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Page 1 Of 4 DAILY SITE SAFETY, HEALTH AND ENVIRONMENT INSPECTION REPORT

S / NU. ITEMS OBSERVATIONS
1 GENERAL

1.1 Housekeeping
1.2 Personal Protective Equipment
1.3 Smoking Area
1.4 Others

2 FALLING ACCIDENT PREVENTION

2.1 Scaffolding
2.2 Ladder and Step Ladder
2.3 Safety Netting
2.4 Safety Belt or Fall Arrest Equipment
2.5 Opening, Barriers, Railing & Signages
2.6 Others

3 ELECTRICAL SAFETY

3.1 Condition of Tool and Equipment

3.2 Cable Condition, Switch Boxes, Distri -
bution Boxes, Socket Plugs, etc.
3.3 Generator
3.4 Others

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Page 2 Of 4 DAILY SITE SAFETY, HEALTH AND ENVIRONMENT INSPECTION REPORT
S / NU. ITEMS OBSERVATIONS
4 FIRE PREVENTION

4.1 Gas Cylinder Condition

4.2 Hose Condition
4.3 Fire Extinguisher
4.4 Others

5 MACHINE GUARDING

5.1 All Moving Parts of Machinery Completely

Guarded
5.2 Fencing / Guarding Maintained Regularly
and Kept In Position At All Times
 5.3 Others

6 MACHINERY

6.1 General Condition

6.2 Pressurized Tanks and Vessel with Valid
D.O.S.H. ( P.M.T. ) Certificate
6.3 Warning Signs and Operating Instructions
Are In Place
6.4 Fire Extinguisher Provided Near the Heat
and Spark Generated By Machinery
6.5 Maintenance and Oil Leakage
6.6 Others

7 MATERIAL HANDLING EQUIPMENT

7.1 General Condition ( Wire Slings, Chain,

Shackles, Rope, etc. )

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S / NU. ITEMS OBSERVATIONS
7.2 Cranes and Lifts with Valid D.O.S.H.
( P.M.A. ) Certificate
7.3 Competent Crane Operator Available
7.4 Safe Working Load for Hoisting Equip -
ment Clearly Marked
7.5 Safety Latches on All Hooks Are In Place
7.6 Others

8 EXCAVATION WORKS

8.1 Permit to Carry Out Works

8.2 Shoring, Bracing or Slopped
8.3 Barricade and Warning Signs
8.4 Others

9 HOT WORK

9.1 Permit to Carry Out Works

9.2 Fire Extinguisher In Place
9.3 Others

10 FIRST AID FACILITY

10.1 First Aid Personnel Available

10.2 First Aid Box Available
10.3 Nearest Clinic or Hospital
10.4 Others
 11 OTHERS

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Page 4 Of 4 DAILY SITE SAFETY, HEALTH AND ENVIRONMENT INSPECTION REPORT
S / NU. ITEMS OBSERVATIONS
Total Manpower Report Sub-Contractors

Prepared By : - Name Signature

Safety and Health Officer

Acknowledge By : -

Site Manager
 DATE : -
GLBSB/OSH/DSSR/F/8
ACTION BY DATE RECTIFIED

DATE : -
PM-F309-02 ( Rev. 1 )
ACTION BY DATE RECTIFIED
DATE : -
PM-F309-02 ( Rev. 1 )
ACTION BY DATE RECTIFIED
DATE : -

ACTION BY DATE RECTIFIED

Remarks