Department Head Subcontractor Date Time Location Equipment to be inspected
Participant Requester Inspected / Approved By Acknowledge By H.O.D, Subcontractor Maintenance Depart. Safety Depart.
Name Signature
Date
* Whichever applicable Inspection Results :
Inspection passed – Machine allowed to use.
Inspection Failed – Machine was rejected & not allows using.
Inspection accepted – Machine allowed using but comments need to be rectified & comply. Date Line - From ______________ until ________________ (Close date : _________ ) Remarks / Comments:
___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ * Please attach copies of
:-a. PMA / PMT e. Safety Construction Certificate b. Competency Certificate f. Insurance Certificate
c. Certificate of Registry g. Others d. Crew List
SAFETY DEPARTMENT REQUEST FOR INSPECTION
SAFETY DEPARTMENT YNESB/OSHEF/03 DAILY PLANT SAFETY INSPECTION CHECKLIST
S.No Description Yes No N.A
01 Foremen on job area
02 All employees wearing proper eye/head protection? 03 All wearing hearing protection where necessary? 04 All wearing protective clothing where necessary. 05 All wearing respiratory protection where necessary? 06 All wearing adequate safety shoes/gloves?
07 All overhead workers using safety belts? Line? If required? 08 Is proper permit at job site attained?
09 All provisions on permit satisfied? 10 All hot work/entry permits as required?
11 Is fire watchman on duty alert & knowledgeable of duty? 12 Equipment properly locked out /tagged out?
13 Electrical connections/cords, proper twist lock connections? 14 Welding machines, sand blusters etc properly grounded? 15 All necessary blind installed/blind list ok?
16 Has shoring been done as necessary?
17 Have underground drawing been checked for safe excavation? 18 Roads properly blocked if necessary?
19 Scaffolding properly installed? 20 Ladders properly used? 21 Tools properly used?
22 Proper lifting method s/material handling? 23 Proper/approved lighting in use?
24 Retainer pin or air hose/tools connections? 25 Hose reels or hoses used properly?
26 Compressed gas cylinders secured upright?
27 Good house keeping
28 Special warning posted if necessary 29 Labels affixed to chemical container.
Other Items /Comments
Supervisor : _________________ Safety Officer : _________________ Name : _________________ Name : _________________ Date : _________________ Date : _________________ Signature : _________________ Signature : _________________
LOCATION: WEEKLY PLANT INSPECTION CHECKLIST
Items Inspected Tick Remark Items Inspected Tick Remark
Yes No 2.Hazardous Material Yes No
1. Housekeeping a. MSDS Available
a. Access b. Register Available
b. Stairways c. Signboards Posted
c. Signs d. Proper Storage
d. Lighting e. Labeling
e. Waste Disposal g. Fire Protection
3. PPE 4. Work At Height
a. Safety Helmet a. Working Platform
b. Safety Boots b. Safety harness
c. Eye Protection c. Lifeline
d. Ear Protection d. Tools Secured
e. Gloves e. Barricade area below
f. Overall/Apron f. Fall Arrest Equipment
g. Filter/Dust mask g. Access
5. Lifting Activity 6. Confined Space
a. Crane a. Permit Obtained
b. Lift Permit/Prelift Check b. Gas Test Done
c. Barricade/Signs c. Standby Person
d. Signalman d. Proper Ventilation
e. Taglines e. Lifeline
g. Vehicle Entry Permit g. Explosion-proof
Lights
h. Supervision h. BA (if necessary)
7. Equipments (W/Set, 8. Work Areas
Generator, Compressor) a. Housekeeping
a. Guards b. Ladders/Platforms
b. Emergency Stop c. Hand Tools
c. Fire Extinguisher d. Obstruction
d. Oil Leaks e. Access
e. PMT f. Floor Opening
f. Earthing g. Overhead Works
g. Leads/Cables h. Emergency Exits
h. Oil/Fuel/Radiator Cap 9. Electrical a. ELCB Functional b. Industrial Cable c. Proper Connections d. Correct Plugs e. BD Condition f. Cable Management
SAFETY DEPARTMENT YNESB/OSHEF/04/02 LOCATION: WEEKLY PLANT INSPECTION CHECKLIST
Items Inspected Tick Comments Items Inspected Tick Comments
Yes No Yes No
11.Weld/Cut/Grind 12.Scaffolding
a. Cylinder Secured a. Tagging Available
b. Flash-back Arrestor b. Access
c. Regulator/Hose/Torch c. Walkways
d. Fire Extinguisher d. Working Platforms
e. Hand Tools e. Handrails/Guardrails
f. PPE f. Toe-boards
g. Hot Work Permit g. Tie-back/Bracing
h. Housekeeping h. Ground Condition
13.Machinery 14.Fire Equipment
a. Inspection Certificate a. Extinguisher(type/qty)
b. Noise b. Hydrant/Hose/Nozzle
c. Oil Leakage c. Smoke/Heat Detector
d. Smoke Emission d. Suppression System
15.First Aid 16.Hygiene/Welfare
a. First Aid Box a. Toilet Facilities
b. Signage b. Drinking Water
c. Adequate Stock c. Canteen
d. Readily Accessible d. Garbage Disposal
e. Housekeeping
17.Radiography f. Rest Area/Surau
a. Area Barricaded b. Warning Lights c. Worker Competency d. Storage of Isotape e. Work Permit Audit Conducted by : 1. 2.
