12 13 Constr ‘ery of Ireo’s Mixed Use Project (Office & Retail) 4, Site Entry and Roads: Personnel, equipments and materials shall enter & exit the Site only through the designed gate. All roads will be properly maintained and it should be free from debris etc. 2. Storage Area: All materials should be stacked in neat stockpiles in a workman like manner with proper walkways for easy access without obstructions. 3, Work Area : All working area shall be free from loose material, scraps, tools, spillage of oll and lubricants et. All approaches to ladders, ramps, stairs etc should be clear of all obstacles to avoid accidents. 4. Scrap Yard: Separate bins should be made for keeping MS steel / TMT steel bars along with wooden scrap. ‘The wooden scrap yard should be at a safe distance from any gas cutting, welding operations. It should be treated as * No Smoking “ zone. Oil drums shall be stored at a separate enclosed location away from working 5. Lighting : Adequate lighting should be provided in and around the work area, passages, stairs, ladders, boundaries etc. All openings / cut outs in slabs should be protected with railings from all sides to prevent accidents due to fal 6. Orderliness (@) Scraps, debris and other wastes shall be placed in defined areas. (©) Work area shall be cleaned every day after the completion of works. (©) All materials, tools and equipments shall be stored properly in a stable position properly tied and ‘staked to prevent accident. (@) All vehicles shall be parked in designated parking areas. (©) Proper safety signages should be displayed for directions, emergency exits ete. PERSONNEL PROTECTION: 4. Sufficient stock of safety equipments shall be maintained at Site such as goggles, gloves, helmets, ear plugs. safety belts and safety shoes including safety net 2. Safety officer shall ensure that all employee at Site are trained to use appropriate safely equipments and no work shall commence til all safety equipment desired for that work are in place and also are in use. The maintenance of safely equipments in proper conditions will be the responsibilty of the safety officer. Any ‘worker not using appropriate safety equipment will be removed from his work place (Site) without fail GUIDELINES FOR SCAFFOLDING: Principal Contractor shall deploy a separate trained gang for scaffolding for preventing unsafe conditions for ‘workers. Principal Contractor shall inspect and ensure the following, 1. No work shall commence on incomplete or weak scaffolding. It shall be the responsibilty of the Principal Contractor to satisfy himself about the strength, stability, and safety of the scaffolding, 2. Allscaffolding shall be erected in level and line on a firm base with proper bracing, 3. The safe working loads on all scaffolding should not be exceeded in any circumstances. 4. No worker should be allowed to throw materials from scaffolding / platforms at height.Construction, Management, Coordination, Supervision & Delivery of IMP-Hotel, Office & al Genoral site Inspection Checklist Retail (To be maintained by Principal Contractor Ef EMA0 Project Date= Pr Description Yes [No [NA Remarks Access: Safe ladder provided. ‘Access free rom obstruction Construction materials ‘Safe rungs provided in ladder. The ladder should be placed properly (angie, ealy at 75degree), ‘Ground condition suitable for ladder placed. Ladder should be ted property ‘Handrail provided in ladder. Working Piatfom. ‘Working platform secured properly Landing mat provided properly. ‘Coupler and joints pin adequately provided. Diagonal bracing provided proper ‘Scaffolding material in sound condition. ‘Scaffolding to be checked by responsible parson. ‘Soaffolds erected in plumb and secured on a firm base. ‘Working platform and access fied with Guardrail and Toe board. ‘Scaffold is to be adequately tied or supported 5. ‘Condition of Housekeeping at location. ‘Condition of Access, Egress and approach. onerete pipe lying with proper and stands, CGonerete pump operator is authorized. Has a good communication for operator with lookout man. ‘All power supply through ELCB Vibrator & starter are to be earthed properly ‘All power cable hanged properl Fire fighting equipment at nearest location ale|=|)>)>= 5] ‘Workers with suitable PPEs. Name: Designation: Date: ‘Sionature 25‘Construction, Management, Coordination, Supervision & Delivery TH of IMP-Hotel, Office & Retail {To be maintained by Principal Contractor, prior to use of crane after installation ) Project site Date: Inspected B) ‘SWNo.