GC3 CHECKLIST

SR. NO TITLE THINGS TO CHECK

YES NO
1.1 OBSERVATION
LOCATION
OBSERVATION SHOULD HAZARD IDENTIFIED
1
BE IN A SENTENCE RISK
SPECIFIC CONSEQUENCES
MIN 5 CATEGORY IDENTIFIED
2 REQUIREMENTS
20-25 UNSAFE ACT/CONDITIONS
IMMEDIATE ACTIONS (SPECIFIC)
3 CONTROL MEASURES LONG TERM ACTIONS (SPECIFIC)
3 - 4 POINTS
MENTIONED FOR ALL THE MEASURES
4 TIMESCALES
REASLITIC

1.2 INTRODUCTION YES NO

NAME OF WORKPLACE
DATE OF INSPECTION
DESC ON WORKPLACE SELECTED
DESC OF THE WORK ACTIVITIES
PRESENCE OF COMPANY LOCATION
1 THINGS TO CHECK NO. OF WORKERS
SHIFT PATTERNS
EQUIP/MACHINERY DESC
NET WORTH OF THE COMPANY
STANDARDS ACHIEVED BY COMPANY
OBJECTIVE OF INSPECTION

1.3 EXECUTIVE SUMMARY YES NO

BRIEF INTRODUCTION ABOUT THE PLACE
1 PARAGRAPH
INSPECTED

2 5 MAIN FINDINGS 2 LINES IN SENTENCE FORMAT FOR (EACH)

HAZARDS AND CONTROLS

3 PARAGRAPH SHORT JUSTIFICATION BASED ON MORAL,

LEGAL AND ECONOMICAL
 1.4 MAIN FINDINGS YES NO

1 HAZARD JUSTIFICATION
DETAILED DESCRIPTION OF THE HAZARD
2 LAWS THAT HAS BEEN BROKEN WITH
2 BREACHES
CLEAR DEMONSTRATION

TECHNICAL MEASURES

3 CONTROL MEASURES DETAILED EXPLANATION

RESONS FOR RECOMMENDATIONS

4 TOTAL 5 MAIN FINDINGS

1.5 CONCLUSION YES NO

PLACE INSPECTED ALONG WITH THE
1 PARAGRAPH OBSERVATION(ISSUES AND GOOD
PRACTICES)

2 10 - 15 POINTS RECOMMENDATIONS IN POINTS BASED ON

THE FINDINGS

JUSTIFICATION BASED ON MORAL, LEGAL

3 PARAGRAPH AND ECONOMICAL AS TO WHY COMPANY
SHOULD BE CONVINCED

1.6 RECOMMENDATION YES NO

RECOMMENDATION AS PER M.F - MENTION THE CONTROL

MEASURES IN POINTS
RESOURCES LIKELY APPROPRIATE COST INVOLVED FOR THE
IMPLICATION CONTROLS SUGGESTED
1
PRIORITY PROPER PRIORITIZATION (HIGH, MEDIUM
OR LOW)
APPROPRIATE DATE TO COMPLETE THE
TARGET DATE ENTIRE CONTROLS

2 ABOVE IS FOR 1 5 RECOMMENDATIONS IN TOTAL

RECOMMENDATION