
Announcement
80022220 www.adm.gov.ae/hse
Introduction
1. Project Details
2. Project Brief Description and Project Layout
3. EHS Management Requirements
4. Planning
5. Implementation and Operations
6. Audit and Review
7. Appendices
8. Forms
9. Checklists
10. Screen Windows
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2
With reference to The Municipality of Abu Dhabi City policy and the vision
of Department of Municipal Affairs, The Municipality of Abu Dhabi City and
based on Abu Dhabi - EHSMS framework is keen to support and assist
consultants, contractors and developers in building and construction sector
to establish and develop their EHS plans. This would improve the efforts
and measures to maintain high standards of EHS at construction projects in
order to protect people, assets and environment.
This booklet contains the basic elements for developing Environment,
Health and Safety (EHS) plan. The implementation of the EHS plan will
enhance the EHS standards to achieve best levels of environment, health
and safety compliance in construction sites in Abu Dhabi Emirate.
4
6
Leadership & Commitment
Defne how senior management lead by example and demonstrate
commitment through participation & communication with employees
on EHS issues.
EHS Policy:
Includes commitment towards continual improvement.
Contains commitment to comply with applicable
current legislations & other requirements.
It should be signed by the top management.
Organization, Roles & Responsibilities:
Project & EHS organizational chart.
EHS personnel roles & responsibilities.
Management of subcontractors and suppliers.
Project key personnel & their contacts.
Communication:
Regular and periodic meetings.
EHS alerts and notice boards.
Rewards, incentives, recognition & discipline.
Training:
EHS induction.
Toolbox talks.
Special EHS training and awareness.
Site Inspection and Monitoring
Incidents Reporting and Investigation
Site EHS Rules & Instructions
Personal Protective Equipment (PPE)
EHS Document Control and Recording System
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
3.10
3.0 EHS Management
Requirements
9
10
Risk Management:
Identifcation of hazards, assessing the risks and specifying control
measures.
Legal and Other Requirements:
EHS laws, regulations, codes of practice, etc.
Emergency Management and Evacuation Plan
Site Security Plan and Access Control.
Permit To Work (PTW)
Traffc Management Plan
How to manage detours, diversions, road closure and vehicles
movement (refer to Traffc Engineering and Roads Safety Department
procedures and guidelines).
4.1
4.2
4.3
4.4
4.5
4.6
4.0 Planning
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Environmental Arrangements
How to manage the environmental aspects and impacts by developing &
implementing control measures for the following:
Waste Management:
Include appropriate control measures for collection,
segregation and disposal for the waste with conformance
of Abu Dhabi Waste Management Center procedures and
guidelines.
Hazardous waste
Non-Hazardous waste
Soil, Water-Courses and Groundwater Pollution Protection:
Containment areas (bunding) for oil, fuel or chemicals
storage tanks
Washing area for concrete mixing trucks and pumps
Dripping trays for machinery, equipment and trucks
Oil spill combating kits or materials
(Refer to Abu Dhabi Environment Agency - EAD
guidelines, standards and codes of practice).
Air Pollution Protection:
Dust suppression program
Air emission (periodic maintenance programs for the
engines of vehicles, trucks, equipment, plants,
machinery, etc.)
5.3
16
6.0 Audit and Review
Contractor shall defne the basis under which internal & external EHS
auditing and management reviews will be conducted.
18
Checklists
(not required submission to the municipality, just for guidance).
Risk Assessment
(required to be submitted to the municipality attached with the EHS
plan).
EHS Performance quarterly Report
(required to be submitted to the municipality on quarterly basis).
Incidents Report
(required to be submitted to the municipality whenever there is a
reportable incident).
EHS Induction Training
(not required submission to the municipality, just for guidance).
Toolbox Talks
(not required submission to the municipality, just for guidance).
NB: All EHS records should be kept on site and shown when requested.
7.1
7.2
7.3
7.4
7.5
7.6
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GeneraI Information
Registration Number: Classification Code:
Name of Entity:
Address of Entity: Telephone Number:
Number of Employees:
Working Hours Performed
this Quarter:
Reporting Period:
Year:
Q1 (Jan-Mar) Q2 (Apr-Jun) Q3 (Jul-Sep) Q4 (Oct-Dec)
Reporting Timeframe:
End of the second
week in April
End of the second
week in July
End of the second
week in October
End of the second
week in January
HeaIth and Safety Incident Consequence and Severity Summary
(A single incident may be reported in more than one category)
Health and Safety
ncident Summary:
(Total number of each
type of incident
Reported and
Recorded in the
Reporting Period)
Near Miss:
Medical
Treatment Case:
Reportable
Dangerous
Occurrence:
Reportable
Occupational
llness /
Disease:
First Aid njury:
Restricted
Workday Case:
Reportable
Serious njury:
Equipment /
Property
Damage:
Lost Time njury:
Journey
ncident:
Fatality:
Environment, HeaIth and Safety Performance - CompuIsory Reporting to ReIevant Authority
Note: Refer to the AD EHSMS Glossary of Terms for definitions of EHS terms.
KPI 2-01
EHS Department
Resources
Number of
Employees in EHS
Department
Number of UAE Nationals in
EHS Department
No. of Nationals x 100
No. of Employees in EHS Dept.