| ASSEMBLY ‘CHECK POINT ‘OBSERVATIO | MANUFACTURER] REMA N RECOMMENDAT! | RKS ON. y nh Ts the load limit switch ted? Ts it working proper ‘Give readings of cut off observed at various toads 2 | Slewiimitewitch Ts slew limit switch filed? ‘Give cit off observed at slew angle in both directions, Ts the slewing movernent smooth ‘and free of any noise? Is itwell greased? Ts it over heating under load when slowed? Ts i Piled oF NOL ‘Condition of mounting bolls and ruts, Ts the foundation as per ts design ‘and drawing? Has any welding/ repair done on the mast? Is if considered strong enough to with stand the designed load? ‘Ae all ladder rungs without any ‘damage? ‘are they Clear of any concrete droppings? | Counter weiahts ‘Are they properly supported? Fe] Pl el | ef el ep] PP] P| Pl el ey ‘Are they crack and damage free? Ts the total weight as per manual? 7 | Hoist drum Ts the gear box movement free of noise? | [Is the hoist drum clean and greased? 8 | Wire Rove Z| Is the wire rope free of any | damage? ‘Are all guide rollers maving freely ‘without any jam? Has the wire rope jumped out oF | ‘any ofthe guide pulley? ‘What is diameter of wre Tope? Is there any bird caging in the rope? Is fcfack and damage free? = Has X ray/ ultra sound testing for internal cracks done? is the Safety Latch there? T el] PP Is Safety Latch spring working smoothly and freel pele How much is the hook throat size? I ‘How much is the throat T expansion? Ts ifs expansion within limits? he [s there any welding done on it? 26Ts max safe ifing joad embossed? lengraved on the lifting hook? 70. rT ‘Are all lights on the jb working? Has any welding/repair Deen to done the Jib? | FP Is it considered strong enough to withstand the p How much ie the jb deflection at various loads? Ts it within acceptable mits? Is there any welding/ repair done ‘on the Jib? Pe is it considered ft enough to with ‘stand designed load? i Is aviation waming light working? Is it red/blue /white as per aviation regulations? Is it static or binking, Single or twin hi. 7% P| Py ep Is Anemometer fited? If not, what is the arrangement to measure wind speed? Fi Is it working properiy? When it was last calibrated? % | Ts the walky talky provided? Te it working properly? Ts there signaiman facity? 4 Is there any arrangement to ‘measure the load being lifted? lai ‘What isthe arrangement? Is it working properly? ‘When it was last calibrated? 6 ‘Operator rescue ‘arrangement, Is Gotcha Rescue Kit provided to rescue operator in case of ‘emergency? 6 Ee Fighting is there firefighting arrangement? rp ‘What type offre extinguisher provided? 7 URTENING ARRESTOR ‘Whether lightening arrestor is provided at top? cy EARTHING ‘Whether proper earthing system is ensured? Mention the earth resistance ‘Onm) 5 Signature Principal Contractor Safety Officer Name: Designation Date: ‘Owner's Site Safety Officer Name: Designation Date: 27Construction, DETAILS OF ELECTRICAL PANEL SCSAF ‘Management, (weekly basis - from Principal muryyyy | FMet2 Coordination, Contractor to Owner's safety officer) ‘Supervision & Delivery of IMP-Hotel, Office & Retail PROJECT SITE - DATE= NAME OF THE PRINCIPAL CONTRACTOR: - ‘SER | PANEL | LOCATION |ELCB/RCCB [INSPECTION |SAFEFOR [REMARKS No | NO FITTED TAG USE YES/NO YES/NO YES/NO Name Designation Signature Name ofthe Principal Contractor 28Construction, Management, DETAILS OF PLANT AND Coordination, Supervision | MACHINERY (weekly basis - & Delivery of IMP-Hotel, | from Principal Contractor to Office & Retail ‘Owner's safety officer) my FM-13 PROJECT SITE NAME OF THE PRINCIPAL CONTRACTOR SER] NAME OF [NAME OF THE ] P&M [REGDNO No | THE Equipment [NO |& OPERATOR MODEL NO Name: Designation, Signature Name ofthe Principal Contractor: INSPECTION [SAFE ] REMARKS TAG. ‘YESINO