Title Page

  • Report No.

  • Person In Charge

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

INTRODUCTION

  • Definition-
    High: High risk/priority which requires Immediate Action to solve the issue.
    Moderate: Moderate risk/priority which requires a planned approach to solve the issue.
    Safe: Safe and maintain the good practices.
    None: Not Applicable or Not Available during the inspection.

    Phase 1- The corrective action for the non-compliance should be accomplished as high priority. The overall compliance of Phase 1 will be measured during the year-end performance review for Year 2019.

1. TOOLS & EQUIPMENT (PART 1)

  • 1.1 Is the air compressor area well ventilated and away of combustibles storage?

  • 1.2 Is the air compressor in good working condition (i.e. oil level, safety valve, motor guarded, water drained, etc.)?

  • 1.3 Is the weekly inspection to the air compressor being carried out correctly and according to schedule?

  • 1.4 Is the forklift in good working condition (i.e. tyre, lamp, horn, chain, fork, reverse buzzer, signal light, seat, etc.)?

  • 1.5 Is daily inspection for the forklift carried out and inspection records available?

  • 1.6 Are the equipment (i.e. air compressor, mobile column lift, goods lift, overhead crane) possess valid PMA/PMT license and PMA/PMT number displayed clearly at the equipment ?

  • 1.7 Are the electrical panel & electrical room closed from unauthorized access and the clearance maintained?

  • 1.8 Are all the electrical appliances safe and free of frayed cable, broken socket & plugs?

  • 1.9 Is the gas cylinder in safe and good condition (flash back arrestor, pressure gauge, air hose, chained, trolley)?

  • Updates (Corrective Action)

  • Photo (Corrective Action)

  • Comment (* filled up by EHS upon the review of report)

2. WORK PRACTICES

  • 2.1 Does the staff stand/walk away from moving vehicle?

  • 2.2 Does the mechanic apply safety lock when lifting up the cabin?

  • 2.3 Does the mechanic apply wheel stoppers when carrying service for truck?

  • 2.4 Does the mechanic lift the heavy parts (tyres, etc.) with correct posture?

  • 2.5 Does the mechanic apply safety pole when the tipper is lifted up?

  • 2.6 Does the vehicle lifted up by floor jack supported securely with jack stand?

  • 2.7 Does the mechanic dismantle the propeller shaft/engine/transmission parts in the correct method (well supported, sufficient manpower, etc.)?

  • 2.8 Is the truck chassis free of tools when mechanic working underneath the truck?

  • 2.9 Does the mechanic use the platform when climbing up and down the truck?

  • 2.10 Are the open flame activities isolated from combustibles and flammables?

  • 2.11 Are the staff driving/testing trucks with valid driving license?

  • 2.12 Is the spray booth free of combustible chemical storage? (For MRC only)

  • Updates (Corrective Action)

  • Photo (Corrective Action)

  • Comment (* filled up by EHS upon the review of report)

3. ENVIRONMENTAL ISSUE (PART 1)

  • 3.1 Is the scheduled waste store designed according to DOE requirement (i.e. spill containment, protected from weather, clean, signboard and warning sign, isolated from ignition source, etc.)?

  • 3.2 Are the waste labels displayed correctly (i.e. display on container, generation date, waste code, symbol, etc.)?

  • 3.3 Are the waste containers suitable and covered when not in use?

  • 3.4 Are the spent engine oil, used oil filters, used vehicle battery, used thinner/solvent, waste of inks/paints, contaminated containers, cotton rags being managed as scheduled waste and separated accordingly?

  • 3.5 Are the inventory records and consignment notes updated and printed out from eSWIS system?

  • 3.6 Is the oil interceptor constructed to filter all the oil contaminated water discharged from workshop?

  • 3.7 Is the oil interceptor well maintained and the maintenance record documented?

  • 3.8 Are the drain and workshop compound clean and free of stagnant water?