NAME DESIGNATION SIGNATURE / DATE
Audit Attend by : Contractor/ H.O.D 1. 2. 3. 4. 5. 6.
NAME DESIGNATION SIGNATURE / DATE
SAFETY DEPARTMENT YNESB/OSHEF/05 CRANE / SKY LIFT INSPECTION CHECKLIST (INITIAL / QUARTERLY)
Contractor Crane
Crane Type Crane No. Rated Capacity
DOSH Reg. No. PMA No PMA Expiry
S/No Item Description Tick Remarks
Yes No 1 Tires in good condition and inflated
2 All wheels off the ground 3 Oil leakages
4 Lifting/Rigging equipments acceptable 5 Horn/buzzer/hazard lights functional 6 Valid Road Tax/ Insurance
7 Lights/signals in working condition 8 Any damage to wire ropes 9 Operator registered with DOSH 10 Valid PMA
11 Fire extinguisher available 12 Load chart available
13 Any welds/visible cracks on the boom 14 Outriggers fully extended and pads available 15 Noise/smoke level acceptable
16 Extension jib safely secured 17 Height limit alarm functioning 18 Hoist brakes functioning
19 View from operator cabin not restricted 20 Boom angle indicator accurate 21 Lifting blocks/hooks in good condition 22 Safety latches in good condition 23 Barricades and signs installed 24 Taglines available
25 Signalman available
26 Operator/Signalman familiar with signals 27 Crane crew safety briefed
Attached are true copies of:-
Valid PMA Load Chart
Operator’s Competency Cert. (DOSH/JPJ License) Road / Insurance Tag Reg.
Inspection Result : PASSED FAILED
ACCEPTED WITH COMMENT DATE LINE: …………
NAME & SIGNATURE
CRANE SUPPLIER NAME & SIGNATURESAFETY OFFICER NAME & SIGNATUREYARD MANGER
SAFETY DEPARTMENT YNESB/OSHEF/06
CRANE / SKY LIFT INSPECTION DAILY CHECKLIST
Contractor
Crane
Operator
Inspection
Date
Crane Type
Crane
No.
Rated
Capacity
DOSH Reg.
No.
PMA No
PMA
Expiry
S/No
Item Description
Tick
Remarks
Yes
No
1
Tires in good condition and inflated
2
All wheels off the ground
3
Oil leakages
4
Lifting/Rigging equipments acceptable
5
Horn/buzzer/hazard lights functional
6
Valid Road Tax/ Insurance
7
Lights/signals in working condition
8
Any damage to wire ropes
9
Operator registered with DOSH
10 Valid PMA
11 Fire extinguisher available
12 Load chart available
13 Any visible cracks on the boom
14 Outriggers fully extended and pads
available
15 Noise/smoke level acceptable
16 Extension jib safely secured
17 Height limit alarm functioning
18 Hoist brakes functioning
19 View from operator cabin not restricted
20 Boom angle indicator accurate
21 Lifting blocks/hooks in good condition
22 Safety latches in good condition
23 Barricades and signs installed
24 Taglines available
25 Signalman available
26 Operator/Signalman familiar with signals
27 Crane crew safety briefed
Remark :
SAFETY DEPARTMENT YNESB/OSHED/07 Date : ___________
DAILY WELDING & CUTING MACHINE CHECKLIST
NO DESCRIPTION YES NO N/A REMARKS 1 STARTER & WIRING SYSTEM IN GOOD CONDITION
2 GAS HOSES AND COUPLING IN GOOD CONDITION 3 FIRE EXTINGUISHER IN PLACE
4 FREE FROM COMBUSTIBLE MATERIAL 5 WELDING MACHINE INSPECTED 6 IS THE MACHINE EARTHED
7 IS THE GAS CYLINDER UPRIGHT AND SECURED 8 IS FLASH-BACK ARRESTOR AVAILABLE
9 RESPONSIBLE PERSON FOR THE INSPECTION OF WELDING MACHINE AND EARTHING :
NAME:____________________ ____
DESIGNATION:_____________ ____
10 ARE THESE PPE PROVIDED:
SAFETY GLASSES FACE SHIELD GLOVES 11 ARE THE HAND TOOLS IN GOOD CONDITION 12 ARE THE ELECTRICAL CONNECTIONS SAFE
13 ARE THE LEADS / CABLES IN GOOD CONDITION AND PLACED OVEREAD
14 ARE SCREENS IN PLACE
16 CUT OFFS REMOVED AND PLACED IN DRUMS 17 HOUSEKEEPING ACCEPTABLE
18 IS COMPLETED AND APPROVED JSA AVAILABLE REMARKS
Responsible Person On site :
_______________ _________________________ ___________ Name Signature Date
SAFETY DEPARTMENT YNESB/OSHEF/08 Date : ___________
