HALC DSTI Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

• Are Workers Medically Fit for work?

  Yes

  No

  N/A

• Is the Team wearing the correct PPE to be on the project? (steel tip shoes, Hard Hat, Reflective Vest)

  Yes

  No

  N/A

• Is access to the work place safe?

  Yes

  No

  N/A

• Have the tools been pre inspected and in good conditions to work with for the tasks of the day?

  Yes

  No

  N/A

• Have the appropriate permits been signed?

  Yes

  No

  N/A

• Is there any lifting and rigging required for the day's activity with loads greater than 3tons or abnormal shape?

  Yes

  No

  N/A

• Is there any excavation required deeper than 2m planned for the day's activity?

  Yes

  No

  N/A

• Do all scaffold in your area have the correct tag placed and signed for?

  Yes

  No

  N/A

• Have the team members been properly trained for works

  Yes

  No

  N/A

• Is the MS RA for the activity availble on site?

  Yes

  No

  N/A

Activities above

• Are there any construction activities happening above your area of work?

  Yes

  No

  N/A

• Has the team leader of that activity been notified?

  Yes

  No

  N/A

• Has your team be notifed?

  Yes

  No

  N/A

• Is the area barricade to limit access?

  Yes

  No

  N/A

Activities below

• Are there any construction activities happening below your area of work?

  Yes

  No

  N/A

• Has the Team leader of that activities been notified

  Yes

  No

  N/A

• Has your team be notified

  Yes

  No

  N/A

• Is the area of work been barricade to restrict access

  Yes

  No

  N/A

Activities Adjacent Work area

• Are other teams working in the same area as your team

  Yes

  No

  N/A

• Have you informed their team leader of your activity

  Yes

  No

  N/A

• Is your team aware of their activities

  Yes

  No

  N/A

• Are any mobile plant being used in this area

  Yes

  No

  N/A

• is there a flag man available

  Yes

  No

  N/A

• List main Construction activities for the day

  Select Excavation with plant Formwork with labour Fixing rebar with labour Femoving formwork from structure Casting concrete slab Casting Concrete vertical element house keeping

  • Excavation with plant
  • Formwork with labour
  • Fixing rebar with labour
  • Femoving formwork from structure
  • Casting concrete slab
  • Casting Concrete vertical element
  • house keeping

• What Main hazards are present in work area?

  Select Trip hazard injury to body hazard Damage to property hazard Electrocution hazard Drowning hazard Fall from height Hazard Repetition of body movement hazard scaffold material collapse Trench Collapse

  • Trip hazard
  • injury to body hazard
  • Damage to property hazard
  • Electrocution hazard
  • Drowning hazard
  • Fall from height Hazard
  • Repetition of body movement hazard
  • scaffold material collapse
  • Trench Collapse

• What Controls have been put into place to ensure compliance for Daily task

  Select Compentence person inspected scaffold Trench area has been inspected Edge protection has been inspected House keeping done Covering of floors and holes are done fall protection harness are worn by team members

  • Compentence person inspected scaffold
  • Trench area has been inspected
  • Edge protection has been inspected
  • House keeping done
  • Covering of floors and holes are done
  • fall protection harness are worn by team members

• Team attendance photo for DSTI

  Media

• pre start area of work photo

  Media

I hereby certify that the above items were checked and all workers under my supervision received a safe task

• Foreman Name

• Foreman Signature

  Sign

• Team leader Name

• Team Leader Signature

  Sign