  • 3.9 Is the lighting sufficient at all the places?

  • Updates (Corrective Action)

  • Photo (Corrective Action)

  • Comment (* filled up by EHS upon the review of report)

4. EMERGENCY RESPONSE (PART 1)

  • 4.1 Is the provision of fire extinguisher sufficient and ready for use?

  • 4.2 Are all the fire extinguishers visible, accessible and free from obstacles?

  • 4.3 Is the fire extinguisher inspected according to schedule (quarterly) and inspection tag available at fire extinguisher?

  • 4.4 Are the first aid supplies sufficient, clean and free of edible medicine?

  • 4.5 Is the first aid inspection record available?

  • 4.6 Is the security personnel briefed on the emergency procedure (emergency contact, fire extinguisher, fire alarm system, etc.)?

  • 4.7 Is the smoking area available, provided with ashtray and away from non-smoker?

  • Updates (Corrective Action)

  • Photo (Corrective Action)

  • Comment (* filled up by EHS upon the review of report)

5. PERSONAL PROTECTIVE EQUIPMENT

  • 5.1 Is the appropriate foot protection (safety shoes or rubber boots) provided and worn by the workers (mechanic, and cleaner) at all time in the workplace?

  • 5.2 Is the safety glass provided and worn during grinding, drilling, knocking, cutting, preparing or other hazardous activities?

  • 5.3 Is the safety goggle provided and worn when handling the chemicals (battery acid, etc.)?

  • 5.4 Is appropriate hand protection glove provided and worn for mechanical work or task exposed to sharp edges?

  • 5.5 Is the chemical hand glove provided and worn when handling the chemicals (paint, solvent, battery acid, etc.)?

  • 5.6 Is the appropriate respirator (OV or N95 mask) provided and worn when exposed to dust particles and chemicals vapor (paint & thinner)?

  • 5.7 Are welding shield, leather glove and N95 mask provided and worn for welding activity?

  • 5.8 Is the earplug provided and worn when worker exposed to noise (i.e. grinding, knocking, etc.)?

  • 5.9 Is the surgical mask provided and ready for sick person?

  • 5.10 Are all the provided PPE clean and well maintained (i.e. sharing of PPE is not allowed)?

  • Updates (Corrective Action)

  • Photo (Corrective Action)

  • Comment (* filled up by EHS upon the review of report)

6. DOCUMENTATION (PART 1)

  • 6.1 Is the weekly tool-box briefing conducted and briefing records kept in good manner?

  • 6.2 Is the safety briefing conducted to discuss EHS policy, emergency response procedure, driving safety, chemical handling, safety alert and safe work instruction?

  • 6.3 Are the EHS workplace committee and relevant documents available and updated (committee chart, inspection records, meeting minutes) ?

  • 6.4 Is the updated EHS policy displayed clearly?

  • 6.5 .Are the incident notification records (JKKP 6, 7 & 8) and incident investigation report available and kept in proper manner?

  • 6.6 Is the JKKP log book available?

  • Updates (Corrective Action)

  • Photo (Corrective Action)

  • Comment (* filled up by EHS upon the review of report)

7. OTHERS

  • Is there any other non-conformance observed?

  • undefined

  • Photo (Non-conformance)

  • Updates (Corrective Action)

  • Photo (Corrective Action)

  • Comment (* filled up by EHS upon the review of repot)

CONCLUSION/RECOMMENDATION

Conclusion/ Recommendation

  • Compliance (%)

  • Very poor EHS MS implementation. Immediate action is required to avoid the disciplinary action taken by the authority.

  • Poor EHS MS implementation. Need to work harder on legal compliance first before move to next level requirements.

  • Moderate EHS MS implementation. A lot of corrective action required.

  • Good EHS MS implementation. Several corrective action required.

  • Excellent EHS MS implementation. Few corrective action required and ready for EHS MS level enhancement.

  • Deadline

Completion

  • Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.