QUARTERLY WELDING & CUTING MACHINE CHECKLIST
NO DESCRIPTION YES NO N/A REMARKS
1 STARTER & WIRING SYSTEM IN GOOD CONDITION 2 GAS HOSES AND COUPLING IN GOOD CONDITION 3 FIRE EXTINGUISHER IN PLACE
4 FREE FROM COMBUSTIBLE MATERIAL 5 WELDING MACHINE INSPECTED 6 IS THE MACHINE EARTHED
7 IS THE GAS CYLINDER UPRIGHT AND SECURED 8 IS FLASH-BACK ARRESTOR AVAILABLE
9 RESPONSIBLE PERSON FOR THE INSPECTION OF WELDING MACHINE AND EARTHING :
NAME:________________________ DESIGNATION:_________________ 10 ARE THESE PPE PROVIDED:
SAFETY GLASSES FACE SHIELD GLOVES 11 ARE THE HAND TOOLS IN GOOD CONDITION 12 ARE THE ELECTRICAL CONNECTIONS SAFE
13 ARE THE LEADS / CABLES IN GOOD CONDITION AND PLACED OVEREAD
14 ARE SCREENS IN PLACE
16 CUT OFFS REMOVED AND PLACED IN DRUMS 17 HOUSEKEEPING ACCEPTABLE
18 IS COMPLETED AND APPROVED JSA AVAILABLE REMARKS
Area : Responsible Person On site :
Checked by : Name : Signature : Acknowledged By : _______________ _________________________ ___________ Name Signature Date
SAFETY DEPARTMENT YNESB/OSHEF/09 Date: ____________
QUARTERLY CHECKLIST FOR LIFTING SLING, CHAIN AND WIRE ROPE
Statutory and licensed
equipment/machinery Non -statutory and licensed equipment/machinery Location :
Colour code:
Department/section
Yes No N.A a. Is lifting chain/sling/wire in good working order(visual check)?
b. Is safe working load clearly labeled on individual lifting chain/sling/wire?
c. Is there a register to encompass all lifting chains/slings/wires? d. Any signs of worn or frayed slings/wires?
e. Is standard operating procedure for using lifting chains/slings/wires?
f. Is there clear access to retrieve or return lifting chains/slings/wires?
g. Any signs of excessive corrosion on lifting chains/wires? h. All fastening devices intact?
i. Is there any proper storage for lifting chains/slings/wires? j. Is there a record a proper functional and load testing on lifting chains/slings/wires?
k. Is there any signs of proper maintenance of lifting chains/sling/wires?
l. Is there any sign-in or signed-out procedure of retrieving/returning lifting chains/sling/wires?
m. Are lifting chain/slings/wires appropriate for their use?
Note : Responsible persons must record and maintain the monthly checklist for 24 months
Area : Responsible Person On site :
Checked by : Name : Signature : Acknowledged By : _______________ _________________________ ___________ Name Signature Date
SAFETY DEPARTMENT YNESB/OSHEF/10 Date : ____________
DAILY CHECKLIST FOR LIFTING SLING, CHAIN AND WIRE ROPE
Statutory and licensed
equipment/machinery Non -statutory and licensed equipment/machinery
Inspected item Visual inspection Remarks
Yes No N.A
a. Is lifting chain/sling/wire in good working order(visual check)? b. Is safe working load clearly labeled on individual lifting chain/sling/wire?
c. Is there a register to encompass all lifting chains/slings/wires? d. Any signs of worn or frayed slings/wires?
e. Is standard operating procedure for using lifting chains/slings/wires?
f. Is there clear access to retrieve or return lifting chains/slings/wires?
g. Any signs of excessive corrosion on lifting chains/wires? h. All fastening devices intact?
i. Is there any proper storage for lifting chains/slings/wires? j. Is there a record a proper functional and load testing on lifting chains/slings/wires?
k. Is there any signs of proper maintenance of lifting chains/sling/wires?
l. Is there any sign-in or signed-out procedure of retrieving/returning lifting chains/sling/wires?
m. Are lifting chain/slings/wires appropriate for their use?
