SJR PRIME CORP

PALAZZA CITY
Daily Checklist of Builder Hoist from to .

Sl.No. Description Operator:

1 Is the hoist brake working properly ?
2 Is the wire rope in working condition ?
3 Are the wire rope strands cut ?
4 Is the wire rope kinked ?

5 Is the diameter of the wire rope less ?

6 Is the wire rope rusted ?

Are the nuts and bolts of the hoist are
8
tightened properly ?
Are the pulleys rotating freely without
9
any noise ?
Are the moving parts of the machine
10
covered properly ?
Are the supports from the hoist channel
11
to the permanent structure OK ?
Is the illumination sufficient to carry out
12
the work ?
Is approach to the builder hoist safe in
13
all floors?
Are any cutouts and openings
14
barricaded on the floors ?
Is the wire rope movement area
15
barricaded properly ?
Is the platform in each floor properly
16 provided and barricaded to unload the
material ?
Is access to the hoist clear of
17 obstruction, is it protected from falling
objects?
Is the motor sprocket chain loose and is
18
running to the tolerance ?

CKECKED BY: VERYFY BY: SAFETY INCHARGE:

 JMC PROJECTS ( INDIA ) LTD.
Safety Department

BUILDER HOIST SAFETY INSPECTION REPORT

Site: Mantri Flora
BLOCK - A DATE-

1 Make - Ambish Engineers

Manufactured at - Ahmedabad
Year of manufacturing :
Maximum Height- 48 mts.
Installed Height- 21mts
Safe Working Load
Statutary Inspection Date :

2 Foundation Details
L X B x H - 1600mm X 1000 mm X 150mm
Grade of concrete- M 25

3 Frames
C Channel - 100mmX 50mm
Length of each frame - 3mts
Width between two frames - 1500mm

4 Mechanical Suports- given at floors

Given at - 3rd Floor, 5th floor, 6th floor
With- Anchor Bolt - 400mm X 12mm
Angle - 200mm

5 Pulley
Dia of pulley - 300mm
Fixed properly with high tensile bolts.

Wire Rope
Diameter - 20mm
6 No. of Strands -6 Nos.
Length of rope- 120 mts
Safe working load : 01 Ton
Electrical motor
 3 Phase Induction Motor
7 HP - 15
RPM - 1460
Starter - L & T
Type- ML-2
Earthing ; Provided
Operator
Name - Prabodh Kumar Samal
8 Experience- 01 Year

Maintainence- greasing ,kink,wire cut,

Induction to lift operator

B Block -Vinod Kumar -06 months

BUILDER HOIST SAFETY INSPECTION REPORT

BLOCK - A DATE-
Description

The Builder Hoist can be used until a height of 48 mts.

The foundation is made of 1600mm x 1000mm x 150mm and M-- Grade concrete.
The frames are made of 100mm X 50mm C Channel each of 3mts. Length and
width of 1500mm connected with an angle of ----mm are fixed properly & tightly with
high tensile nut & bolt of 400mm X 12mm.
The support is given at two places with anchor bolt of 400mm X 12mm & angle of
125mm to the beam.
The pulleys of 300mm dia and carrying capacity of 1.5 ton are fixed properly and
are running on good bearings.
The 20 mm wire rope with 6 strands of length 120 mts. is in good condition.
The 3 phase Induction Crompton Greaves electrical motor of 15 HP having 1460
rpm with L&T Starter is in good condition.
The moving part is covered with MS plate.
The operator Prabodh Kumar Sawanth is experienced in operating the machine.
He has 01 year experience in operating the machine.
The motor is connected to rope drum with chain link and sprocket
 SJR PRIME CORP Sl. Started on
PALAZZA CITY A
B
Lifting capacity of the Hoist
HOIST - 01,02,03
Safe Working Load-500 Kg.

4" - 30 Nos.

6" - 20 Nos.
This is to certify that Mr. _____
8" - 15 Nos. aged _____ years, is _____ year
We checked his operating skil
Cement Bags 06 Nos. He is given the permission to o

Sand Bags 18 Nos.

P & M Incharge

This is to certify that Mr. _____

aged _____ years, is _____ year
 We checked his operating skil
He is given the permission to o
Block Weight (Kg) o. of Blocks
4" 15-16 33.3333333333
6" 23-26 20
8" 32-35 14.7058823529
Cement Bag 50 10 P & M Incharge
Sand Bag 25-30 18.5185185185

DATE-
 Make of builder Hoist Capacity of builder Hoist Height of Hoist Foundation Frame Details

SARJAPUR, BANGALORE

Certificate for local Hoist Operator

This is to certify that Mr. ___________________________________________

aged _____ years, is _____ years experienced in operating the builder hoist.
We checked his operating skills and method. He is doing good.
He is given the permission to operate the builder hoist.