!Zero Divide
KPI 2-02
Number of EHSMS
Workshops / Seminars
or Similar Training
Organized / Performed
/ Attended
No. of Participants Title / Subject
Training Level
(Management, Supervisory,
Operational)
Duration (Hrs)
KPI 2-03
Number of written warning notices received
from the SRA as a result of non-compliance to
EHSMS requirements
Number of warning notices received:
Number of improvement notices received:
Number of prohibition notices received:
KPI 2-04
Number of fines / penalties / prosecutions
received from the SRA as a result of non-
compliance to EHSMS requirements
Number of penalties / fines received:
Number of enforceable undertakings
performed:
Total value of all fines / penalties/
enforceable undertakings enforced (AED):
KPI 2-05
Lost Time njury Frequency Rate (LTFR)
Number of Lost
Time njuries in the
Reporting Period
Number of Working
Hours in Reporting
Period
No. of LT's x 1,000,000
Working Hours
!Zero Divide
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KPI 2-06
Lost Time njury Severity Rate (LTSR)
Number of Work Days
lost due to njuries in
the Reporting Period
Number of Working
Hours in Reporting
Period
No. of Days Lost x 1,000,000
Working Hours
!Zero Divide
KPI 2-07
Total Reportable Case Frequency (TRCF)
Number of Total
Reportable Cases in
the Reporting Period
Number of Working
Hours in Reporting
Period
TRC x 1,000,000
Working Hours
!Zero Divide
KPI 2-08 - 2.09 - 2.10
Environmental ncidents - Severity
(Number of Pollution ncidents in Reporting
Period)
Number of Pollution
ncidents - Minor
Number of Pollution
ncidents - Moderate
Number of Pollution
ncidents - Major
KPI 2-11
Environmental ncident - Type
(Number of Pollution ncidents in Reporting
Period)
(ncluding fuel, oil, waste material or other
polluting substance)
Spill / Release / Discharge to Land
Spill / Release / Discharge to Water, including Groundwater
Release / Discharge to Atmosphere
Unauthorized / Accidental Vegetation Removal or Harm
Accidental Harm to Animal Species
Unauthorized / Accidental Damage to Heritage Site / tem
Other (Provide Details): _ _
KPI 2-12
Power Consumption
(Total Kilowatts Hours (kW h) and
kW h per Employee)
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Total kW h
kW h Per
Employee
Total kW h
kW h Per
Employee
kW h Per Employee
KPI 2-13
Water Consumption
Water use (in production
processes, office activities or as
drinking water)
(Total cubic meters (m
3
) and m
3
per Employee)
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Total m
3
m
3
Per Employee Total m
3
m
3
Per Employee m
3
Per Employee
KPI 2-14
Paper Consumption
Average number of paper pages
used per employee per month
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Average No. of Pages used per
Employee
Average No. of Pages used per
Employee
% Per Employee ncrease
or Decrease
KPI 2-15
Fuel Consumption
Average fuel consumption of entity
owned and /or operated vehicles.
(Liters per 100 kilometers)
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Number of vehicles
owned and/or
operated by entity
Average fuel
consumption of
vehicles
(Combined Cycle
L/100 klms)
Number of
vehicles owned
and/or
operated by entity
Average fuel
consumption of
vehicles
(Combined Cycle
L/100 klms)
% Fleet Fuel Consumption
ncrease or Decrease
KPI 2-16
Non-Hazardous Waste Disposal
Amount of non-hazardous (solid
and liquid) waste collected by
Service Providers for disposal.
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Solid (kg) Liquid (L) Solid (kg) Liquid (L) Solid (kg) Liquid (L)
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KPI 2-17
Non-Hazardous Waste Recycling
Amount of segregated non-
hazardous (solid and liquid) waste
collected by Service Providers for
recycling / reuse / further
processing.
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Solid (kg) Liquid (L) Solid (kg) Liquid (L) Solid (kg) Liquid (L)
KPI 2-18
Hazardous Waste Disposal
Amount of hazardous (solid and
liquid) waste collected by Service
Providers for disposal.
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Solid (kg) Liquid (L) Solid (kg) Liquid (L) Solid (kg) Liquid (L)
KPI 2-19
Hazardous Waste Recycling
Amount of hazardous (solid and
liquid) waste collected by Service
Providers for recycling / reuse /
further processing.
This Reporting Quarter Previous Reporting Quarter
Percentage Reduction
or ncrease
(ndicate reduction as a
negative figure eg 3.5 %)
Solid (kg) Liquid (L) Solid (kg) Liquid (L) Solid (kg) Liquid (L)
DecIaration
declare that all information provided in this document is true, correct and complete.
Signature of the
Authorised
Contact Person :
Official
Stamp:
Date : _____ / _____ / _____
OfficiaI Use
Remarks :
ReIevant Authority Stamp Entered into Database by:
Name:
Signature:
Date: _____ / _____ / _____
Reviewed by:
Name:
Signature:
Date: _____ / _____ / _____
25
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Part A - Incident Notification
To be submitted to the concerned Sector Regulatory Authority within 24 hours for all Reportable ncidents
1. GeneraI Information
Name of Entity:
Registration Number: Classification Code:
Address of Entity:
Authorized Contact Person: Email Address:
Telephone Number: Mobile Number:
Report on Behalf of
Non-Nominated Contractor
Entity:
Yes

No
Entity Name:
Contact Person: Contact Number:
2. ReportabIe Incident Information - ImmediateIy ReportabIe to SRA - within 24 Hours
Health and Safety ncident:
(May select more than one)
Serious FataI
Reportable Dangerous Occurrence
Reportable Occupational
llness / Disease
Fatality
Reportable Serious njury
Environmental ncident:
(May select more than one)
Environment - Moderate Environment - Major
Spills / Releases /
Discharges to
Land
Spills / Releases / Discharges to
Water, including Groundwater
Releases / Discharges
to Atmosphere
Vegetation
Removal / Harm
Harm to Animal Species
Damage to Heritage
Site
Other:___________________________________________________________________
3. RecordabIe Incident Information - Not Required to be ImmediateIy Reported To SRA
For Entity Use OnIy - data to be submitted as part of EHS Performance QuarterIy Report - Form E or E2
Health and Safety ncident:
(May select more than one)
Minor / No Injury / SIight Moderate
Near Miss Lost Time njury
First Aid njury Medical Treatment Case
Equipment / Property Damage Restricted Workday Case
Environmental ncident:
(May select more than one)
Environment - Minor
Spills / Releases /
Discharges to
Land
Spills / Releases / Discharges to
Water, including Groundwater
Releases / Discharges
to Atmosphere
Vegetation
Removal / Harm
Harm to Animal Species
Damage to Heritage
Site
Other:___________________________________________________________________
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4. Incident DetaiIs:
Description of Circumstances
leading to the ncident:
Date of ncident: _ / _ / _ Time (24 hr): :
ncident Workplace Address:
ncident Location on Site:
Police Report Number:
(f applicable)
5. Injured Person's PersonaI DetaiIs (If appIicabIe)
Name: Occupation:
Nationality: Date of Birth: / /
Passport Number: Residency Visa Number:
Contact Address:
Contact Phone Number: Gender: Male Female
Part A - DecIaration by Entity:
declare that all information provided in this document is true, correct and complete.