Note : Responsible persons must record and maintain the daily checklist for 24 months
Checked By :
_____________________ ___________________ __________________ Name Signature Date
BARBENDING,ROLLING & CUTTING MACHINE QUARTERLY INSPECTION CHECKLIST
Company : Supervisor : Date : Type : Model : Series No: Inspection By : Next Inspection : Tag No :
SAFETY DEPARTMENT YNESB/OSHEF/12 BARBENDING, ROLLING & CUTTING MACHINE DAILY INSPECTION CHECKLIST
Company : Supervisor : Date : Type : Model : Series No:
Item Description Yes No N/A Remarks
Item Description Yes No N/A Remarks
1. Body & Engine Condition 2. Starter & Wiring System 3. Noise
4. Leakage of Oil 5. Radiator & Fuel Cap
6. Belting damage, safety guard 7. Emergency Stop Button 8. Any Modification
9. Rotating part guard & protected
10. Condition of bending & cutting machine 11. Condition of bending & cutting table 12. Surrounding area cleanliness & obstructed 13. Used by trained / competent workers 14. Necessary PPE provided
15. Operating manual provided 16. Manufacturing stickers 17. Series / model stickers 18. Material proper store
Company :
Area : Responsible Person On site :
Checked by : Name : Signature : Acknowledged By : _____________ _________________ ___________ Name Signature Date
1. Body & Engine Condition 2. Starter & Wiring System 3. Noise
4. Leakage of Oil 5. Radiator & Fuel Cap
6. Belting damage, safety guard 7. Emergency Stop Button 8. Any Modification
9. Rotating part guard & protected
10. Condition of bending & cutting machine 11. Condition of bending & cutting table 12. Surrounding area cleanliness & obstructed 13. Used by trained / competent workers 14. Necessary PPE provided
15. Operating manual provided 16. Manufacturing stickers 17. Series / model stickers 18. Material proper store
Checked By :
_____________________ ___________________ __________________ Name Signature Date
SAFETY DEPARTMENT YNESB/OSHEF/13
WRITTEN WARNING FOR SAFETY MISCONDUCT
REPORT NO : DATE :
NAME :
AFTER ISSUING VERBAL WARNING FOR CONTINUOS VIOLATION OF SAFETY
REGULATIONS, IT HAS BEEN DEEMED NECESSARY TO NOW ISSUE AN
OFFICIAL WRITTEN WARNING ANY FURTHER VIOLATIONS WILL RESULT IN
IMMEDIATE REMOVAL OF YOURSELF FROM SITE AND DISMISSAL FROM THE
COMPANY.
REASON FOR ISSUING OF WARNING.
SAFETY OFFICER :
YARD MANAGER :
EMPLOYEE :
SAFETY DEPARTMENT YNESB/OSHEF/14
NOTIFICATION OF OVERTIME AND REST DAY/PUBLIC HOLIDAY WORK
CONTRACTOR: DATE:Fill the appropriate row Overtime Works On : Rest Day Works On : Public Holiday Works On :
_____/_______/_______ _____/_______/_______ _____/_______/_______
Time : From_________To_________ Time : From_________ To_________ Time : From _________To_________
Specific Work To Be Carried Out : No Of Persons
Contractor On Duty : ______________________ (Name) Contractor’s Safety Personnel On Duty : ______________________ (Name) Contractor’s Authorized Personnel : ______________________ (Name)
Signature ________________ ________________ ________________ Approved by (YNESB PERSONALS)
Production Manager : __________________________(Name) Safety officer : __________________________(Name)
Signature
________________ ________________
Safety Instructions:
# To standby vehicle for Emergency Use throughout the working duration
Note :
# Normal day overtime work notification to be submitted to OSHED by or before 1700 hours on the intended working day
# Rest day/Public Holiday work notification to be submitted to OSHED one (1) day prior to the intended working day
SAFETY DEPARTMENT YNESB/OSHEF/15 Date :
HEAVY LIFTING PERMIT
SECTION 1
DEPT/CONTRACTOR LOCATION DESCRIPTION OF WORK
SECTION 2
Item Description Purpose of Lift Special Work Instruction A. Normal lift <6 metric tons
B. Lifting between 6-12metric tons C. Critical lift exceeding 12 metric tons (Attach sketch & capacity calculation) D. Multiple crane lifting (wt...
E. Use of overhead crane (wt... F. Lifting over unprotected/live equipment G. Removal or installation of equipment H. Overhead lift (sling not made of wire rope) I. Using more than 4 legged sling
J. Lifting inside confined space
Originator/User...Designation...Signature... Name of crane operator Signalman... Signature... SECTION 4 : WORKSITE PREPERATION
PRECAUTIONS Yes / No Initial by S’visor SLING SPECIFICATION
A. Valid PMA A. Sling test date
B. Crane inspected (safe for use) B. Sling Assy. SWL C. Competent crane Operator / Signalman C. Load wt. (mt) D. Rigging equipments in good condition D. Sling ID No
E. Load weight ascertained E. Size of wire rope
F. Ground condition firm and level (use
steel plates if reqd) G. Size of shackle
G. Pre-job meeting carried out H. Shackle SWL
H. Overhead obstruction/ services checked I. No of shackle used SECTION 5 : PERMIT VALIDATION
Approved By : Lift Permit No: Date Time Name Position
Signature
From To SECTION 6 : WORK COMPLETION / SUSPENSION
The work has been completed/suspended on...(date) at...(hrs)
Reason for suspension (if any)... ... ...