P & M Incharge

SJR PRIME CORP

WATER MARK PROJECT
SARJAPUR, BANGALORE

Certificate for local Hoist Operator

This is to certify that Mr. ___________________________________________

aged _____ years, is _____ years experienced in operating the builder hoist.
We checked his operating skills and method. He is doing good.
He is given the permission to operate the builder hoist.

P & M Incharge
PulleyDetails Wire Rope Details

Safety Officer
Safety Officer
 SJR PRIME CORP
PALAZZA CITY
Block:
Checklist of Builder Hoist from to .
BLOCK- DATE:

Sl.No. Description YES / NO Remarks

1 Is the hoist brake working properly ?
2 Is the wire rope in working condition ?
3 Are the wire rope strands cut ?
4 Is the wire rope kinked ?
5 Is the diameter of the wire rope less ?
6 Is the wire rope rusted ?
Are the nuts and bolts of the hoist are tightened
8
properly?
Are the pulleys rotating freely without any
9
noise ?
Are the moving parts of the machine covered
10
properly ?
Are the supports from the hoist channel to the
11
permanent structure OK ?
Is the illumination sufficient to carry out the
12
work?
Is power supply installed with earthing, fully
13
functional and three phase wiring ?
Is power supply given with rain protection and
14
are cables over-routed ?

15 Is approach to the builder hoist safe in all floors?

Are any cutouts and openings barricaded on the

16
floors ?
Is the wire rope movement area barricaded
17
properly ?
Are any unwanted projections or rods protruding
18
in the wall or beam ?

Is the platform in each floor properly provided

19
and barricaded to unload the material ?

Is stairways and access to the hoist clear of

20 obstruction, any hindrance installed and it is
protected from falling objects?

Prepared by Operator P & M Incharge Safety Officer

 SJR PRIME CORP
WATER MARK PROJECT

CheckList prior to Operating Hoist

Block- Date:

Sl.No. Description OK NOT OK

1 Is approach to the building hoist safe ?

2 Is area around lift entrance clear ?

Stairways- clear of obstruction, hindrance installed,
3 illumination is sufficient ?

4 Is any cutout / openings kept open on the floor ?

Are any unwanted projections / rods protruding in the
5 wall / beam ?
Hoist way lighting installed with earthing, fully
6 functional, three phase wiring ?
Is power supply installed with rain protection sufficient
7 ?

Prepared by P&M Incharge Sign of Safety Officer

 SJR PRIME CORP
PALAZZA CITY

Certificate for local Hoist Operator

This is to certify that Mr. ________________________________________

aged _____ years, is _____ years experienced in operating the builder hoist.
We checked his operating skills and method. He is operating well and fine.
He is given the permission to operate the builder hoist.

P & M Incharge Project In Charge: Safety Officer:

SJR PRIME CORP

PALAZZA CITY
SARJAPUR, BANGALORE

Certificate for local Hoist Operator

This is to certify that Mr. ________________________________________

aged _____ years, is _____ years experienced in operating the builder hoist.
We checked his operating skills and method. He is operating well and fine.
He is given the permission to operate the builder hoist.

P & M Incharge Safety Officer

 SJR PRIME CORP
PALAZZA CITY

Lifting capacity of the Hoist

HOIST - ( -BLOCK)

Safe Working Load-450 Kg.

4" Blocks 30 Nos.

6" Blocks 20 Nos.

8" Blocks 15 Nos.

Cement Bags 06
09 Nos.
NOS

Sand Bags 18 Nos.

 SJR PRIME CORP
WATER MARK PROJECTS

TOWER CRANE CHECKLIST

Block:
Report from to .

Sl.No. Description Checked OK Remarks

1 Horn
2 Swing Brake
3 Hoisting Brake
4 Limit Switches
5 Hook Safety Lock
6 Hoisting Rope
7 Trolley Rope
8 Lubrication of pulleys
9 Strands Cut
10 Wire rope kinked
11 Is Diameter less
12 Rusted
13 Is centerline visible

NOTE:

Prepared by Operator P&M Incharge Safety Officer

 SJR PRIME CORP
Project

Checklist before / during / after Excavation

Date :

Sl.No. Description OK NOT OK

1 Is excavation area checked against
a. Any under ground cabling ?
b. Any under ground piping ?

2 Is excavation checked for

a. Slope / step cut / shoring ?
b. Approach / stairway ?
c. Safe barricading ?
d. Disposal and stacking method ?

