EMAMI SAF

FM-03
Emami Infrastructure Limited MONTHLY SAFETY REVIEW
REPORT

Project Name: Date:

Name of Contractor:

SL. DESCRIPTION NUMBER SINCE REMARKS

NO. INCEPTION
1 STRENGTH

1.1 STAFF
1.11 Manhours
1.2 Departmental Workmen

1.21 Normal Manhours

1.22 OT Manhours
1.3 Subcontractor's Workmen
(including security personnel
1.31 Normal Manhours
1.32 OT Manhours
1.4 Total Manhours worked since inception
1.5 Safe Manhours from last reportable
Lost time injury
2 Near Miss Cases
3 Dangerous Occurrences
4 Occupational Injuries

4.1 Fatalities (F)

4.2 Permanent Total Disabilities (PTD)
4.3 Total Number of Lost Time Injuries
(TLTI)
4.4 Man-days Lost due to reportable injury
4.5 No of reportable sick cases
4.5 First Aid cases
6 SAFETY Enforcement

6.1 No. of SAFETY violation memo issued

by contractor
6.2 No. of SAFETY Non Conformance by
contractor
Reports in Internal / external audit
6.3 No. of SAFETY Stop Work Notices
6.4 No of Cases of SAFETY Penalty,
voucher issued by IREO (mention total
penalty amount of this month in
remarks column)
7 Training Programme
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7.1 Safety Induction given
7.2 Tool Box Talk
7.3 Need based Training for staff
7.4 Need based Training for workers
8 SAFETY INSPECTION

8.1 Total No of Unsafe Acts and Conditions

8.2 Number of Not Attended points
8.3 No of SAFETY walk down carried out
8.4 Inspection of Labour Camp
8.41 Total points observed
8.42 Total attended points
9 P&M Inspection

9.1 Lifting Equipments

9.2 Lifting gears
9.3 Number of RCCB tested
10 Fire Extinguisher Inspection

10.1 No of fire extinguisher

10.2 Inspection of full body harness

Prepared by
Name:
Designation:
Signature:

CC: Project In-charge

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