SAFETY DEPARTMENT YNESB/OSHEF/16 PERMIT TO WORK
Work Activity (delete
as applicable) Hot Work Lifting Work
Repair/ Maintena nce Machine Confined Space Entry Blocking Access OTHERS
A. Application ( to be completed by H.O.D, Contractor, ) Requesting
Dept/Cont Request by Date
Plant Area Description of work (attach drawing / sketch as necessary)
Permit is required From:
B. Precautions to be taken prior to commencement and during the work (delete/add as appropriate) Hot Work
Is Approved Method Statement and Risk Assessment available
Area cleared of Flammable Waste Fire Extinguisher available
Overhead work to have area below barricaded Pipelines etc free of gas/liquid
Fire blanket provided to arrest spark / flame Welding screens in use to protect others Appropriate PPE available
Cylinders secured & flash-back arrestor fitted
Lifting Work
No lifting machine shall be operated except by an authorized person. All lifting equipment must be examined by the supervisor and operator before use. Protect wire rope or chain sling from sharp edges and corner with padding. The centre of gravity for the load must be determined for proper balancing of the load. The chain opening angle shall not exceed 60%.Stay clear from any suspended load.
Repair/Maintenance Machine
Is Approved Method Statement & Risk Assessment available, PPE available. Log In and Log Out sign display.
C. REQUEST (PRODUCTION TEAM)
Permission is given for the work to proceed subject to the conditions specified above Signed ( Permit
Controller) Sign Print Date Time Company
D. Performing Authority Acceptance (SAFETY PERSONAL)
I certify that I have read and understood this permit and that the work will be carried out in accordance with the requirements Signed : Sign Print Date Time Company
E. Completion of work (PRODUCTION TEAM)
I hereby declare that all work for which this permit was issued has been complete, all personnel under my control have been withdrawn and the work area and all associated equipment has been left in a safe condition.
Signed : Sign Print Date Time Company
F. Cancellation (SAFETY PERSONAL)
This permit is cancelled
Signed : Sign Print Date Time Company
SAFETY DEPARTMENT YNESB/OSHEF/17 ELECTRICAL TOOLS / EQUIPMENT QUATERLY INSPECTION CHECKLIST
Company : Supervisor : Date : Type : Model : Series No: Inspection By : Next Inspection : Tag No :
Item Description Yes No N/A Remarks
B O D Y P
1. Casing – damage / crack
2. Handle – installed securely
A R T
4. Switch – damage / no function
5. Trigger lock – faulty / damage
6. Main dead switch – faulty / damage
7.Power cord defect – cracking / frying
8. On / Off switch – faulty / damage
9. Guardrail / shield / hazard part protection provided
C A B L E / W I R E / P L U G 10. Damages of wire 11. Proper Connection
12. Earth, properly grounded
13. Plug – crack, loose, missing
14. Use 3 prong plug (faulty prongs)
15. Check earth leakage
16. Broken wire insulated
17. Wire cable / quality
O T H E R S
18. Used by trained / competent workers
19. Necessary PPE provided
20. Operating manual provided
21. Manufacturing stickers
22. Series / model stickers
23. Proper store
NAME & SIGNATURE
MAINTENANCE/ FACILITY DEPT. NAME & SIGNATURESAFETY PERSONAL NAME & SIGNATURESTOR SUPERVISOR
SAFETY DEPARTMENT YNESB/OSHEF/18 ELECTRICAL TOOLS / EQUIPMENT DAILY INSPECTION CHECKLIST
Company : Supervisor : Date : Type : Model : Series No: Inspection By : Next Inspection : Tag No :
Item Description Yes No N/A Remarks
B O D Y P A R
1. Casing – damage / crack
2. Handle – installed securely
3. Handle – damage / crack
T 5. Trigger lock – faulty / damage
6. Main dead switch – faulty / damage
7.Power cord defect – cracking / frying
8. On / Off switch – faulty / damage
9. Guardrail / shield / hazard part protection provided
C A B L E / W I R E / P L U G 10. Damages of wire 11. Proper Connection
12. Earth, properly grounded
13. Plug – crack, loose, missing
14. Use 3 prong plug (faulty prongs)
15. Check earth leakage
16. Broken wire insulated
17. Wire cable / quality
O T H E R S
18. Used by trained / competent workers
19. Necessary PPE provided
20. Operating manual provided
21. Manufacturing stickers
22. Series / model stickers
23. Proper store
Checked By :
_______________________________ Name/
Signature/ Date
( GENERATOR, WELDING MACHINE, AIR COMPRESSOR, ETC)
SAFETY DEPARTMENT YNESB/OSHEF/19
Company : Type of Inspection : INITIAL / QUARTERLY / RENEWAL Type of Equipment :
Serial / Equipment No : PMT No.(air compressor) : Expiry Date :
Inspection Certificate No.: Expiry Date :
Item Description Yes No N/A Remarks
A. Is wiring in good condition B. Is insulation in good condition C. Is information plate visible D. Is ELCB in good condition E. Is safety guard in place F. Is radiator cap fired G. Is fuel cap fitted