3 Are mobile equipments checked for

a. Competent operator with valid license ?
Lights, horns,backlights, reverse horn,
b. brakes etc ?
c. Properly maintained and fit for use ?

4 In case of dewatering pump, is it checked for

a. Proper earthing mechanism ?
Safe connections / improper joints /
b. Improper splice cable / switches etc. ?

Is proper lighting arrangement done in case

5 of night work or darkness ?

6 Are proper PPE being used by the worker ?

7 Location

Prepared by Engineer Sign of Safety Officer

 SJR PRIME CORP
PROJECT

Checklist before starting any Welding / Hot work

Date:

Sl.No. Description OK NOT OK

Is the surrounding area checked and flammable
1
material removed ?( 10 m )
Is the drain, pit, sewer and floor opening covered /
2
protected to prevent spark entering in ?
Is the control of welding spark provided using wet
3
gunny bags / welding curtain ?
Is the proper lighting and proper means of exit
4
available / provided ?
Are welding cables in good condition ? (no cuts, no
5
bare conductors exposed )
Are the required Personal Protective Equipment
( Welding shield, Leather hand gloves, Apron, Helmet,
6
Safety glasses, Shoes, Safety belt, etc.) arranged and
being used ?
Is the ventilation adequate to allow welding fumes
7
extracted / diluted ?
Is the welding set energized through Earth Leakage
8
Circuit Breaker ( ELCB ) and earthed ?
Are the gas cylinder mounted on trolley, secured and
10
capped ?
Are the gas hose pipes in condition, tested and as per
11
IS colour codes ?
Is the gas cutting torch provided with flash back
12
arresters ?
Are the appropriate fire extinguishers provided ?
13
( Water type, Foam, CO2, DCP etc.)
Are the available sprinklers, hose stream, extinguishers
14
in service / operable ?
Is the location of nearest phone, safety shower / eye
15
wash, fire extinguisher reviewed ?
Are the tools and tackles removed after the work?
16
( After completion of work )
Is the dirt / waste and material removed from the site
17 after the work and properly disposed off ? (After
completion of work )

Prepared by Sign of contractor Sign of Safety Officer

 SJR PRIME CORP
PROJECT-

CHECKLIST TO WORK ON SCAFFOLDING

Sl.No. Description Remarks

1 Location:

2 Is the base of the Scaffolding OK ?

Is the scaffolding straight and in
3
vertical position ?
Is crossbracing provided to all
4
structural members ?
Is the handrail provided for the
5
platform ?

Are there supports fixed to the scaffold

6
from the permanent structure ?

If YES, are they done properly with

7
clamps ?
Are 03 jali's fixed with toe board on the
8 scaffolding for the worker to work
properly and safely ?
Are the jali's on which they work are
9 fixed with binding wire to the
scaffolding ?
Have the workers hooked their safety
10
belts to the life line rope ?
Are people wearing their respective
11
PPE's ?

PREPARED BY: CKECKED BY: SAFETY IN-CHARGE

 SJR PRIME CORP
WATER MARK PROJECT
Shaft / Confined Space Work Permit

1 Location
2 No. of workers deployed with their
names
3 Nature of work
4 Date and Work permit time
5 Are appropriate PPE's issued
6 Is the Lighting proper
7 Is the Ventilation OK
Is the artificial respiratory system
8 required
9 Access to the work place
10 Safety Precautions informed
to the Contractor

Checked by SubContractor Safety-Incharge

Sl.No. Name Designation Sl.No. Name Designation

01 21
02 22
03 23
04 24
05 25
06 26
07 27
08 28
09 29
10 30
11 31
12 32
13 33
14 34
15 35
16 36
17 37
18 38
19 39
20 40
 SJR PRIMECORP
PALAZZA CITY
SAFETY INDUCTION
01. P.P.E. 05. FIRE PROTECTION 09. WELDING & GAS CUTTING
02. HEIGHT WORK 06. LADDER WORKS 10. EMERGENCY EXIT
03. HOUSEKEEPING 07. FIRST AID 11. EXCAVATION WORK
04. ELECTRICAL WORKS 08. MATERIAL HANDLING 12. NEIGHT WORK
NAME OF THE CONTRACTOR: DATE:
NATURE OF WORK:
CONTACT NO:
1 NAME: ADRESS SIGNATURE
S/W OF