FOR USE YESINO 29Construction, Management, _| INSPECTION REPORT OF SCSAE Coordination Supervsion & | ELCBIRCCB mmrvyyy | FMA Delivery of MMP-Hotal Office & | (woekly basis - from Principal Retail Contractor to Owner's safety officer) PROJECT SITE: pate NNAME OF THE PRINCIPAL CONTRACTOR SER|DATE | RATING DB LOCATION | INSPECTION No |or | oF IOIPANE TAG INSP | ELCB/RCC LNO YEsINO 5 Name: - Designation: Signature Name of the Principal Contractor: ‘SAFE FOR USE. YESINO INSPECTE [REAR D BY KS 30Bl CKUST Construction, Management, _| (to be maintained by Principal | MMVYYYY | SC SAF Coordination, Supervision & | Contractor) FMS Delivery of IMP-Hotel, Ofice & Retail Name of Site Inspected By Date Sr Points Pis.tick (| Observation No. Vv ymark. 1_ | Whether Masts properly vertical? Yes/No 2_| Whether condition of Mastis OK? Yes7No 3-_| Whether anchorage for the Mast and supporting structure is adequate? | Whether End Mast piece is provided? Yes 7 No 5 _| Whether Over-Hoist Limit Switch provided? Yes No S| Whether Condition of Ropes and diversion pulleys | Yes/No are ok? 7 [is Hoist positon is safe, ree from faling material | Yes 7No hazard? @ | Whether Winch platform ok and toe guard, mid& | Yes7No top rail provided? ‘9 _| Whether Hoist break is checked? Yes TNO, 0 _| Whether Operator vistiliy o all unloading Yes7No platforms and Vice verse? Ti] Whether Warning signals are established & used | Yes/No before every movement? "2_| Whether Hoists protection from unauthorised Yes No coperations?. 13 | Whether Earthing is provided? Yes No 74_| Whether Rotating paris ofthe Hoists adequately | Yes/No uarded including finger guard for bucket movement? 76_| Whether Ground level enty to winch areas, Yes7No restricted? 6 | Whether Protection against ripping hazards Yes No ensured? 7 | Whether proper Signaling systems are provided? _| Yes/No 78 _| Whether weekly check procedure is followed? Yes No 79 | Whether authorised operators with photographs & | Yes/No SWL displayed? 20_| Restriction on the size & loading in the bucket Yes/No ‘Signature Name: Designation: Date & Time 31[ Construction, Management. | PASSENGER HOIST CHECKLIST Coordination, Supervision & | (to be maintained by Principal | MM/YYYY | SC. SAF Delivery of IMP-Hotel, Office & | Contractor) FMt6 Retail Name of Project: Inspected By Date Si Points Ps. tick ‘Observation No. (A mark T_| Whether Mastis properly vertical? Yes No 7_| Whether condition of Masts ok? Yes No 3] Whether anchorage for the Mast and supporting structure | Yes/No is adequate? | Whether End Mast piece is provided? ‘Yes No 5 _ | Whether Ovar-Hoist Limit Switch is provided? Yes/No &_| Whether Over run imi switch is provided? Yes TNO 7__| Whether Over load lit switch with warnings provided? _| Yes/No ‘| Whether Condition of Ropes / Rack & Pinion ok? Yes/No 70_| Whether interiocking arrangement provided? Yes TNo 71 | Whether Hoist positon is sae, free from faling material | Yes/No hazard? 72_| Whether Emergency stop push button is working? Yes No 73 | Whether communication device for operator & person, | Yes7 NO ‘who wants to call the passenger hoist at required floor censured? T5__| Whether proper earthing is provided? ‘Yes/No "16 | Whether Third Party Inspection is carried out once in six | Yes/No month? 77__| Whether rotating parts ofthe Hoists adequately guarded? | Yes/No 76 | Whether entry at ground level to hoist area is restricted | Yes/No with wicket gate? ¥9_| Whether Signaling systems are functioning? Yes No 20_| Whether weekly check procedure is followed? Yes/No 21_| Whether display of authorised operator with photograph | Yes/No ensured 22 | Whether FRP Ladder provided? Yes TNO 724 | Whether Display of Load chart & Emergency ‘Yes/No "| preparedness ensured = “ ‘Sonate SSS oa Rana Name: Designation: Date & Time 32Construction, Management, _| Pre Pouring inspection checMlist Inspection | SC SAF Coordination. Supervision & | (Tobe maintained by Principal Contractor) | No: Fua7 Delivery of IMP-Hotel Ofce & Retail Project Site:- Name ofthe Principal Contractor~ ee Description Yes [Wo] NA] Remar io ‘A _| BELOWITHE FLOOR, [Are all support given tothe shuterng for slab of adequate strength and properly fired and braced Z__ [Are all Props rests on the ground fly? '3.