Signature of the
Authorized
Contact Person :
Official
Stamp:
Date : _____ / _____ / _____
OfficiaI Use - Part A
Remarks :
Inspection / Incident Investigation Required by Sector ReguIatory Authority
Yes No
Remarks:
ReIevant Authority Stamp
Entered into Database by:
ncident Record Number:
Name:
Signature:
Date: _____ / _____ / _____
Reviewed by:
Name:
Signature:
Date: _____ / _____ / _____
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Part B - Incident Investigation
To be completed and submitted to SRA as soon as practicable
Maximum One Month from Date of ncident - For all Reportable ncidents
1. Injury DetaiIs
Nature of njury / llness /
Damage:
Abrasions / Bruising Traumatic Amputation Bite / Sting
Burn Concussion Crush / nternal njury
Cuts/ Laceration / Open
Wound
Hearing Loss / Deafness Dislocation
Electric Shock
Equipment / Property
Damage
Fracture
Foreign Body in Eye Foreign Body under Skin Hernia
Heat Related llness nfectious Disease
Musculoskeletal Disorder
- Chronic / RS
Nerve / Spinal Cord
njury
Occupational llness /
Disease
Poisoning / Toxic Effect -
ngestion
Poisoning / Toxic Effect -
nhalation
Psychological (Stress) Respiratory Disease
Skin rritation / Disease Strain / Sprain Other _______________
Mechanism of njury / llness:
Animal Bit / Sting Biological Factors Cave-n or Collapse
Chemicals / Substances
/ Radiation
Drowning / Submersion Dust / Fumes / Gases
Extreme Temperature /
Fire
Electricity Fall from Height
Hit by Moving Object /
Crush / Vehicle
Manual Handling Mental Stress
Occupational Violence Penetrating njury (needle stick, puncture wound)
Repetitive Motion Slip, Trip and Fall Sound and Pressure
Struck by Falling Object Other Unspecified Mechanism:_____________________
Journey ncident -
ncident occurred during work-related travel, including traveling to
or from work. Refer AD EHSMS Glossary of Terms.
Agency / Source of
njury / llness:
Animal / Human Confined Space Environmental Conditions
Fixed Machinery / Plant nfectious Agent
Materials or Chemical
Substances
Mobile Plant / Equipment Non-Powered Equipment / Tools / Appliances
Powered Equipment /
Tools / Appliances
Road Transport /
Vehicles
Scaffolding or Ladders
Sharps / Scalpels /
Needles / Etc
Trench or Excavations Other ______________
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Bodily
Location:
Head /
Neck
Cervical Spine Ear Eye
Face (excluding eye) Forehead Mouth
Neck Nose Scalp
Trunk
Abdomen Back Genitals
Pelvis Spine Thorax
Upper
Extremity
Clavicle (Collar Bone) Elbow
Fingers (other than
Thumbs)
Forearm Hand Shoulder
Thumb Upper Arm Wrist
Lower
Extremity
Ankle Buttocks Foot
Hip / Groin Knee Lower Leg
Thigh Toes
nternal
Organs
Arteries Brain Heart
ntestines Kidney Liver
Lungs Spleen Stomach
General Heat Related Occupational llness Other: ______________
Other ReIevant Incident Information:
Remarks:
2. Risk Assessment:
Likelihood of Recurrence:
Severity of Outcome:
Level of Risk:
3. Corrective Actions to Prevent Recurrence
Actions: By Whom: By When: Date Completed:
4. Actions CompIete:
Name:___ __________________________________________________
Signed (EHS Manager / Equivalent) :____________________________________
Feedback to person(s) involved.
Title:_
Date:_
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DecIaration by Injured Person (If PossibIe)
declare that all information provided in this document is true, correct and complete.
Name of njured
Person or
Representative:
Signature of njured
Person or
Representative:
Date : _____ / _____ / _____
Part B - DecIaration by Entity:
declare that all information provided in this document is true, correct and complete.
Signature of the
Authorized
Contact Person :
Official
Stamp:
Date : _____ / _____ / _____
Incident Reporting Progress
Open Closed
Further evidence attached to report (eg. Photos, Drawings, SDS, Copy of Police Report, Detail nvestigation Report, etc)
OfficiaI Use - Part B
Remarks :
Incident Investigation / FoIIow-up Required by Sector ReguIatory Authority
Yes No
Remarks:
ReIevant Authority Stamp Entered into Database by:
Name:
Signature:
Date: _____ / _____ / _____
Reviewed by:
Name:
Signature:
Date: _____ / _____ / _____
Personal inIormation will not be disclosed to other parties without your consent unless required to do so by law.