AGE: SEX:

DESIGNATION

2 NAME:

S/W OF

AGE: SEX:

DESIGNATION

3 NAME:

S/W OF

AGE: SEX:

DESIGNATION

4 NAME:

S/W OF

AGE: SEX:

DESIGNATION

5 NAME:

S/W OF

AGE: SEX:

DESIGNATION

6 NAME:

S/W OF

AGE: SEX:

DESIGNATION

7 NAME:

S/W OF

AGE: SEX:

DESIGNATION

8 NAME:

S/W OF
AGE: SEX:

DESIGNATION

CONDUCTED BY:
DESIGNATION SAFETY IN CHARGE
 SJR PRIME CORP
WATER MARK PROJECT
VEHICLE CHECKLIST Date:

01 TYPE OF VEHICLE
02 VEHICLE NO.
03 NAME OF DRIVER
04 LICENCE NO.
05 R.C. BOOK
06 INSURANCE
07 HORN
08 REVERSE HORN
09 DRIVER FITNESS
10 LIGHT
11 INDICATOR
12 TYRE AIR PRESSURE
13 GUARD / DOOR
14 ENGINE START WITH KEY
15 BRAKE CONDITION
16 EMMISSION TEST
17 FIRE EXTINGUISHER
18 FIRST AID BOX
19 NEXT INSPECTION ON
 SJR PRIME CORP.
PALAZZA CITY

DATE: -
VEHICLE CHECKLIST
YES NO

01 TYPE OF VEHICLE : _________________________

02 VEHICLE NO. : _________________________

03 NAME OF DRIVER : _________________________

04 LICENCE NO. : _________________________

05 R.C. BOOK : _________________________

06 INSURANCE : _________________________

07 HORN : _________________________

08 REVERSE HORN : _________________________

09 DRIVER FITNESS : _________________________

10 LIGHT : _________________________

11 INDICATOR : _________________________

12 TYRE AIR PRESSURE : _________________________

13 GUARD / DOOR : _________________________

14 ENGINE START WITH KEY : _________________________

15 BRAKE CONDITION : _________________________

16 EMMISSION TEST : _________________________

17 FIRE EXTINGUISHER : _________________________

18 FIRST AID BOX : __________________________

19 NEXT INSPECTION ON : __________________________

CHECKED BY AUTHORISED PERSON SAFETY IN CHARGE

 SJR PRIME CORP.
VEHICLE CHECKLIST DATE:

01 TYPE OF VEHICLE
02 VEHICLE NO.

03 NAME OF DRIVER

04 LICENCE NO.

05 R.C. BOOK

06 INSURANCE

07 HORN

08 REVERSE HORN

09 DRIVER FITNESS

10 LIGHT

11 INDICATOR

12 TYRE AIR PRESSURE

13 GUARD / DOOR

14 ENGINE START WITH KEY

15 BRAKE CONDITION

16 EMMISSION TEST

17 FIRE EXTINGUISHER

18 FIRST AID BOX

19 NEXT INSPECTION ON

_________

_________

CHECKED BY AUTHORISED PERSON SAFETY IN CHARGE

 SJR PRIME CORP
PROJECT: DATE:
PPE STOCK POSITION AS ON

Sl. No. Name of PPE Stock Unit Remarks Require

1 White Helmet No.
2 Green Helmet No.
3 Red Helmet No.
4 Blue Helmet No.
5 Yellow Helmet No.
6 Yellow Helmet (Load) No.
7 Helmet Refill- PVC No.
8 Safety Goggles No.
9 Ear Plug / Muff No.
10 Nose Mask No.
11 Shoulder Apron No.
12 Leather Apron-Welding No.
13 Full body Safety Harness No.
14 Leather Hand Gloves Pairs
15 Cotton Hand Gloves Pairs
16 Rubber Hand Gloves Pairs
17 Knitted Hand Gloves Pairs
18 Welding Shield No.
19 Face Shield No.
20 Workers Shoes Pairs
21 Staff Shoe Pairs
22 Gum Boot Pairs
23 Safety Nets No.
24 Rain Coat No.
25 Barrication Tape Rmts
26 Life Line Rope Bundle
27 Fire Extinguisher No.
28 Fire Bucket No.
29 Fire Stand No.
30 Rubbermat No.
31 Umbrella No.
32 R. Jacket(Red) No.
33 R. Jacket (yellow) No.
34 R. Jacket(Green) No.
PREPARED BY STORE KEEPER SAFETY OFFICER
 SJR PRIME CORP
PALAZZA CITY
PEP TALK
Sub: House Keeping, PPE, Electrical Safety, No Smoking, First Aid, Fire Safety,
Work at Height, General Safety Rules, Health, etc.,
Training given by : Time : to am
Designation : Date :