__| Are all Props pin in place ‘4__| Are all Props braced with ledger with pipe and ted by coupler? 5.__| Are all props straight? ‘6 Are bottom of props not on the any slope? i 3 8, Ae all legs of pod on the fr ground? ‘Are wall to ins in place correct and wall in postion? is there provaion of usage wooden peces, stone pieces ete 3S distance pieces? 70._| Are edges of tne slab propery baricaded? ‘re an Adequate sluminaton has been ensued? B__| ABOVE THE FLOOR 17. | Are edges ofthe slab propery baricaded? 42] Has vertcal Rebar (20mm) been inserted at every 2s minimum for edge protection? 73__ | A al oose materials removed fom te SSB? 44] Do all props start from the next lower slab or tie EGOS protection? 75. [is conation of cabo of vibrator to bo used while casing good connected tothe ELCB? 76. | Ar there any damage! jointin the cable? 17] Ae te safety bel. Gumboot etc avaiable forthe workers engaged inthe casting? 78 ['s ighting arrangement preper? 19" Are walk way chalis provided to walk on reinforcament while cast ood? ‘© | SURROUNDING AREA 20. [is approach to the Siab undbsrucied afd proper? 31 [Is the wth of @ working platform propery mantained according tousage? “Ave opening in working patform kept safely covered fenced? is thee a provision of handrais? is there a provision of anchoring fll body harness? Ae al the workers have been explained safe work procedures? Are ladder providing access To the Slab securely Ted top and bottom? 27 [ Ae al the materials stored onthe working platfom secured? 28 Ate wakway! aisles and workplaces cleared of lose materia 28 | Are route ofthe Concrete Pipe ine clears it supported at ‘enough places using propersans, and Is propery clamped? 30. fs Wally: Talky avaiable forthe communication between Pump Operator and person onthe Slab! a 32 [1s good approach forthe transi miler othe conete pump proper? cs 33 [Is bal catcher avaiable to clear the biocked ine 34 [Is the stopper forthe ball ere inthe piace? 35 [Are work area inpectod pir starting tothe job? 36 [Ave safely nels provided wherever required ‘Checked by Confirmed by Verified by ‘Section Incharge Safety Officer Safety officer (Principal Contractor) (Principal Contractor) (Owner) Name Name: Name Designation, Designation Designation: Signature signature ‘Signature: Date Date Date 33Construction, Management, Coordination, Supervision & FIRE POINT EQUIPMENT INSPECTION RECORD (weekly basis ~ to be maintained by SC SAF Fut Delivery of IMP-Hotel, Office | Principal Contractor) Muy & Retal PROJECT SITE: DATE= NAME OF THE PRINCIPAL CONTRACTOR SER [FIRE | TYP |CAPICI [PRESS |FIRE [FIRE [FIRE | FIRE INSPECT! | INSPEC [R No |powr |e |TYOF | URE |BUCKE | BUCKE | BEATE |HOOK | ONDATE | TEDBY | E No |OF |FIRE | OKINO |T T R AVAILABL, M FIR | Ex T SAND | WATER | AVAILA | E A E YESINO | YESINO | BLE | YESINO R x Yes! K NO Ss Name: Designation: Signature Name of the Principal Contractor:Construction, DETAILS OF FIRST AID CASES mney ‘Management, (monthly basis - from Principal Fut Coordination, Supervision | Contractor to Owner's safety & Delivery of IMP-Hotel, | officer) Office & Retail PROJECT SITE DATE: NAME OF THE PRINCIPAL CONTRACTOR : - ‘SL. | DATE No Name: Designation, Signature. ‘NAME OF INJURED DESI_|10 CARD | NATURE OF GNAT | NO’ INJURY ION. Name of the Principal Contractor: NAME OF SUB CONTRACTORS, REMARKS 35Construction, Management, | ANALYSIS OF FIRST-AID CASES | MM/YYYY | SC. SAF_ Coordination, Supervision & | (From: Contractor To: Owner's FM-20 Delivery of IMP-Hotel, Office & | Site safety Officer) Retail Na ime of Project: NAME OF THE PRINCIPAL CONTRACTOR: - SER | GROUPING OF CASES BASED ON CAUSATIVES | NUMBER OF CASES, No. | sphyaia (suffocation) 2.