PROJECT NAME

PROJECT NO.
WEEKLY REPORT
WEEKLY HEALTH, SAFETY & ENVIRONMENT
PERFORMANCE STATISTICS
Month: month Name of the Contractor:

S. No. Data / Particulars This Week Cumulative

1 No. of Employees (Average) 0 0

2 Man Hours worked (Since last LTI) 0 0
3 Fatalities 0 0
4 First Aid Injuries 0 0
5 Lost Time Injuries (LTI) 0 0
6 Days Lost due to LTI 0 0
7 Restricted Work Day Cases (RWDC) 0 0
8 Medical Treatment Cases (MTC) 0 0
9 Heat stress related cases 0 0
10 Observation 0 0
11 Near Misses 0 0
12 High Potential Near misses 0 0
13 Damage to Property 0 0
14 Vehicle Incidents 0 0
15 Fire Incidents 0 0
16 Oil Spill Incidents 0 0
17 Chemical Spill Incidents 0 0
18 Accidents involving Third Parties 0 0
19 HSE Management System Audits 0 0
20 Camp Audits 0 0
21 Behavioral Audits 0 0
22 Site HSE Inspections 0 0
23 HSE Meetings 0 0
24 Municipal waste (Tons) 0 0
25 Hazardous waste (Tons) 0 0
26 Risk Assessments 0 0
27 Drills (Evacuation / Fire / Gas release) 0 0
Induction conducted 0 0
Employees Inducted 0 0
28 Trainings: Tool Box Talk 0 0
Safety Trainings 0 0
Employees Trained 0 0
Water (Gallon ) 0 0
29 Energy Consumption: Power (KWH) 0 0
Diesel (per Gallon) 0 0