Job Hazard Analysis Form

Rows	Safety Helmet	Safety Shoes	Visibility Vest	Dust Mask	Safety Gloves(Depending on task)	Ear Protection	Eye Protection	Overall
Site set out and excavation	1	2	3	4	5	6	7	8
Backfilling	9	10	11	12	13	14	15	16
Construction of plinths and perimeter wall	17	18	19	20	21	22	23	24
Cabling	25	26	27	28	29	30	31	32
Moving Equipment	33	34	35	36	37	38	39	40
Loading &Offloading material	41	42	43	44	45	46	47	48
Electrical Works	49	50	51	52	53	54	55	56
Welding/Grinding an Hot works	57	58	59	60	61	62	63	64
Use of Power tools	65	66	67	68	69	70	71	72
Site completion works	73	74	75	76	77	78	79	80
Site Clean up	81	82	83	84	85	86	87	88
Threading	89	90	91	92	93	94	95	96

Rows	Yes	No	N/A
Exact scope of work discussed associated risks and mitigation measures	97	98	99
Absolute site rules and EHS commitment	100	101	102
Equipment Inspection	103	104	105
PPE Inspection	106	107	108
Results of risk assessment and fall protection plan	109	110	111
Emergency rescue procedures, evacuation procedures and first aid briefing	112	113	114
Plant,Exacavations,Backfilling,Tower rigging and electricals works discussed	115	116	117
Safety moment Topic	118	119	120
Others	121	122	123

COMMITMENT

''We have participated in todays safety meeting and agree with the topics discussed and the way necessary safety measures have been taken into consideration in the planning of activities.''

Rows	Yes	No	N/A
Are the windows in good condition and do they open properly?	124	125	126
Do the doors open and close properly?	127	128	129
Are the windscreen and the rear window in a good condition?	130	131	132
Do the wipers front and rear operate properly and are the blades in good condition?	133	134	135
Is the rear view mirror in place and in good condition	136	137	138
Is the side mirrors in place and in good condition?	139	140	141
All the four tires in good condition including a spare tire	142	143	144
Are the airbags intact?	145	146	147
Is the air conditioning functional?	148	149	150
Vehicle fluid levels okay?(oil,brake fluid, power steering fluid coolant)	151	152	153
Are the door locks functional?	154	155	156
Do all sits have seatbelt? Are the seatbelts functioning properly?	157	158	159
Does the horn operate properly?	160	161	162
Is the battery in good condition?	163	164	165
Do the brake lights illuminate when the brake pedal is depressed?	166	167	168
Does the headlights operate properly?	169	170	171
Does the parking /hand brake work properly when engaged?	172	173	174
Do the turn signal indicators blink front and rear	175	176	177
Do the headlight operate properly?	178	179	180
Are the chevron reflectors in place and in good condition?	181	182	183
Does the vehicles have any dents or scratches?	184	185	186

Rows	Yes	No	N/A
is thers an adequate and well supplied firt aid kit?	187	188	189
Is fire extinguishers in place, properly charged and currently inspected?	190	191	192
SIs there a wheel spanner in a good condition?	193	194	195
Is there a wheel jack in a good condition?	196	197	198
Are the life savers in place and in a good condition?	199	200	201

Job Hazard Analysis Form

Emergency Evacuation Plan

Emergency Response Team

PPE Matrix

Tool Box Talk Sheet

Employees Present

Vehicle Inspection Checklist