__| Breaking of Grinding wheel 3. | Bum injury due to Fire 4 | Ghemical bums ._ | Contact with hot objects 6 T. é Cantact with moving parts ofthe machinery ‘Contact with moving Grinding whee! Defective tools / wrong tools 9] Browning 70_ | Electric Shock 71._| Electric Burn ¥2._| Explosion 13_| Fall of materials 74_| Fall rom height 75._| Foreign body in Eye ¥6_| Fallinto depth T7_| Gas poisoning 7 | Hitby objects 79,_| Pressed between objects 20,_| Road accident (Vehicle / Equipment) 2i_| Sip & fall on level 22_| Soil subsidence 23._| Struck against object 24,_| Welding Flashin eye 25. | Others INCIDENCE RATE® OF FIRST AID CASES Number of Fist Aid Cases per millon man hours worked. ‘Number of fist aid cases X 10° Frequency Rate of First Aid Cases = Man-hours worked Name: Designation Signature Name ofthe Principal Contractor: 36Construction, Management _| PRELIMINARY INCIDENTREPORT | MMIYYYY | SC SAF Coordination, Supervision & | {PIR} = to be maintained by Principal Fz Delvery of IMP-Hotel, Office & | Contractor & to be sent to Owner's, Retail safety officer Name of Project Personal details of Injured Person Name Working Since: Ae _ 1D Card No: Designation: Sie N Location of the incident: Brief Description of the Incident (Add sketches and Photographs) Remedial measures taken to prevent reoccurrence ny other relevant information Signature (Site Engineer) (Section Head) Employee ID Employee ID Date Date: 37Construction, Management, Coordination, Supervision & Delivery of IMP-Hotel, Office & Retail Accit N REPORT (From Principal Contractor to ‘Owner's safety officer & Head ~ Safety - Owner) Name ofthe Site Name of the SPM 1 Site Engineer =< Name of Principal Contractor Reportable Loss Time Injury 31) Name of the person ‘Age | Sex | Designation Date Tee = cr fo} 3.2) Exact Location where the Accident occurred: 3.3) Nature of injury: 3.4) Name / identity of the P&M / Equipment +35) Describe briefly how the accident occurred (Add sketches and additional sheets to support the description} 4.1) Direct Causes: 42) Proximate Causes: 5, Precautionary Measures. '51) What are the precautions taken / being taken to prevent similar occurrence? 6. Any other information jgneture Name: Safety in-charge Date & Time: 38A ‘Construction, Management, MONTHLY comparative | Mmiyvvy | SC SAF Coordination, Supervision & Delivery of EVALUATION OF SUB- FM-23 7 IMP-Hotel, Office & Retail ‘CONTRACTORS (to be maintained ‘by Principal Contractor & be cf x EO. Name of Project Month Sub- sub- sub- sub- Sub- Deserition Contractor | Contractor | Contractor | Contractor | Contractor Marks_| not 102 103 nod no Effecve Implementation of 10 1. | hard barrication (GI sheet) & Edge Batrication 2. | Effective Compliance of 0 Safety System +3 | Compliance status of Safety is 2 observations, Parlicipation towards Safety 10 related Programme, Drills, Drama, safety fim screening ote 70 5 | Compliance of PPE's 0 6 | Reporting and information - 70 7. | Repetition of Safety violation | sr 8 | Housekeeping | Innovative idea and 10 implementation to save losses > Behavioral aspect and 0 10 | discipline of supervisor and workmen Z Total Points 100 | Safety Parameters IR= Incidence Rete AAR ~ Accident Rate FR — Frequency Rate 0 Signature Principal Contractor Safety officer 39Construction, Management, Coordination, Supervision & Delivery of IMP-Hotel, Office & Pormit to Open Handrails / Cut ined t Principal Contractor Retail Location of Guard rails handrails Nature of Activity tobe executed ired remo. is Date From hrs to hs. Display of Cautious board / temporary altematives to ensure 100% fal prevention Js area fenced / cordoned off” Yes / No |g red light /blinker ensured? Yes / No | proper ilumination provided? Yes/No Mention the value (Use Lux meter) Signature: ((ssuer ~ Authorised) (Receiver) Name: Name! Designation: Designation Company Name: Company Name: {To be filed in by Section Head, permiting to Open Handrails / Cut out covers after ensuring that safety precautions have been made at the proposed area for opening the cover) Dispose of Permit Date: From hrs to. hs. findrais 1 cut out cover have beon placed back — Yes /No {To be filed in and certified by person who had asked for the permission to open the handrails / cut out ‘cover stating that the handrails / cut out cover. has been placed back in position property ater the work was, ‘completed and the area is cleared} Signature, (Return by) (Werifed by) Name: Name: Designation, Designation: Company Name: Company