H. Is exhaust spark arrestor fitted I. Is air induction control valve fitted J. Is drive belt cover fitted
K. Is there any evidence of fuel leakage L. Are pressure regulators in good condition M. Are gauges in good condition
N. Are the leads and hoses in good condition P. Is Emergency Stop button available and clearly marked
Q. Is earthling system available
R. Is equipment fitted with fire extinguisher S. Is copy of PMT displayed on the equipment
NAME & SIGNATURE
MAINTENANCE SUPERVISOR NAME & SIGNATURESAFETY PERSONAL NAME &SIGNATURESTOR SUPERVISOR
( GENERATOR, WELDING MACHINE, AIR COMPRESSOR, ETC)
NAME POSITION SIGNATURE / DATE
Statutory and licensed
equipment/machinery Non -statutory and licensed equipment/machinery
Location Department/section
Company : Type of Equipment :
Serial / Equipment No : PMT No.(air compressor) : Expiry Date :
Inspection Certificate No.: Expiry Date :
Item Description Yes No N/A Remarks
A. Is wiring in good condition B. Is insulation in good condition C. Is information plate visible D. Is ELCB in good condition E. Is safety guard in place F. Is radiator cap fired G. Is fuel cap fitted
H. Is exhaust spark arrestor fitted I. Is air induction control valve fitted J. Is drive belt cover fitted
K. Is there any evidence of fuel leakage L. Are pressure regulators in good condition M. Are gauges in good condition
N. Are the leads and hoses in good condition P. Is Emergency Stop button available and clearly marked
Q. Is earthling system available
R. Is equipment fitted with fire extinguisher S. Is copy of PMT displayed on the equipment
SAFETY DEPARTMENT YNESB/OSHEF/21 MONTHLY CHECKLIST - FIRE EXTINGUISHERS
Inspected item
Visual inspection and
functional test Remarks
Yes No N.A
Is fire extinguisher conspicuously located?
.Is there any proper space demarcation for fire extinguisher. Is trigger pin intact?
Is wire seal of fire extinguisher unbroken?
Is standard operating procedure for using fire extinguisher displayed?
Is there clear access to fire extinguisher?
Is discharge hose and horn in good working condition and free from cracks and surface grazing?
Is pressure indication gauge within the green zone? Is the body of fire extinguisher free from corrosion?
Is the fire extinguisher close to hazard area (i.e 1.5 m apart at high fire hazard area)
Is the fire extinguisher affixed with approved labels? Is the fire extinguisher inspected by licensed fire extinguisher contractor annually?
Is the fire extinguisher appropriate for the area served? Note :
Responsible persons must record and maintain the monthly checklist for 36 months Inspected By :
NAME POSITION SIGNATURE / DATE
SAFETY DEPARTMENT YNESB/OSHEF/22 QUATERLY CHECKLIST - EXIT LIGHTS
Statutory and licensed
equipment/machinery Non -statutory and licensed equipment/machinery
Location Department/section
Area manager in-charge Reviewed by and date
Inspected item Visual inspection and functional test Remarks
Yes No N.A
a. Batteries of exit lights properly charged
b. Exit lights are ‘No’ when conducting inspection. c. Light bulbs are intact and working order.
d. Supplementary electricity supply to exit lights is intact and normal.
e. Any signs of missing or damaged hardware, such as, wires, screws and lamps.
f. Any sign of obstruction to lamps. g. Any signs of worn or frayed cables. h. Any sign of improper support to exit lights i. Any inventory of all exit lights in the facility. j. Any obstruction to gain access to exits? Note :
Responsible persons must record and maintain the quarterly checklist for 36 months Inspected By :
NAME POSITION SIGNATURE / DATE
SAFETY DEPARTMENT YNESB/OSHEF/23
QUATERLY CHECKLIST - FIRE DOORS
Statutory and licensed
equipment/machinery Non -statutory and licensed equipment/machinery
Location Department/section
Inspected item Visual inspection Remarks
Yes No N.A
a. Are fire doors conspicuously located?
b. Is there any proper space demarcation for fire doors? c. Are rivets, bolts or screw intact?
d. Are wires (Connected to counter weights)disconnected or broken?
e. Are warning sign “Not to damage fire door “ printed on fire doors?
f. Are fusible links intact?
g. Is there any signs of cracks or dents on fire doors? h. Is there any “ fire rating” sign on fire doors? i. Are fire doors free from oil and grease?
j. Is any standard operating procedure on operating fire door displayed near the affected area?
k. Is there an inventory of all fire doors? l. Are fire doors free from obstruction?
m. Is fire door/fire shutter closed completely during functional testing?
n. Is there any warning signal or audio alarm associated with fire door/fire shutter when there is an activation?
