WEEKLY HSE STATISTIC REPORT
PROJECT NAME / ID:
CONTRACTOR:
REPORTING PERIOD: FROM: TO:
(1) MAN HOURS* WORKED
Man Hours from Start Man Hours for this Week Total Man Hours to Date
(Cumulative) (A) (B) (Cumulative) (A+B)
* Man hours = The total number of man hours the site has worked inclusive of subcontractors.
* Average Manpower: 7
(2) ACCIDENTS
S/N Type of accident For the Period To Date (cumulative)
1 0 0
Near Misses
2 First Aid Case (FAC) 0 0
3 0 0
Medical Treatment Case (MTC)
4 Restricted Work Case (RWC) 0 0
5 0 0
Lost Workday Case (LWC)
6 Fatality (F) 0 0
7 0 0
Fire Incident
8 Property Damage 0 0
(3) MAN DAYS LOST
From Start (Cumulative) For the Week To Date (Cumulative)
0.00 0.00 0.00
(4 - A ) SEVERITY RATE
Formula Calculation Result
Total Man Days Lost X 2000000
00*200000/3152 0.00
Total No. of Manhours Worked
(4 - B ) LOST TIME INCIDENT FREQUENCY RATE
Formula Calculation Result
No of Lost Time Incident X 2000000
00*200000/3152 0.00
Total No. of Manhours Worked
(4 - C ) TOTAL RECORDABLE INCIDENT RATE
Formula Calculation Result
Total Recordable Cases X 200,0000
00*200,000//3152 0.00
Total No. of Manhours Worked
(5) HSE ACTIVITIES
S/N
Types From Start For the Week To Date (Cumulative)
1 HSE Observation Reports 0 0 0
2 Open HSE Observations 0 0 0
3 Award & Recognition 0 0 0
4 HSE Violation Reported 0 0 0 C
5 External Trainings 0 0 0
6 HSE Induction 0 0 0
7 Tool Box Talks 0 0 0
8 Internal Trainings 0 0 0
9 RA / JHA Conducted / Reviewed 0 0 0
10 Number of HSE Walkthrough 0 0 0
11 Number of HSE Checklist completed 0 0 0
12 HSE Meetings 0 0 0
(6) Record of Last LTI
Total Safe Man Hours Since LTI
Name Empl. ID # Date
For the Period To Date (cumulative)
0.00 0.00
x x
Total SMH After LTI 0.00
(7) Result Of Audits, Assessments & Walkthrough
Project / Location Audit, Assessment & Walkthrough Score
%
HSE Manager / Supervisor (Name& Signature) Project Manager (Name & Signature):
GULF BUILDER A ccide nt Stati sti cs
1
0
Near Misses First Aid Case Medical Restricted Lost Workday Fatality (F) Fire Incident Property
(FAC) Treatment Work Case Case (LWC) Damage
Case (MTC) (RWC)
For the Period To Date (cumulative)
GULF BUILDER HSE Acti viti es
1
0.8
0.6
0.4
0.2
0
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