Name: 40‘Construction, Management, CORRECTIVE ACTION & PREVENTIVE ACTION | MMIYYYY | SC SAF. ‘Coordination, Supervision & REGISTER (tobe FMr2s Delivery of IMP-Hotel, Ofice & maintained by Principal Contractor) Retail Name of Project Month SING. | Date Description - Complaint Receiving ‘Status of | Date of | Remarks Opportunity for Improvement (Received from Owner) Media Compliance | action taken Signature: (Principal Contractor Safety In-charge) (Principal Contractor Project In-chargs) a~ Construction, Management, Coordination, Supervision & Delivery of IMP-Hotel, Office & | Mon availabl the inspection of Owner's safety officer) Retail QFFICE INSPECTION REPORT __(to mmyyyy | scSAE F286 PECTI a Name of Project Inspected By Date & Time SL.NO. Description Findings ‘Retion Proposed Whether entry roads / walkways / passages are kept clear. Whather Illumination level satisfactory in access / egress and room? Whether escape route /Fire exit (Nuorescent type) provided? Ts the ventilation of the rooms adequate? ‘Are materials stored safely? ‘Whether combustible materials are kept at safe place? ‘Whether dustbin provided in sufficient numbers. (Mention the toe) ‘Whether disinfection actviles carried out at regular interval ‘Whether PC screens free from reflection and glare? ‘Whether keyboards/screens clean and functioning properly? Tt Whether chairs adjustable and in good repair? Whether the tollets being cleaned on regular basis? 13 Is water tank cleaned regularly? 4 Whether canteenipantry Kept clean and tidy? 15 Ts the garbage of pantry being disposed off every day? 6 Ts power connection ensured safely? 17 ‘Are gas cylinders & other flammable materials Keptin safe ‘area (away from fre)? 78 ‘Whether all working crew dressed properly? 78, Ty ter information ‘Signature: Inspection TeamConstruction, Management, WORKMEN CAMP EVALUATION (to ‘SC.SAF Coordination, Supervision & ‘be prepared by Principal Contractor - FM-27 MMYYYY DeneryomiPow Ofc & | Monty ae Rett fe nspeain of Gamers ate ofa ame of S= Dai Location ofthe Camp = S| artrisutes Parra cneria Observations | Rang a) Carpet Area ‘a) 20 Sqft. / Person b) Height b)24m , face 6) Lacking Amangement + | Accommodation | now 3) 10% of Poor Non e) Bed ‘e) Smooth flat surface A Prosion or ‘Wal hanger! Lockers eons ay Adee Sy pean at 2 | Tome acity Bare Dios 2) Foaing Glaze Tes sro 3 Gras a oo 2 | orinking water Fcity |B) uration Systm |B} Heavy Duy Putar ¢ekmningt Tank” |e} Onc va Monn ymca tbls" —Pa) 10 St 7 Peean (Ss tsege) an) 4 | wasting & eating |b) Sorepe ark |b) Lares Person Day A rears Paved Pee d) Drainage <4) Proper Drainage Facility 2) Geant Furie SveopeT Siesuentyot | BiDety 1S | Wveeta Diepces Cleaning c) A50 Litre capacity bin / 50 sbi gee a) Canteen lity : th Conon Factor iy (Cooking Inside the Ss Meee eaeany ‘Cooking Living Room not permitted) Serge 2} Canlnaes ond ont ahi SyPVE cons Brom 3) Board win 2 po pin, ant pont & Fan pon wih woes (6 7 | etecica! rangement ‘imps Room yma aning |e) ule tuminaton Syearhing Earth resaarca ohm sjorcut Beater | =) ACCS svataby/ Checking a Sere Shi sm weih 24m hoght EMR Som iongtn 2 | [ceeeae 'b) Flooring b) Paved Floor Qjitcin Passage |e) 28m wan Sh eainguster——} ) one ABC type (SRG capacTT © | Fre Fighting system | )Testnas Fness | 50 persons and ane i tchen Bors of og nspecion a Fist Ra Gor ——T) Atay wi ihe Sect 10 | Fret By content Coord BAe per OCW Act ro abt) Tetarma = 100 obtsnes Note: 1) Allthe parameters mentioned above are bare minimum, Improvement on the same is Beller, 2) Each attribute carries 10 marks Evaluated By - ome Nee 2 3) Signature 43Construction, Wanagement Coordination, Supervision & ‘SAFE WORK PERMIT FORMS Delivery of IMP-Hote, Office & Permit to open Handralls/ Cut out covers (Revision-01) Retail (No overwriting , no alteration permitted) Penni to open Handrails/ Cut out covers To be filled by permit seeker pening handrail cut out cover Location: Nature of activity to be executed: Date Time from To: {confirm the following safety status: Display of cautions board! temporary alternatives to ensure 100% fall prevention. Js area fenced! cordoned off? - Yes! Nol illumination