Note :
Responsible persons must record and maintain the monthly checklist for 24 months
Inspected By :
NAME POSITION SIGNATURE / DATE
SAFETY DEPARTMENT YNESB/OSHEF/24
QUARTERLY CHECKLIST - MAIN SPRINKLER CONTROL AND HYDRANT
Statutory and licensed
equipment/machinery Non -statutory and licensed equipment/machinery
Location Department/section
Inspected item Visual inspection Remarks
Yes No N.A
Are fire sprinkler control valve/hydrant isolation valves conspicuously located?
Is there any proper space demarcation by hydrant isolation valve?
Is there a proper means of securing the main fire sprinkler control valves?(i.e straps & locks)
Are straps and locks of sprinkler control valve intact. Is wire seal if hydrant isolation valve unbroken?
Is there any standard operating procedure and drawing of operating sprinkler control valve intact.
Is there clear access to sprinkler control valves.
Are local alarms /bells of deluge control valve of sprinkler system in good working condition order and free from cracks of surface glazing
Are pressure indication gauges and in good working conditions?
Is there any ‘open or shut’ indicator for hydrant isolation valve?
Is the body of sprinkler control valve or deluge valve free from corrosion?
Are fastening bolts, nuts or gaskets for sprinkler control valve or deluge valve intact and in good working conditions? Are there signs of leaks of sprinkler valves/deluge valve/hydrant isolation valves?
Is there an inventory of sprinkler control valves deluge valves/hydrant isolation valves?
Note :
Responsible persons must record and maintain the monthly checklist for 24 months Inspected By :
NAME POSITION SIGNATURE / DATE
Rules and Regulations
1. I have been instructed and understood the OSHE rules and regulations and
agree to abide by them.
2.
I have been instructed and understood that if I have any questions or concerns
then I should consult with my immediate supervisor. If he is unable to give a
solution then I have a right to seek higher assistance from the Safety Personals.
SAFETY DEPARTMENT YNESB/OSHEF/25
Name of employee : ______________________________________________
Designation: ______________________________________________
Project badge no.: ______________________________________________
NRIC/Passport No. ______________________________________________
Employee signature:_____________________________________________
Date inducted: _____________________________________________
Company :________________________________________ Date :________________________________________ Post :________________________________________ Name Of Employee :________________________________________ I/C No. :________________________________________ (To be contacted during emergency)Next Of Kin :___________________________________________ Address :___________________________________________
____________________________________________
SAFETY DEPARTMENT YNESB/OSHEF/26
WORKER PARTICULAR
Tel No. : ____________________________________________ H/P No. :_____________________________________________
I have been given the following P.P.E. Safety Helmet Safety Shoe Safety Goggles Gloves Dust Mask Welding Shield Grinding shiled
Incase any accident happen and being traced me not wearing the above P.P.E
Provided to me than I shall not to blame the company as it will be considered as my own carelessness. Employee Signature
* I/C or Passport photocopy attached ________________________
MEDICAL HISTORY
_________________________________ __________________
NAME IC/Passport No.__________________________ _______________ MALE / FEMALE D.O.B AGE
EMERGENCY CONTACT : ___________________________________________________ NAME PHONE#
ALLERGIES: ___________________________________________________________________________ ________________________________________________________________________________________
PAST MEDICAL HISTORY (ie,HEART,LUNG,LIVER , ETC.:APPENDECTOMY, TONSILECTOMY, HYSTERECTOMY, ETC. )
________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ MEDICATIONS TAKEN ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
IF NOT TAKING ANY MEDICATION OR DO NOT HAVE A PAST MEDICAL HISTORY NOT ALLERGIES, PLEASE WRITE IN N/A.
ALL MEDICAL INFORMATION WILL BE CONFIDENTIAL.
THIS IS TO BENEFIT YOU IN CASE OF AN EMERGENCY INJURY OR ILLNESS.
