Title Page

  • Site conducted

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Area Inspected

  • Date

  • Inspected by

  • Name

  • Signature

  • Plant Superintendent

  • HSE team (Safety Officer or Safety Supervisor or Safety Specialist or Safety Superintendent)

  • Maintenance Superintendent

  • She Rep

  • The status of all items on this checklist should be indicated as conforn, non conform or not applicable. All non conform items must be given a written explanation and remedial action captured on log and to be registered on INX for follow up

  • Important note: For the Mine, MSP and Jetty, the Plant Superintendent and the Operation Superintendent must attend at the same time this once a month inspection with the HSE Team. The plant SHE rep is highly advised to attend as well

  • ITEM



(This section include the access, exits walkway, pontoon walkway, pathway, …to access the building/plant/area)

  • Is there a board presenting the specific risks, precautions and PPE required to access the area/plant ?

  • Is there a color code board at the access?

  • Are exits properly marked and exit lights working?

  • Are the access obstructed?

  • Are access properly lighted/illuminated?

  • (Check all lights, bulbs, fluorescent tubes are clean and working)

  • Are unsafe access barricaded and signposted?

  • Are the pontoon walkways levelled? Are gang planks levelled? Are pontoons chains in place?

  • Are the anchore/emergency rope obstructing the walkway?

  • Are operational life ring available on the pontoon walkways and jetty platform?

  • Is there a system to register who is going to the plant?

  • Is there safe access from the barge to the plant ?


(Look at toilets, change rooms, tea rooms, cantines and hand washing facilities)

  • Are tea rooms (cantines), change rooms and ablution facilities cleaned and sanitized ?

  • Are ablution facilities equipped with toilet papers and water?

  • Are ablution facilities equipped with hand wash bassin and soap?

  • Are ablution facilities for male and female separate and sign posted?

  • Is the ablution inspection sheet in place and up to date?

  • Are ablution facilities (including sewage treatment plant) part of the maintenance program?

  • Is the Sewage Systems operational?

  • Are employees/contractors only eating on authorized and designated area?

  • Are tea rooms (cantine) equipped with waste bins?

  • Ask an employee if he/she is feeling safe using the ablution facilities and tea rooms (cantine) ?


Check floors, grating, stairways

Open shelves, container storages,…

  • Are the floors, gratings, stairways and aisles… free of debris and obstruction?

  • Are the floors, gratings, stairways and aisles… free of oil and grease?

  • Is cleaning done to prevent accumulation of unnecessary dust, chemicals, wastes…on the workplace?

  • Are individual work stations kept clean, organized and orderly?

  • Are pipelines, machinery and equipment free of drippings oil or grease?

  • Is there a dedicated and barricaded place to temporarily store unsused materials/scraps until they are removed from site?

  • Are staking of material stable and not creating obstruction and risk of fall of obect?

  • Are staking on shelves storage respecting load limits?

  • Is the stacking of materials on the service barge safe to avoid risk of fall of object to the operator/slinger?

  • Is the personnel barge clean and safe to use?


  • Are lifting equipments and accessories checked and tagged according to the current color code and logged into a register?

  • Are working at height equipments (safety harnesses, lanyards, anchore points, portable ladders, …) checked and tagged according to the current color code and logged into a register?

  • Are confined space equipments, checked and tagged according to the current color code and logged into a register?

  • Are portable electrical equipments checked on monthly basis and logged into a register?

  • Are lifting, working at height, confined space equipments, portable electrical equipments stored appropriately while not in use?

  • Is a physical (pre-use) inspection performed before using these type of equipments?

  • Are pipelines coded in term of color coded standard?

  • Are wall plugs, switches and other switchgear checked and labelled?

  • Are unsafe equipments being red tagged and quarantined?


  • Are employees wearing properly their basic and specific PPE while performing their job?

  • Do supervision carry out regular inspections on their team to ensure that their PPE are in good condition?

  • Are employees with long hair respecting the agreed precaution to secure their hairs inside the hard hat?

  • Are employees having prescription glasses equipped with side shields? Otherwise, are overprotection used?

  • Are mosquito repellent products available on the workplace for employees to use?


  • Soils contaminated with hydrocarbons to the bioremediation area. Empty chemical and explosive containers to hazardous waste container. Expired chemical to hazardous waste container

  • Is there adequate labelled bins per type of waste in the workplace according to the waste volume of the plant?

  • Is there no waste placed outside the bins?

  • Are waste bins kept closed ?

  • Is the waste segregation done according to Kenmare standards?

  • Are all used oil drums sealed?

  • Is the condition of the bund in compliance: no cracks, no deterioration, no direct release to the environment?

  • Is the drain equipped with impervious drain valve?

  • Is the net capacity of the bund posted and visible?

  • Is there accumulated spillage, water or rain water within the bunded area?