ensured? - YesiNo Signature Name: Designation Company Name. Date: Time: To rior of person applying for have verified the Safety status and perm recommenda jon to remove above mentioned opening cover! hand rail is, ‘Signature: Name! Designation Company Name: Date: Time: Permission is Recommended by Civil & Seeking Principal Contractor ‘safety Incharae Signature Name: Designation Date: Time: To be filled Incharge of work Work is considered essential & Permit may be considered, Signature Name Designation: Date: Time: To bo iss ‘Tower incharge of Ci ipal Contractor Permission granted vide permit no: For work on Date. To. Signed Designation ‘Company Dated Time Disposal after completion of work. To be filled by the Permit Seeker after work completion, | have completed the required work and placed back the safety guards/ cover. Permit may be closed. Signature of permit seeker Date Closure . To be filed by the Tower In charge who is the Permit issuer. ‘The safety status of guards/ covers has been verified and the permit is closed. ‘Signature of permit issuer Date: Time:‘Construction, Management ‘SC SAE Coordination, Supervision & ‘SAFE WORK PERMIT FORMS Fu2s-A Delivery of IMP-Hotel, Ofce & = Cradle (Revision-01) Retail (No overwriting , no alteration permitted) Permit to operate cradle. To be filled by permit seeker Kindly issue a work permit for operating Cradle and removing the requisite covers/ edge protection Location: Nature of activity to be executed: Date Time From To | confirm the following safety status: Display of caution boards. Has Safety check list as given over leaf been filled and is the Cradle safe? Is area fenced! cordoned off? = Yes! No. Is illumination ensured?-_YesiNo Signature: Name: Designation Company Name: Date! Time ‘To_be filled by immediate superior of person apsiving for permit, | have verified the Safety status and permission to operate the Cradle as above is recommended, after stopping the work at other affected locations hazardous to this cradle operation. Signature: Name: Designation: ‘Company Name: Date: Time: Pe ned by Civil & Seeking ‘safety Inchar Signature: Name: Designation Date: Time: {illed by Owner's incharge of work Work is considered essential & Permit may be considered ‘Signature: Name: Designation Date: Time: i ued by t is f Princ Permission granted vide permit no. For work on Date. From___To. Signe Name: Designation Company Dated ime smplotion of {illed by the Permit Seeker after work compl Ihave completed the required work and placed back the safety guards/ cover. Permit may be closed. Signature of permit seeker Date Time: Closure, To be filled In charge whe Permit issuer, Permit issuer will ensure thal ‘all permits are returned to him by end of ‘The safety status of guards/ covers has been verified and the permit is closed. ‘Signature of permit issuer Date: Time 45‘Construction, Management, Coordination, Supervision & Delivery of IMP-Hotel, Office & Retail SAFETY CHECKLIST CRADLE (No overwriting , no alteration permitted) Location: No. Name of the Operator charge: Cradle Ser Date Name of tie Area In Cerliied that | have personally checked the following and found in good condition. Description ‘Yes | No ‘Check fasteners of the Pulley on the Bucket ‘Chock fasteners ofthe Pulley on the Boom. ‘Gheck the sling of the Boom Lubricate the Pulleys ofthe Boom ‘Gheck the Wire Rope for any damage or twists ‘Check the Counter Weights xp) oP PP FB ‘Check the Safety Ropes for Bucket properly tightened. ‘Check the Life ine Rope and fal arestor. Has TPI been done of Cradle? Display TPI copy inthe Cradle Ts SWL and TPI certificate displayed at cradle? ‘Check all elecrical joints with proper insulation. Permission granted for use (Work Perm. 1s walky Talky available and working? Is working area barricaded? Is Tool Box Talk given the workers and Wile name of Person who gave TET, ‘operator by Area in charge? Ts alarm system in cradle for up and down working ‘Are required PEs wom by the workers and their supervisor. Has medical examination been done for ‘operator and workers engaged in cradle by authorized Government Doctor in last six months? ‘Display