Sl.No. Name Designation Signature

01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20

Sl.No. Name of Contractor Nature of Work No. of workmen Signature

01
02
03
04
05
06
07
08
09
10
11
12
Safety In Charge Project Manager
 SJR PRIME CORP
PALAZZA CITY
TOOL BOX TALK
Sub:- House Keeping, PPE, Electrical Safety, No Smoking, First Aid, Fire Safety, Work at Height,
General Safety Rules, Health, etc.,
Name of Contractor : Date :
Training given by :

Sl.No. Name Designation Signature

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
30
31
32

Prepared by Safety Officer

 SJR PRIME CORP
PALAZZA CITY
ELECTRICAL SAFETY CHECKLIST

Report from : to :

ELCB/RCCB PLUG AND IS CABLE RUBBER DB ROOM IS CABLE

DB EARTHING IS OK
DATE LOCATION DB. NO. WORKING SOCKET OK CONNECTION MAT IS IS DRY & JOINT REMARKS
RATING
PROPERLY CONDITION PROPER PROVIDED CLEAN PROPER
ELECTRICIAN ELECTRICAL IN CHARGE SAFETY IN CHARGE
 SJR PRIME CORP
WATER MARK PROJECT

Block: Date:

ELCB trip
Continuity Continuity
Board Rating YES / NO
Sl.No. Earth to Earth to Location Remarks
No. of ELCB l
phase neutral
x

Checked by P&M Incharge Safety Officer

 SJR PRIME CORP
PALAZZA CITY

PERMIT FOR WORKING AT HEIGHT

Permit No. Date:

01.Location: 02.Supervisor's name

03.Contractor's name: 04.Responsible person's name:

05.No. of labours:

06.Nature of work - Scaffolding / Block work / External plastering / Shuttering

07.Area of work permitted: 08.Permission from to

09.Safety Precautions taken :

a) Have they worn proper PPE's?

b) Is the working platform properly fixed?

c) Is overhead protection provided?

d) Is fall arrester provided at required place?

e) Is PEP talk given to the team?

f) Are any other precautions taken? ( YES/NO. If YES-Specify )

All the areas should be practically inspected and to be carried out with below points:
a) All the scaffolding base condition.
b) Supports, verticals, horizontals etc…

Checked by Permitted by
Safety Officer
Note
* If any Unsafe act / Unsafe condition are observed the permit will be cancelled at anytime.
* If the work is not completed within the stipulated time the same permit can be renewed.
* Name and Age of workers to be entered at backside of the page.

Declaration
Received and understood the safety precautions given by the safety person. Hence we
follow safety precautions explained to us. We ensure safety at workplace by way of
taking Responsibility and continuous Supervision.

Engineer's Signature Supervisor Signature Contractor's Signature

 SJR PRIME CORP.
PALAZZA CITY

FIRE EXTINGUSHER DETAILS

Sl.No. Location placed Type of Class of Weight Date of Next Date

Extingusher Fire in kgs. refilling of refilling

01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

Prepared by
 SJR PRIME CORP
PALAZZA CITY
FIRST AID MEDICINE
FIRST
STOCK
AID MEDICINE STOCK
SJR PRIME
STATEMENT
CORP

Sl.No. Medicine STOCK MFG -DATE EXP-DATE REMARK

Dressing Cotton
1

25mm Roller Bandage

2

75mm Roller Bandage

3

Hydrogen Peroxide
4

Dettol
5

Tincher
6

Burnol
7

Eye drop
11

Moov
12

Adhesive Plaster
13

Scissor / Safety Pins

14

Powder Sprinkling
16

Blade
18

Voliny spray
19
 SJR PRIME CORP.
PALAZZA CITY

SAFE MAN HOURS MONTHOF-

Cumulative Cumulative
Daily Safe Safe Safe Safe
Date ManPower DAY NIGHT Manhours Manhours Mandays Mandays Safe Days Remarks
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
30

31
Prepared by
 SJR PRIMECORP PALAZZA CITY Date:

SAFETY OBSORVATION
Time
Frame(By Status Remarks
Sl.No. LOCATION CONCERN/OBSORVATION Corrective Action Person Responsible date)

CC to Project in charge Signature: Safety In Charge:

Signof Responsbility 1) 2) 3)