Main Contractor Co LOGO Company Name Project Number: Client Logo Client: HSE OBSERVATION REPORT Date & Time of Inspection: Project : Report Number: Consultant Main Contractor Inspected By: Categories Checked: 1. Working practice 4. Fire precautions 7. Electricity 10. Working at height 13. Permit systems Hazard observations: Sr. Description of hazard No 1 2 Observed water filters damaged condition. Need an immediate replacement to ensure water safety. Water coolers are not working. No cool water available for workers at site. Accompanied by: 2. 5. 8. 11. 14. Photos Health & welfare House keeping Plant/Machinery Signage/notice board Trainings 3. 6. 9. 12. 15. Risk Rating H M L First aid PPE Access/Egress Hazardous substances Environmental Action required Responsibility Replace the water filters on monthly once and provide filters inspection tag. Company Name Provide cool water for workers and improve welfare facilities. Company Name Health & Safety Management System Page 1 of 3 Main Contractor Co LOGO 3 Company Name Project Number: Unsafe work practises by workers at work place Client Logo Client: Provide training for workers about safe work methods with abrasive machines. Unsafe practices while working with tiles cutting machine. 4 Unsafe scaffolding observed at site. Absence of guard rails , ladder access, wooden boards and supports observed. Provide guard rails, ladder and extender supports for scaffolding. Risk of scaffold or collapse leading to major injury. 5 Poor housekeeping at spa floor and Ground floor areas. Ensure good housekeeping on staircases and access ways of the building. Risk of slip-trip-falls causing personal injury and fire risk Health & Safety Management System Page 2 of 3 Main Contractor Co LOGO Company Name Project Number: Client Logo Client: Action Plan: Sr.No Description of required action Responsibility Target Date Closing date Status (Closed/Open) 1 Replace the soiled water filters Immediate Immediate Closed 2 Provide cool water for workers and ensure welfare facilities. 10-11-2019 10-11-2019 Closed 3 Provide training for workers about safe work methods with abrasive machines. 11-11-2019 11-11-2019 Closed 4 Provide guard rails, ladder and supports for scaffolding. 11-11-2019 5 Ensure good housekeeping on staircases and access ways of the building. 12-11-2019 Close out By Site Execution : Open 12-11-2019 Closed Noted By HSE Department Name: Name: Designation: Designation: Signature: Signature: Follow up: At a later date please attach the communication evidence & agreed solution for the rectification of non conformity. Reviewed By HSE Manger Name Signature: Date: Comments: Health & Safety Management System Page 3 of 3