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Entity EHS Incident Report Form (AD EHSMS Form G) - Guidance Notes
What is this Form used for?
This form has been designed to be used by entities nominated under the Abu Dhabi EHSMS as an
EHS ncident Report Form.
This form has primarily been designed to report certain EHS incidents to the concerned Sector
Regulatory Authority (AD EHSMS Form G Part A Section 2).
The form can also be used to report and record all EHS incidents within the entity (AD EHSMS Form
G Part A Section 3) - not all EHS incidents are reportable to concerned Sector Regulatory
Authorities.
Specific EHS incidents may require reporting to other relevant authorities (eg. Police, Ministry of
Labour, EAD, etc).
What Incidents need to be reported to the concerned Sector ReguIatory Authority?
AD EHSMS Reportable ncidents include:
Fatality;
Reportable Serious njury;
Reportable Dangerous Occurrence;
Reportable Occupational llness / Disease; and
Major or Moderate Pollution ncident (EAD reporting may be required).
Reporting Timeframes (ReportabIe Incidents)
The concerned Sector Regulatory Authority must be officially notified within 24 hours of an incident
occurring at a workplace which results in a reportable incident using Part A of this Form.
ncident investigation and report must be complete and submitted to the concerned Sector Regulatory
Authority within one month of the incident date using Part B of this Form.
Definitions - Full definitions of terms used in this document refer to the AD EHSMS RF - Glossary of Terms.
OccupationaI IIIness or Injury:
Any of the work-related diseases listed in (Schedule No. 1 of Federal Law No. 8 of 1980 and EHS RI Mechanism
03 EHS Performance and Incident Reporting Schedule C) or any other injury sustained by a worker during and
by reason of carrying out his duties. An injury may be considered as an occupational injury if it occurs at work or
arises from a work practice or the conditions in a workplace.
Occupational njuries include the recurrence, aggravation or exacerbation of previous work-related injuries. For
example, if an employee has previously had a work-related knee injury and the injury happens again because of
work, the new injury may have to be reported.
FataIity:
Fatality is a death resulting from an injury or illness, regardless of the time intervening between injury and death.
ReportabIe Dangerous Occurrences - Schedule A of AD EHS RI - Mechanism 3.0
For detail definitions of the following incidents refer to Schedule A of AD EHS RI Mechanism 3.0
Explosion or Fire;
Collapse of Equipment;
Machinery Damage;
Collapse of Building / Structure or Excavation;
Overhead Electric Lines;
Malfunction of Radiation Generating Equipment;
Escape of Flammable Substances / Hazardous Substances; and
Fall from Heights
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Serious Injuries that require Immediate Notification - ScheduIe B of AD EHS RI - Mechanism 3.0
An incident requiring reporting is classified as:
the employee requiring medical treatment within 48 hours of exposure to a substance;
an employee requiring immediate treatment as an in-patient in a hospital; and
an employee requiring immediate medical treatment for:
the loss of a distinct part or organ of the injured person's body, including the amputation of any part of
an employee's body;
loss of consciousness and/or requiring resuscitation;
a serious head injury;
a serious eye injury, including loss of sight (temporary or permanent);
the separation of skin from any underlying tissue (such as scalping or de-gloving);
electric shock;
a spinal injury;
dislocation of the shoulder, hip, knee or spine;
the loss of bodily function; and
serious laceration.
Lost Time Injury
Lost Time njury (LT) is a work-related injury or illness that results an individual is unable to work on a
subsequent scheduled work day or shift.
Example: An employee is injured on the job on Tuesday. He was scheduled to work on Wednesday and
Thursday on regular time and Saturday on overtime. He was instructed to stay off work until Sunday, and did so.
This is a lost time injury. The employee missed three scheduled days of work (Wednesday Thursday, and
Saturday) and all three days are counted as lost workdays for this case.
OccupationaI IIIness
Any work-related abnormal condition or disorder, other than an injury, which is mainly caused by exposure to
environmental factors associated with the employment.
t includes acute and chronic illness or diseases that may be caused by repetitive motion, inhalation, absorption,
ingestion or direct contact.
Whether a case involves a work-related injury or an Occupational llness is determined by the nature of the
original event or exposure that caused the case, not by the resulting condition of the affected employee.
An injury results from a single event and cases resulting from anything other than a single event are considered
Occupational llness.
PoIIution Incident
An incident or set of circumstances during or as a consequence of which there is likely to be a leak spill or other
escape or deposit of a substance, as a result of which pollution has occurred, is occurring or is likely to occur. t
includes an incident or set of circumstances in which a substance has been placed or disposed of on premises.
Major PoIIution Incident
Substances or materials have escaped the site causing significant pollution of adjoining areas which will require
containment, clean up and/or remediation involving other agencies and/or additional resources not available to
local site management. rreversible or long term environmental impacts have occurred or are likely to occur to
the environment and/or there is a significant health risk to workers and/or the community. Significant, long-term
remediation and regulatory intervention will be required.
Moderate PoIIution Incident
Substances or materials have escaped the site causing pollution of adjoining areas which may require
containment, clean up and/or remediation involving other agencies and/or additional resources not available to
local site management. Moderate reversible environmental impact has occurred or is likely to occur to the
environment and/or there is a moderate health risk to workers and/or the community. Moderate, medium-term
remediation and regulatory intervention may be required.