Contractor Name : ___________________
Induction Date Booked : ___________________ Time Booked : __________________
S/N Name Passport/IC No. Designation AbsentRemarksPresent
1 2 3 4 5 6 7 8 9
SAFETY DEPARTMENT YNESB/OSHEF/28
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
Total For This Page :
Verified By Submitted By Received By
Name / Signature / Date Name / Signature / Date Name / Signature / Date
SAFETY DEPARTMENT YNESB/OSHEF/29
WARNING FOR SAFETY VOILENCE
NAME : _______________________________________ CONTRACTOR: _______________________________________
PLACE: _____________ DATE: _____________ TIME: _____________ VOILENCE : ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ FEATHER ACTION : ______________________________________________________________ TAKEN ______________________________________________________________ 1ST WARNING 2ND WARNING 3RD WARNING
DEMIRIT POINTS:
ACCUMULETE DEMIT POINTS:
GIVEN BY:- NAMA :____________________________________________ SIGNATURE:_____________________________________________ RECEVED BY:-NAME : ___________________________________________________ EMP. NO : ___________________________________________________ DESIGNATION: _______________________________________________ SIGNATURE: _____________________________ DATE : _____________________________
Cc: Mr. M.S.Han – Senior Manager
Mr. Yusufirashim - Admin& HR Manager Mr. Samuel Wong –Yard Manager Sub- Contactor
• Picture as attached
SY
STEM DEMERIT
The demerit system provides penalties and disqualification for staff and workers who contravene safety rules within a three (3) month period.
1. PERSONAL PROTECTIVE EQUIPMENT
1.1 Working without safety helmet 10
1.2 Working without safety shoe 10
1.3 Working without eye protection 10
1.4 Working without ear protection 10
1.5 Working without hand protection 10
1.6 Working without dust mask 10
1.7 Working without safety harness above 3 meters 30
2. UNSAFE ACTS AND CONDITION
2.1 Off all electrical equipment when not using 10
2.2 Absent from Tool Box Meeting 10
2.3 Close all gases valve when not using 10
2.4 Working without proper access 10
2.6 Eating / sleeping during working hours at workshop 20 2.7 Blocking emergency access or fire fighting equipments 20 2.8 Dumping of waste or scrap at unauthorized areas 20 2.9 Failure to report accidents, near misses and incident 20
2.10 Smoking inside plant 20
2.11 Throwing of tools 20
2.12 Using matches or lighter to light cutting torch 20
2.13 Unauthorized person doing heavy lifting 20
2.14 Violating gas cylinder procedures and incorrect storage 20
2.15 Using foul language against superior 20
2.16 Horseplay 25
2.17 Misuse of fire fighting equipment 25
2.18 Under influence of drug or alcohol, gambling, fighting, stealing, vandalism, illegal
workers. 50
3. TRAFFIC
3.1 Riding motorcycle to around workshop area without approval 20 3.2 Speeding or dangerous driving around workshop area 20
3.3 Parking unauthorized area 20
PENALTY
30 Points Suspension for 3 days 40 Points Suspension for 7 days
50 points above Dismissal and bar from entering factory Value of every one demerit point equal to RM 1.00.
Penalty will be double for above foreman level.
Prepared By:- S.ESWARAN - Safety Officer
Approved By:
______________________ ______________________ Mr. S.K. SIAU MR.SADIR MOHAMMED Executive Director Director
Effective Date: September 2008
C.C. Mr K. C. Seow – General Manager Mr M.S.Han – Senior Manager
Mr. Yusufirashim - Admin& Safety Manager Mr. Samuel Wong –Plant Manager
Mr. They.H.S- Production Manager Mr. Mandy Lua – Account Manager All Dept. Heads and Sub- Contractors.
SAFETY DEPARTMENT YNESB/OSHEF/03 Block :
Work Shop :
DAILY PLANT SAFETY INSPECTION CHECKLIST
S.No Description Yes No N.A
01 Foremen on job area
02 All employees wearing proper eye/head protection? 03 All wearing hearing protection where necessary? 04 All wearing protective clothing where necessary. 05 All wearing respiratory protection where necessary? 06 All wearing adequate safety shoes/gloves?
07 All overhead workers using safety belts? Line? If required? 08 Equipment properly locked out /tagged out?
09 Electrical connections/cords, proper twist lock connections? 10 Welding machines earth properly connected?
11 Extension cables is properly lay. 12 Gas hoses in good condition? 13 Flash back arrestor installed?
14 Gas hoses properly installed and properly lay. 15 Firefighting equipment in place and good condition. 16 Roads properly blocked if necessary?
17 Any obstruction on the access way?
18 Scaffolding properly installed? Properly tagging? 19 Ladders properly used?
20 Hand tools properly used?
21 Proper lifting method safe material handling? 22 Over head crane in good condition?
23 Lifting sling in good condition? Inspected?
24 During lifting, padding in use cover the Sharpe edges? 25 Rubbish and scrap bins in place?
26 Good house keeping
27 Special warning posted if necessary Remark:
Supervisor : _________________ Safety Officer : _________________ Name : _________________ Name : _________________ Date : _________________ Date : _________________ Signature : _________________ Signature : _________________