  • Is there enough spill kits for the quantity of chemicals present?


  • Chemical, flamable, explosive materials

  • Is there a register of hazardous chemicals ?

  • Are the MSDS (material safety data sheets) available in the workplace so that users can have access to them?

  • Are the involved employees trained on handling, storage, use and emergency procedures on the hazardous chemicals?

  • Are the mandatory signage ‘’No open flames" and "No smoking" displayed in the vicinity of the flammable liquid store ?

  • Is the maximum storage capacity of the flammable liquid store prominently displayed at the store entrance?

  • Are gas cylinders, the pipes, cutting torches, regulators, flash back arrestors and pressure indicators in good condition and safe to use?

  • Are gas cylinders storage labels in place (Name of the gas and manufacturers plate)?

  • Are gas cylinders kept upright and chained/strapped while stored or transported?

  • Is there ventilated system for the storage of chemicals?

  • Is there adequate fire-fighting equipment available in close vicinity of the flammable liquid store?


  • Are vehicles and mobile equipments clean (mainly interior,windows and lights?

  • Are pre-use checklist completed and available?

  • Are defects on vehicles and mobile equipments raised and adressed for repairs?

  • Is there a separate parking for LDV and HME?

  • Are HME active zone demarcated and signposted as no go zone for pedestrian and LDV?

  • Is the 20m rule respected for employee working around HME? Are employees not putting themselves on blindspot while working around HME?

  • Is the 50m rule respected?

  • Is positive communication respected to manage interaction between employee, LDV and HME?

  • Is radio available, operational and used to establish positive communication?

  • Are LDV and HME moving to the mining area equipped with reflective flag or beacon light?


  • Are fire extinguishers fixed and located on easily accessible positions ?

  • Are fire extinguishers labelled and safety seal in place?

  • Is the fire extinguishing equipments returned on its dedicated place after use?

  • Are fire extinguishing equipments tested, operational and inspections up to date?

  • Is there trained first aider and on site fire fighter in the area?

  • Is there a planned Fire drills for the area?

  • Are fire breaks in place?

  • Are the emergency alarms system operational? Provide monthly test certificate

  • Are ERT training and drills updated on the area?


  • All routine and non critical tasks are covered by General Task Assessment?

  • Each critical task is covered by an approved Task Based Risk Assessment?

  • Are the Critical Controls adhered to?

  • Are leaders (Superintendent) of the area scheduling Planned Task Observation or critical audits for Critical Tasks of their area?

  • Are near misses reported, recorded and managed properly? (To be marked as NA until Near miss campaign launched)

  • Are incidents resulting on Injuries, Significant Potential Incidents and Property Damages reported and investigated?


  • EHS Policy awareness done to all employees, attendance kept in file?

  • Appointments of people with EHS functions done and copies kept in file?

  • Toolbox talks & Training records for employees kept in files? Including new employees

  • EHS rep inspections done on monthly basis and actions addressed?

  • Copies of updated Risk Assessments, GTA and Take 5 kept in file?

  • Are EHS monthly meetings and risk register review performed on the sector?

  • Incident Records and Recalls awareness in file?

  • Emergency drills and fire test records done an in file?

  • Check the GPTW books and identify gaps

  • Check specific permits books (hot work, isolation, confined space, excavation) and identify gaps


  • Are the critical safety systems/ interlocks on the plant/sector identified on a register (Example: critical process valves, Pontoon deeping, Safety interlocks, freeboard sensor, trip safety device ,

  • Are the frequency of test determined for the different type of critical safety systems?

  • Was the monthly test performed on the critical safety systems of the plant or equipment?

  • (Present signed certificate on the following test: Pontoon deeping, Safety interlocks, freeboard sensor, trip safety device ,

  • Is there a Planned Maintenance on these critical safety systems?

  • Are the findings from critical checks or inspections recorded on the system for urgent corrective action ? e.g. ONKEY Is the program adhered to?

  • Are the leaders of the sector peforming awarness to the team on the critical safety system?

  • Are emergency switch and/or equipment controls visible and operational?

  • Are pressure vessels regulatory inspection up to date?

  • Are guards in place for rotating equipments?

  • Are equipment calibrations done and defective equipment tagged?

  • Hazards identified during the inspection which cannot be fixed immediately and require expert skills or equipment to be ordered should to be recorded in the table below. The page should then be photocopied and logged into the work area hazard log file. Completed inspection forms are to be forwarded to the Head of Department for review, follow-up and filing

  • The Responsible Person is responsible for monitoring progress of the hazard log folder. At the end of each month the Responsible Person is responsible for updating progress to the hazard log and forwarding a list of outstanding actions to the Area Manager



  • Area Inspected





  • Target Date

  • Reviewed by Head of Department

  • Name

  • Signature

  • Date

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