31
Ref.No.:ADM/HSED/FM//
IssuanceDate:July
IssueNo.:
EHSInductionTraining
GeneralInformation
CompanyName: ProjectName:
InducteesName: InductionDate:
Topicstodiscuss
S/N Description YES NO Remarks
ProjectDescription
CompanyHSEPolicy

IntroductionofKeyPersonnel
SiteLayoutandwelfareFacilities(restarea,toilet,etc.)

SiteRules(e.g.drug&alcohol&smokingpolicy,differentsignage,nohorseplaying,
wearingPPEs,avoidwearingJewelries,etc.)
Environment&WasteDisposal

Workpermits
RiskAssessment/RiskRegister
AccidentReporting
OtherRelevantTopicsforDiscussion(ifapplicable)
ManagementofChange(newprocess,equipment&machinery,procedures,etc.)
Relevant&applicablelaws,regulations
Signature&Remarks
EmployeesSignature: Remarks:
Conductedby:________________________________
JobTitle:________________________________
Signature:________________________________
Remarks:
Note:Forguidanceanditisnotlimitedtoitscontent
32
EHS
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
Tool Box Talk
General Information
Company Name: Project Name:
Date:____________________________________________________________ Location:__________________________________________________
A. Specifc job to be carried out:
B. Topics Discussed:
1. 4.
2. 5.
3. 6.
C. Name and Signature of workers attended
Conducted By:
Name :
Job Title :
Signature :


Note: For guidance and it is not limited to its content
Name Signature Name Signature
33
The inspection checklists include the
followings:

Confned Spaces
Traffc Management
Electrical Installation
Environment
Excavations
Fire & Emergency
Hazardous Substances
Housekeeping
Ladders
Lifting Equipment & Gears
Machinery
Portable Tools
Personal Protective Equipment (PPE)
Scaffolds
Site General
Vehicles & Mobile Equipment
Welding & Gas Cutting
Welfare Facilities
Working Platforms & Cantilevers
Inspection Checklists
34
35
Ref. No. : ADM/HSED/FM/004/10
Issuance Date: July 2010
Issue No.: 01
Checklist
Conf ined Spaces
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and proposed
corrective action plan)
Good Fair Poor N/A
Hazards identifed, risk evaluated, assessed &
communicated before commencement of work.
Permit To Work implemented & posted in place.
Mechanical and / or electrical isolation of the confned
space done.
Adequate ventilation to ensure a suffcient supply of air
conducted.
Cleaning & purging to remove all hazardous (fammable
& or toxic) gases & fumes performed.
Testing of oxygen concentration conducted to
acceptable standard level.
Detecting of fammable & or toxic gases conducted to
ensure their absence or below minimum levels.
Provision of emergency retrieval system (full body
harness, tripod and hoist)
Availability of the backup personnel or rescue
attendants.
Use of non spark tools / devices (intrinsically safe tools
or devices).
Suffcient lighting is available.
Proper PPE & SCBA (Self Contained Breathing
Apparatus) is used.
Suitable access / egress provided.
Area or surrounding isolated with barriers & or cones
and suitable signage in place (where applicable).
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Advance warning signs boards.
Roadwork signs boards.
Guide signs boards.
Digital or LED* signs boards.
Arrows signs boards.
Delineators.
Cones.
Tubular fexible posts (bollards).
Painted pavement markings.
Raised pavement markings.
Water flled plastic barriers.
Concrete barriers.
Longitudinal crashworthy barriers
Warning lights (fashing lights & beacons).
Street lighting.
Temporary traffc lights.
Rumble strips
Crash cushion (shock absorber)
Buffer zones
Tapers
Flaggers
Pedestrian walkways.
Construction lane access / egress
Fences
Glare screens
Turning radius and lane width.
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Traff ic Management
Evaluation Remarks
(insert your observation,and proposed
corrective action plan)
36
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/004/10
Issuance Date: July 2010
Issue No.: 01
Checklist
Electrical Installation
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Electrical hazards identifed and all associated risks have
been assessed.
Permit To Work (PTW) is used & available on site for
electrical work.
All electrical installations commissioning and repairing
carried out by competent electricians.
All electrical installation and appliances comply with the
relevant international standards.
All external electrical installations are weather proof .
All electrical installations provided with Earth Leakage
Circuit Breakers (ELCB).
All distribution boards are locked and signed.
Cables/wires running across the site are in good
condition, properly protected & checked regularly.
Cables are free of joints, & only industrial sockets used
for extending cables.
No naked wires inserted into electrical sockets, & only
earthed & fused plugs to be used.
Sockets are not overloaded.
Level of lighting suitable for the task.
Tag out / lock out system implemented .
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Evaluation
Remarks
(insert your observation,and proposed
corrective action plan)
37
EHS Engineer/Manager
Ref.No.:ADM/HSED/FM//
IssuanceDate:July
IssueNo.:
Checklist
Environment
GeneralInformation
CompanyName: ProjectName:
ConductedBy: Date:
Poor:Absenceofmajorcontrolmeasures(highrisk),worktobestoppedandriskassessmenttobereviewedimmediately.
Fair:Someminorcontrolsaremissing(mediumrisk),additionalcontrolmeasurestobeimplemented.
Good:Allrequiredcontrolsareinplace(lowrisk),onlymonitoringisrequired.
Description
Item
Evaluation
Remarks
(insertyourobservation,and
proposedcorrectiveactionplan)
Good Fair Poor N/A
Wasteissegregated&collectedatdesignated
appropriateareas(hazardousfromnon-hazardous)&
adequatewastecontainers/skipsprovided.
Wasteisremoved/disposedregularly&accordingtothe
AbuDhabiWasteCenterguidelines.
Properoil/chemicalsleakage&spillcontrolinplaces
(tanksbunding,drippingtrays,oilspillresponse
materials).