copy inthe cradle Thave checked the above given details. deals. Signature: (Name of the Operator) Thave verified the above given Signature: (Name of the in-charge) 46Construction, ‘SAFE WORK PERMIT FORMS ‘SC SAE Coordination, Supe Loe eviion-01) ordination, Supervision © apa 5 ee eet {No overunting no alteration permitted) Office & Retail Hot Work Permit To be filed by permit seeker Kindly issue a work permits for Hot Work Location: Nature of activity to be executed: Date: Time ‘rom To | confirm the following safety status: Descriptions Observation | Descriptions Observation (Yes/No/NA) (YesiNo/NA) ELECTRICAL ISOLATION OF WELD ‘BARRIERS REQUIRED JOB REQUIRED A EQUIPMENT ISOLATED PORTABLE LIGHTING WARNING 5. NO SMOKING OR NAKED FLAME p TOOKOUT SENTRY ‘SCAFFOLDING ETC. REQUIRED. ‘SORROUNDINGS FIRE BLANKET FIRST AID KIT USED ‘WELDING SHIELD FOR WELDER FIRE EXTINGUISHER FIRE PRECAUTION AREA CLEAR OF REQUIRED PPE AVAILABLE COMBUSTIBLES WELD SHIELD, APRON,S BOOTS HAZARD MARKERS AND LIGHTS INSPECTION TAG PUT ON THE - REQUIRED WELDING MIC ‘BODY EARTH PROVIDED IN WELDING ‘WELDING LEAD JOINT WITHOUT - we. ues WELDING APRON (OTHERS (F ANY) Signature: Name Designation Company Name: Date: Time: TTo be filled by immediate superior of person applying for permit Ihave verified the Safety status and permission to above mention is recommended. Signature: Name: Designation ‘Company Name: Date Time Permission fs Recommended by Principal Contractor Safety incharge Signature Name: Designation Date Time: To be filled by Owner's in charge of Work Work is considered essential &Permit may be considered Signature Name: Designation Date: Time: To be issued by the tower incharge of Principal Contractor. Permission granted vide permit no:- ‘Signed Name: Designation Company Name Dated: Time: ~ Disposal: | have completed the required work. Permit may be closed. Signature of permit socker Date Time Tiosure: The safety status has been verified and the permit is closed. 47‘Construction, Management ‘SC SAE Coordination, Supenision & ‘SAFE WORK PERMIT FORMS FMS Delivery of IMP-Hotel, Office EXCAVATION WORK PERMIT & Retail (No ovenwriting no alteration permitted) ‘Signature of permit issuer Date: Time: Excavation Work Permit To be filled by permit seeker Kindly issue a work pormit fr following Excavation Work. Deals of excavation are: Length Depth With, Locatior Date Time from, To | confirm the following safety status: Descriptions ‘Observation | Descriptions ‘Observation (YesiNoINA) (YesINoINA) Underground services checked and ‘Warning signs Required marked at site ‘Underground services properly Isolated ‘rea urination provided (Geectical ine, Water ne, Gas ine) ‘Supervisor / Plant operators informed No of Safe Access / Egress about location of services (Romp! ladder stairs) provided No of Road closure / diversion signs ‘Slope maintained / Shred placed & location (Mention slope) ‘Any nearby stuctures scare ia Excavation at safe dstance from danger of collapse, Name of person caffoids & structures (mention {informed in the neighborhood: tance) ‘Any other PTW associated (TBT, RA) Dewatering facility availability ‘Arrangement of Baricading ‘Maintained good housekeeping “Ambulance, Sireicher, Fist Aid BOX Emergency Response Team positioned at location alerted Signature: ame: Designation: Company Namo: Date: Time. To be filed by immediate superior of person applying for permit Ihave verified the Safety status ‘Signature: Name: ‘Company Name: Designation’ sbove and permission to above mentioned is recommended. Date: Time ‘Permission Is recommended by Principal Contractor Safety Incharge Signature Name: Designation: Date Time: To be filled by Owner's In charge of Work Work is considered essential &Permit may be considered Signature Name: Designation: Date: Time. ‘To be Issued by the tower Incharge of Principal Contractor, Permission granted vide permit no:- ‘Signed Name: Designation Company Name: Dates: Time Disposal: [have completed the required work. Permit may be closed. Signature of permit seeker Date: Time: ‘Closure: The safety etatus has boon verified and the permit is closed, Signature of permit issuer Dat Time: 48