SH&E representative logbook

• Audit No.

• Book No.

• Client / Site

  Phenosolan

  Phenosolan West

  Phenosolan East

  Other

• Other

• Appointed from

  Date

• Appointed to

  Date

• Employer / designated person

• Conducted on

  Date
• Location
  Address

• Personnel

• 1 The SH&E representative must give reasonable notice to the employer before carrying out inspections.
  
  2 The SH&E representative may conduct inspections at such intervals as agreed upon with the employer, normally within one week after the SH&E committee meeting.
  
  3 Use the guideline checklist for unsafe conditions as a trigger for inspections.
  
  4 During inspection concentrate on unsafe conditions and unsafe acts, which may occur.
  
  5 Report potential hazards to the health and safety of employees immediately to the responsible appointed supervisor in control of that area.
  
  6 Report potential hazards and all other deviations to the employer or designated person for actions.
  
  7 The SH&E representative’s report must be taken to the SH&E committee meeting for discussion, endorsement and recommendations. The chairman of the SH&E committee meeting is to sign the inspection report on behalf of the members of the SH&E committee meeting.
  
  8 All deviations that are identified by the SH&E representative must be minuted in the statutory meeting minutes for further actions. These deviations must be retained in the minutes until they have been adequately addressed.
  
  9 A Department of Labour inspector can do an inspection on the SH&E representative’s inspection register at any time and sign such report in the register.

• Checklist for the SH&E representative
  
  a) If indicated no, give description of deviation.
  
  b) Indicate all potential hazards with an X.

1. Condition of building /structures

• Are all items listed below in sound condition

• 1.1. Roofing

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 1.2. Walls and suport columns

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 1.3. Doorways and window frames

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 1.4. Gutters and down pipes

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 1.5. Fixed ladders

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 1.6. Concrete and steel structures

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 1.7. Pipelines

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 1.8. Tanks

  Yes

  No

  N/A

• Notes

• Potential Hazard?

2. Condition of floors

• Are all items listed below in sound condition

• 2.1. Floor

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 2.2. Carpets

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 2.3. Roadways / walkways

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 2.4. Elevated platforms

  Yes

  No

  N/A

• Notes

• Potential Hazard?

3. Physical condition of lighting

• Are all items listed below in sound condition

• 3.1. All bulbs / tubes in good working order

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 3.2. Windows and skylights kept clean

  Yes

  No

  N/A

• Notes

• Potential Hazard?

4. Ventilation

• Are all items listed below in sound condition

• 4.1. Are all air conditioners ducting inlets and outlets clear of obstruction

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 4.2. Are all abnornal heat or cold exposure hazards contained?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

5. Facilities clean and hygienic

• Are all items listed below in sound condition

5.1. All facilities clean (tiles, floors, walls, fixtures and fittings)

• 5.1.1. Soap, towels and toilet paper provided

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 5.1.2. Waste bins kept clean and contents removed regularly

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 5.1.3. Personal lockers and change rooms sufficient and tidy

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 5.1.4. Kitchen and canteens clean and vermin free

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 5.1.5. Sufficient waste bins provided

  Yes

  No

  N/A

• Notes

• Potential Hazard?

5.2. Authorised food areas

• 5.2.1. Are change rooms, clothing lockers and the workplaces free of food

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 5.2.2. Provision made for food storage (lunch boxes, etc.)

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 5.2.3. Food consumed in authorised areas

  Yes

  No

  N/A

• Notes

• Potential Hazard?

6. Pollution

• Are all items listed below in sound condition

• 6.1. Are areas free of visible pollution? ( E.g. oil leaking on ground, chemicals being spilled on the floor, etc. )

  Yes

  No

  N/A

• Notes

• Potential Hazard?

7. Stacking and storage

• Are all items listed below in sound condition

• 7.1. Is the stacking safe and tidy

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 7.2. Are shelves strong enough to safely hold load of equipment stacked on it

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 7.3. Walkways unobstructed

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 7.4. No materials protrude beyond demarcation

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 7.5. Employees aware of purpose and meaning

  Yes

  No

  N/A

• Notes

• Potential Hazard?

8. Yard and outside area

• Are all items listed below in sound condition

• 8.1. Is yard, outside areas and outlying areas near battery limits free of loose lying items and weeds

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 8.2. Is scrap and refuse removal system causing any health and safety threats

  Yes

  No

  N/A

• Notes

• Potential Hazard?

9. Lockout systems

• Are all items listed below in sound condition

• 9.1. Are electrical lockout systems in place

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 9.2. All blank lists for positive isolation in place

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 9.3. Are lockout systems for pneumatic and hydraulic equipment in place

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 9.4. Are alarms and other Safety devices in a working condition?<br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 9.5. All relief (safety) valves physically locked or sealed

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 9.6. Do PSV's releasing to atmosphere, release to a safe place.<br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

Red Line on pressure gauges

• 9.7. All pressure gauges marked with a red line on the dial of the pressure gauge (to correspond with set operating parameters).