Allocationofdesignatedareaforwashingconcrete
mixers&pumps.
Propercollection&disposalofwastewater&sewage
water.
Propermanagementofnoisegeneratedfromtheproject,
byinstallingnoiseenclosuremeasures(e.g.silencers,&
workscheduling).
Dustand/orfumescontrolmeasureshavebeen
implemented.
Regularmaintenanceformobileequipment,vehicles&
machines.
ApprovedBy:
Position Name Date Signature
HSEEngineer/Manager
DistributionandAcknowledgment:
ProjectManager
ProjectEngineer
Note:Forguidanceanditisnotlimitedtoitscontent
Remarks
(insert your observation,and proposed
corrective action plan)
38
EHS Engineer/Manager
Ref.No.:ADM/HSED/FM//
IssuanceDate:July
IssueNo.:
Checklist
Excavation
GeneralInformation
CompanyName: ProjectName:
ConductedBy: Date:
Poor:Absenceofmajorcontrolmeasures(highrisk),worktobestoppedandriskassessmenttobereviewedimmediately.
Fair:Someminorcontrolsaremissing(mediumrisk),additionalcontrolmeasurestobeimplemented.
Good:Allrequiredcontrolsareinplace(lowrisk),onlymonitoringisrequired.
Description
Item
Evaluation Remarks
(insertyourobservation,and
proposedcorrectiveactionplan)
Good Fair Poor N/A
assessed.
Suitableaccess/egressprovided.
Fallingprotectionsysteminstalledproperly(i.e.barriers,
stopblocker,toeboards,conesandwarningtapes
etc).
Appropriatesupportingsystem/method(shoring,
buttering,orstepping)
Spoilheapsstableandkeptinsafedistancefromthe
edgeoftrenches
Oxygentestedandgaseslevelswithinacceptablelevel
(forexcavationwithdepthmorethanmeter).
Emergencypreparednessplandeveloped,
communicatedandimplemented
Propersignage&warninglights(warningsigns,tapes,
etc)andinstructions(i.e.PTW,emergencynotice..etc)
displayed.
permissionsobtained&displayedvisibly.
Excavatorsareingoodworkingcondition
Propertrainingandawarenessdeliveredtoallinvolved
employees(i.e.toolboxtalk&specializedtraining).
ApprovedBy:
Position Name Date Signature
HSEEngineer/Manager
DistributionandAcknowledgment:
ProjectManager
ProjectEngineer
Note:Forguidanceanditisnotlimitedtoitscontent
Remarks
(insert your observation,and proposed
corrective action plan)
Checklist
Excavations
39
EHS Engineer/Manager
Ref.No.:ADM/HSED/FM//
IssuanceDate:July
IssueNo.:
Checklist
Fire&Emergency
GeneralInformation
CompanyName: ProjectName:
ConductedBy: Date:
Poor:Absenceofmajorcontrolmeasures(highrisk),worktobestoppedandriskassessmenttobereviewedimmediately.
Fair:Someminorcontrolsaremissing(mediumrisk),additionalcontrolmeasurestobeimplemented.
Good:Allrequiredcontrolsareinplace(lowrisk),onlymonitoringisrequired.
Description
Item
Evaluation
Remarks
(insertyourobservation,and
proposedcorrectiveactionplan)
Good Fair Poor N/A
Fireriskassessmentoftheprojectiscarriedout&the
controlmeasuresimplemented.
Goodhousekeepingpractices&dailyremovalofwaste.
designatedareaallocated.
PermitToWork(PTW)procedureforhotworks.
Evacuationplandeveloped&distributed.Emergency
communicated.
Adequatemeansofescapeallocated&unobstructed.
sitemaintained&inspectedregularly.
testedregularly.
Emergencysignage&assemblypointsareinplaces&
communicatedtoallparties.
ApprovedBy:
Position Name Date Signature
HSEEngineer/Manager
DistributionandAcknowledgment:
ProjectManager
ProjectEngineer
Note:Forguidanceanditisnotlimitedtoitscontent
Remarks
(insert your observation,and proposed
corrective action plan)
40
EHS Engineer/Manager
Ref.No.:ADM/HSED/FM//
IssuanceDate:July
IssueNo.:
Checklist
HazardousSubstances
GeneralInformation
CompanyName: ProjectName:
ConductedBy: Date:
Poor:Absenceofmajorcontrolmeasures(highrisk),worktobestoppedandriskassessmenttobereviewedimmediately.
Fair:Someminorcontrolsaremissing(mediumrisk),additionalcontrolmeasurestobeimplemented.
Good:Allrequiredcontrolsareinplace(lowrisk),onlymonitoringisrequired.
Description
Item
Evaluation
Remarks
(insertyourobservation,andproposed
correctiveactionplan)
Good Fair Poor N/A
Properlystored,ventilated,isolated,&suitablesigns
displayed.
MaterialSafetyDataSheet(MSDS)available,and
communicatedtoconcernedpersonnel.
Emergencyescape&breathingapparatusavailable,
testedandingoodcondition
AppropriatePPEisprovidedtotheworkeranditisworn
duringthework.
Hazardoussubstancescontainers/drumshaveeligible
labeling&protectedfromleakageorspillage.
Emptyhazardoussubstancescontainers,drums&
receptaclesshouldbeproperlymaintained&controlled.
ApprovedBy:
Position Name Date Signature
HSEEngineer/Manager
DistributionandAcknowledgment:
ProjectManager
ProjectEngineer
Note:Forguidanceanditisnotlimitedtoitscontent
Remarks
(insert your observation,and proposed
corrective action plan)
41
EHS Engineer/Manager
42
Ref.No.:ADM/HSED/FM//
IssuanceDate:July
IssueNo.:
Checklist
Housekeeping
GeneralInformation
CompanyName: ProjectName:
ConductedBy: Date:
Poor:Absenceofmajorcontrolmeasures(highrisk),worktobestoppedandriskassessmenttobereviewedimmediately.
