ehs observation report format

Prepared by: Submitted to: Name/ Staff No/ Designatio n: Preej .J/114 928 /HSEO Name/ Staff No: Mohammed Moussa/1717 16/Project Manager ET S ON ST R GROUP OF OMP NIES Doc. No: DAILY HSE REPORT Revision No: 0 Report No: HSE/PJ/DHR/ 111 Date: 27/08/14 Page No. 01 Name of th e Proj ect/ Fa ctor y/ Workshop / Job No: “ Akoya by Damac ” Service Removal And Bulk Earth Works R155 Division/ Area: Ascon Road Construction / Dubai Name of the Proj ect Director / Site/ Worksho p Manager: Mohammed Moussa Staff No :171716 SECTION A: Project HSE Lea d No of employees worked 136Nos No. of LTI Nil No. of Man days lost Nil No. of Hospit al Ref. cases Nil Man-hours worked 1360Hrs No. of First Aid cases Nil No. of Near Miss Incidents reported Nil No. of HSE Meeting conducted Nil SECTION B: Project HSE Officer/Engineer Sl. No. Data type Equipment/ Doc Ref. Observations Hazard Danger Level (LXSXE) Danger code Remedial Action Proposed/ Ad dit io nal c on tr ol m easur e / App li cabl e Legal req ui rement t o comply Act io n B y wi th Staff No & Name. Target date Ac ti on t aken on 1 UC Mini roller being lifted with rope hooked to the excavator bucket teeth was noticed. Reg no E89415 Failure of rope, Failure of equipment, Personnel Injury 100 A a)Third part certified web sling to be used for lifting the load. b) Excavator are used as lifting equipment slings should be connected to manufacture designed and recomm ended lifting point and lifting with bucket teeth is strictly prohibited. Mr.Naser A la a din 179457 27/08/14 27/08/14 2 UC Un protected manhole observed in under passage demolition area. Fall of person 100 A Provide hard barrication for the manhole with sign boards. Mr.Naser A la a d in 179457 27/08/14 27/08/14 3 UC Observed compressed gas cylinder being laid on ground. subjected to impact, Fire 100 A Remove the excess compressed gas cylinders from the work place and cylinder should be keep in trolley securing with chain. Mr.Naser A la a d in 179457 27/08/14 27/08/14

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8/11/2019 EHS Observation Report Format

http://slidepdf.com/reader/full/ehs-observation-report-format 1/1

Prepared by: Submitted to:

Name/ Staff No/ Designation: Preej .J/114928/HSEO Name/ Staff No: Mohammed Moussa/171716/Project Manager

ET S ON ST R GROUP OF OMP NIES

Doc. No:

DAILY HSE REPORT Revision No: 0

Report No: HSE/PJ/DHR/ 111 Date: 27/08/14 Page No. 01

Name of the Project/ Factory/ Workshop / Job No: “ Akoya by Damac ” Service Removal And Bulk Earth Works R155Division/ Area: Ascon Road Construction / DubaiName of the Project Director / Site/ Workshop Manager: Mohammed Moussa Staff No :171716SECTION A: Project HSE Lead

No of employeesworked

136Nos No. of LTI Nil No. of Man days lost Nil No. of Hospital Ref. cases Nil

Man-hours worked 1360HrsNo. of First Aid cases

NilNo. of Near MissIncidents reported

Nil No. of HSE Meeting

conductedNil

SECTION B: Project HSE Officer/Engineer

Sl.No.

Datatype

Equipment/

Doc Ref.Observations Hazard

DangerLevel