  Yes

  No

  N/A

• Notes

• Potential Hazard?

10. Electrical equipment (portable)

• Are all items listed below in sound condition

• 10.1. Is portable electrical equipment safe for use?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

11. Motorised equipment / bicycles

• Are all items listed below in sound condition

• 11.1. Are vehicles etc. safety devices in safe condition?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

12. Colour coding

• Are all items listed below in sound condition

• 12.1 Is all colour coding applied according to the Colour code

  Yes

  No

  N/A

• Notes

• Potential Hazard?

13. Guarding

• Are all items listed below in sound condition

• 13.1. Are all hazardous moving parts on machinery within normal reach completely guarded?<br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 13.2. Is all dangerous work e.g. x-rays, high pressure cleaning, rigging work barricaded safely?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

14. Labeling

• Are all items listed below in sound condition

• 14.1. Are all electrical distribution boards and relevant equipment labelled and marked correctly?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

15. Lifting gear

• Are all items listed below in sound condition

• 15.1. Is all lifting gear in a safe condition?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

16. Electrical installations

• Are all items listed below in sound condition

• 16.1. Is all electrical equipment safe for use?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 16.2. All main switches accessible (even when circuits are locked out)

  Yes

  No

  N/A

• Notes

• Potential Hazard?

17. Ladders, stairways, draw bridges and scaffolding

• Are all items listed below in sound condition

• 17.1. Is the equipment in a safe condition?<br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 17.2. Is built scaffolding safe for use?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

Stairways

• 17.3. Are all stairways (including access steps to loading dock, etc) fitted with at least one handrail (4 Risers or more)

  Yes

  No

  N/A

• Notes

• Potential Hazard?

18. Hand tools / equipment

• Are all items listed below in sound condition

• 18.1. Are all hand tools/ equipment etc., safe for use?<br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 18.2. All trolleys, wheelbarrows, etc., in good condition?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

19. Personal safety protective equipment

• Are all items listed below in sound condition

• 19.1. Personal protective equipment safe to use (spot check)

  Yes

  No

  N/A

• Notes

• Potential Hazard?

20. Notices and signs

• Are all items listed below in sound condition

• 20.1. Are all notices and signs clean and in good condition?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 20.2. Ambulance points in place and in good state of repair

  Yes

  No

  N/A

• Notes

• Potential Hazard?

21. Fire fighting equipment / breathing apparatus

• Are all items listed below in sound condition

• 21.1. All extinguishers accessible

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 21.2. All hose reels accessible <br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 21.3. All hydrants accessible

  Yes

  No

  N/A

• Notes

• Potential Hazard?

22. Ergonomics

• Are all items listed below in sound condition

• 22.1. Is operating equipment ergonomically accessible to operating and maintenance personnel.

  Yes

  No

  N/A

• Notes

• Potential Hazard?

23. Hazardous chemical substances

• Are all items listed below in sound condition

• 23.1. Are all areas free of uncontrolled hazardous chemicals, fumes, and dust or radiation exposure threats?<br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 23.2. Emergency showers and eye wash equipment operational.

  Yes

  No

  N/A

• Notes

• Potential Hazard?

24. Sample points

• Are all items listed below in sound condition

• 24.1. Are sample points marked clearly?<br>

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 24.2. Does the layout of sample points promote safe operating by personnel?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

25. Permit systems

• Are all items listed below in sound condition

• 25.1. Are work permits, excavations permits, and electrical isolation systems in place?

  Yes

  No

  N/A

• Notes

• Potential Hazard?

26. Other

• Are all items listed below in sound condition

• 26.1. SH&E representative satisfied that all unsafe conditions have been reported.

  Yes

  No

  N/A

• Notes

• Potential Hazard?

• 27. Are you aware of all injuries incidents / accidents within your appointed area?

  Yes

  No

• Notes

• Potential Hazard?

Unsafe acts

• Are there any unsafe acts you would like to report?

  Yes

  No
Description, potential hazard

• Description

• Is this a potential hazard?

• Name an Signature of SH&E representative

  Sign

• Date

  Date

Comments

• Comments

• Name and Signature of chairman of healthy and safety committee

  Sign

• Date

  Date

Recommendations

• Recommendations

• Name and Signature of chairman of healthy and safety committee

  Sign

• Date

  Date

Remarks

• Remarks

• Name and Signature of employer / designated person

  Sign

• Date

  Date

Remarks

• Remarks

• Name and Signature of Inspector

  Sign

• Date

  Date