Fair:Someminorcontrolsaremissing(mediumrisk),additionalcontrolmeasurestobeimplemented.
Good:Allrequiredcontrolsareinplace(lowrisk),onlymonitoringisrequired.
Description
Item
Evaluation
Remarks
(insertyourobservation,and
proposedcorrectiveactionplan)
Good Fair Poor N/A
Clearandsafeaccesstoworkarea.
Propermaterialsstackingandanyloosematerialshave
beenproperlysecured.
orderliness
Constructionwasteanddebriscollectedindesignated
areas.
Adequaterubbishcontainersandrubbishremoveddaily.
Oldtimberde-nailed&allsteelbarscapped.
ApprovedBy:
Position Name Date Signature
HSEEngineer/Manager
DistributionandAcknowledgment:
ProjectManager
ProjectEngineer
Note:Forguidanceanditisnotlimitedtoitscontent
Remarks
(insert your observation,and proposed
corrective action plan)
EHS Engineer/Manager
Ref.No.:ADM/HSED/FM//
IssuanceDate:July
IssueNo.:
Checklist
Ladders
GeneralInformation
CompanyName: ProjectName:
ConductedBy: Date:
Poor:Absenceofmajorcontrolmeasures(highrisk),worktobestoppedandriskassessmenttobereviewedimmediately.
Fair:Someminorcontrolsaremissing(mediumrisk),additionalcontrolmeasurestobeimplemented.
Good:Allrequiredcontrolsareinplace(lowrisk),onlymonitoringisrequired.
Description
Item
Evaluation
Remarks
(insertyourobservation,and
proposedcorrectiveactionplan)
Good Fair Poor N/A
Properlymanufactured(nohandmadewoodenladders).
Allladdersareingoodcondition&suitableforthetask.
Positionedatsuitableworkingangleat
o
tohorizontal.
Securedtop&bottom,andextendedmeterabovethe
platformlevel.
Intermediatelandingplaceprovidedforladdersrise
morethanmeters.
stiles.
Extendableladdersareproperlysecured(i.e.extension
Rungsclearofgrease,oilorotherslipperysubstances.
glassladderscanbeusedinstead).
protectioncage
Laddersshouldbecheckedbeforeuse&regularly
maintained.
ApprovedBy:
Position Name Date Signature
HSEEngineer/Manager
DistributionandAcknowledgment:
ProjectManager
ProjectEngineer
Note:Forguidanceanditisnotlimitedtoitscontent
Remarks
(insert your observation,and proposed
corrective action plan)
43
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/004/10
Issuance Date: July 2010
Issue No.: 01
Checklist
Lifting Equipments and Gears
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Cranes & slings certifed by 3
rd
party, inspected &
maintained regularly & records maintained.
Lifting plan / procedure prepared & communicated.
All lifting equipments & gears are inspected & certifed by
3
rd
party.
Operator & rigger are competent (third party trained). The
driver & operator are licensed.
Slings, wires, ropes, chains, belts, hooks, shackles are in
good condition, appropriate for job & inspected regularly &
records maintained.
Load charts known & considered before any lifting begins.
Load indicators, alarms & other safety devises are
operational.
Ground condition checked & required corrective actions
implemented.
Outriggers are operational & sole plate provided.
Lifting operation area barricaded & suitable sign boards are
in place.
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Remarks
(insert your observation,and proposed
corrective action plan)
Checklist
Lifting Equipment and Gears
Load indicators, alarm & other safety
devices are operational.
44
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/004/10
Issuance Date: July 2010
Issue No.: 01
Checklist
Machinery
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Machine maintained in good working order regularly and
records kept on site.
Machine operated according to the manufacturer
instructions.
Competent operators trained and certifed.
Good overall condition and regular maintenance.
All suitable guard provided
All electrical installations are protected and free of
damages (circuit breakers, plugs, wires).
Protection against weather condition.
Emergency stop button and other safety devices are
operational and clearly marked.
Safety signs and manufacturer instructions clearly
displayed and properly followed.
Suitable PPE provided and properly used
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
45
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
Checklist
Portable Tools
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Electrical Tools:
Power cables present no hazard or obstruction &
connections are appropriate, earthed & fused.
User competent & authorized.
Guard is ftted, adjusted & tool in good condition.
Emergency stop is available & operational.
Manufacturer instruction is available & followed.
All hoses, couplings & fttings of correct rating.
Pneumatic Tools:
Hoses, couplings & fttings inspected & maintained
regularly.
Tools secured to the hose by positive means to prevent
disconnection.
Air supply lines protected from damage, maintained &
inspected regularly.
Safety device is provided for air hose with large diameter.
Manufacturer instruction is available & followed.
Manual (unpowered) Tools:
Tool checked & inspected before use.
Home-made tool is not used & tool fts the job.
Suitable PPE provided for all above types of tools.
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
46
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
PPE policy and signage displayed.
Minimum PPE (i.e. helmet, safety boots, hi-visibility vest,
& safety glasses) provided to all employees & records
maintained.
PPE checkpoint on the entrance.
PPE comply with the relevant international standards &
clearly marked (i.e. CE or EN mark).
Users trained on using, maintenance, and storage of PPE.
Additional PPE have been provided as appropriate for
those who are executing critical activities (e.g. full body
harness for working at height, full face mask, & respiratory
apparatus, etc).
PPE correctly selected based on the task risk assessment.
Regularly inspected, cleaned and maintained and/or re-
placed as deemed necessary.
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Personal Protective Equipment (PPE)
47
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
All scaffolds erected, inspected, altered & dismantled by
competent team.
Clear and visible signage and scaff-tag
Access ladder provided and properly secured
Sound scaffolding materials free of damage
Platforms are properly made of planks, free of damage,
tied & no gaps between planks/timbers.
All platform blanks tied down properly
Proper falling protection provided (guard rail/hand rail, mid
rail, toe board, mesh/bricks guard & safety net).
Scaffolding properly secured ties, and all braces properly
installed.
Sole/base plate or timber provided.
Overhead protection provided.
Mobile scaffold provides with guard rails, toe board, full &
proper platform, access ladder & wheels locked.
Personal protective equipments provided and properly
used (full body harness connected to fxed anchor or
life line)
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Scaffolds
48
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Availability of the site safety sign board.
Proper site security and appropriate fencing (e.g. closed
metallic boards, hoarding).
Site visitors induction training procedure.
Suffcient site offces and car parking.
Adequate safety signage / notice boards.
Availability of the HSE documents & records(e.g. HSE
manual, HSE plan, risk assessment, work permit, inci-
dents reports, induction & toolbox talk records, inspection
records, & training records, etc)
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Site General
49
EHS Engineer/Manager
EHS EHS
EHS
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Vehicles & mobile equipment are licensed by concerned
authority .
Driver/operator is licensed and competent.
Engine in good operational condition.
No visible leaks
Windows & mirrors are clean & obstruction free.
Seat is in good condition and seat belt functioning
properly.
Lights / indicators / wipers / horns properly operational
Tyres free of damage and fully infated
Reversing alarm & beacons working properly
Periodical inspection & maintenance & record kept
Provided with fre extinguisher and frst aid box, and in
good condition
Provided with the noise silencer/enclosure.
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Vehicles and Mobile Equipment
50
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Hazard identifcation & risk assessment conducted, & required control
measures have been implemented.
Valid & approved permit to work available all time & displayed in visible
location.
Working area properly contained & warning signs displayed.
All fammable / combustible materials have been removed from the
working area or properly protected from spark.
All possible health effects (acute and chronic) have been identifed and
proper control measures implemented.
Suffcient ventilation has been provided.
Task is carried out by competent person (s).
Adequate / suffcient fre fghting equipment are available in the
working area during & after the work.
Suitable PPE provided and used all the time.
Electrical Arc Welding:
Welding leads and returns cables have the same length, properly
installed & protected, & free of damage.
Electrical cables are in good condition, free of damage, & properly
protected.
Industrial plugs & sockets provided.
Electrode holders are fully insulated & free of damage.
Earth connection bolted or clamped to ensure a good electrical
contact.
Welding machine frame effectively grounded.
Gas Welding and Cutting:
Different gas cylinders are clearly identifed and marked.
Different types of Gas cylinders have been separated, properly stored,
and not exposed to direct sun.
Proper training on handling gas cylinders for all users (this will include
clothing, moving cylinders, hazards and precaution measures.etc).
Cylinder attachments (regulators, hoses, non-return valves, fashback arres-
tors, blowpipes) are maintained in good working order and free of damage.
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Welding and Gas Cutting
Evaluation
Remarks
(insert your observation,and proposed
corrective action plan)
51
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Adequate ablutions / toilets / washing facilities.
Appropriate clean & cool rest area with clean & cold
drinking water.
Food storage facility.
Changing rooms with facility for keeping protective
clothing used at work (locker).
Prayer area clearly identifed & kept clean all the time
Safe access & egress to and from the facility
Welfare facilities are in clean good hygienic condition.
Designated smoking area with proper fre fghting
equipments
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Welfare Facilities
Evaluation Remarks
(insert your observation,and proposed
corrective action plan)
52
EHS Engineer/Manager
Ref. No. : ADM/HSED/FM/003/10
Issuance Date: July 2010
Issue No.: 01
General Information
Company Name: Project Name:
Conducted By: Date:
Poor: Absence of major control measures (high risk), work to be stopped and risk assessment to be reviewed immediately.
Fair: Some minor controls are missing (medium risk), additional control measures to be implemented.
Good: All required controls are in place (low risk), only monitoring is required.
Description
Item
Evaluation
Remarks
(insert your observation, and
proposed corrective action plan)
Good Fair Poor N/A
Platform is properly designed (the minimum dimension
are in accordance with the safety standards) and
suitable for the purpose.
Platform free of damage and in good condition.
All platform planks tied down properly with no gaps
between planks.
Proper falling protection provided (handrail, mid-rail, toe
board, boy harness, lifeline & safety net).
Load capacity identifed and clearly marked.
Platforms are not used to carry another platform.
Adequate bracing / outriggers installed (Mobile Elevated
Working Platforms MEWP).
3
rd
party inspection. Regular maintenance & adherence
to the manufacturers manual (MEWP & cradles).
Cantilever provided with guard rail, mid rail, toe board, &
mesh / bricks guard.
Cantilever should not be overloaded
(apply only tested load).
Cantilever must be inspected whenever installed,
altered, or shifted by competent person.
Proper PPE should be provided.
Approved By:
Position Name Date Signature
HSE Engineer / Manager
Distribution and Acknowledgment:
Project Manager
Project Engineer
Note: For guidance and it is not limited to its content
Checklist
Working Platforms and Cantilevers
Evaluation Remarks
(insert your observation,and proposed
corrective action plan)
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EHS Engineer/Manager
The following screen windows illustrate the steps on how to
upload the EHS plan into the Building Permits Electronic System
(CDP).
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