Project Name
Electrical Distribution Board
Contractor: Location :
Doc. No : Date:
2 4
3
9
9
11
5
1 8
O/P cable
I/P cable
12 6
13
S No. Description Yes No Remarks
Firm Base with grouting & Easily accessable
1
panel (height of the leg is equal to 1m)
D.B set is weather proof and cover all around To
2
avoid water/ dust
Authorized Operator/Elec. Name/ Photo/ Contact
3
[Link] DB panel are available
Visualization of voltage, current and type of tools
4
to be used in the socket & Panel.
I/P and O/P Cable are good in condition and no
5
exposed cable
Confirmation of LOTO(lock out/ tag out) are
6
available.
Double Earthing System of MDB / DB panel with
7
Std earthing pit has been provided.
Separate ELCB with tripping current of 30 mA &
8
in working condition.
Safety stickers/ signboards / isolate flammable
9
Fire Hazard are display in D.B,
Condition of Cable,Power Socket and Plug are
10
having any damage.
Color coding being followed (RYBWG) for all
11
cables/wires
12 Availibility of rubber mat infornt of the D.B .
13 Plug/ Socket are being used of Industrial type
Fit for use Unfit/Rejected Need improvement
Inspection feedback
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Welding Machine
Contractor: Location :
Doc. No : Date:
6 2
2
1
10
5
4 3
8
S No. Description Yes No Remarks
ON / OFF knob is provided(Check for damage and
1
uninsulated knob)
2 Regulator with indicator is provided
Welding cables connected to the welding machine with
3
lugs at the joints with proper insulation.
4 Any cuts/ damage in the insulation of welding cables
Electrode rod holder and earthing holder are having any
5
cuts/ damage/ broken and properly insulated.
Industrial type Plug / socket being used for power
6
tapping cable of welding machine.
Any internal live electrical parts of welding machine is
7
exposed
Trolley being used w/o damaged wheels. Double
8
earthing has been provided to machine.
DCP/CO2 Fire extinguisher and fire bucket with sand
9
are available near m/c.
10 The painting condition of machine is good
The terminal box of machine is in good condition and
11
rain protected
Need
Fit for use Unfit/Rejected
improvement
Inspection feedback
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Grinding Machine
Contractor: Doc. No :
Equipment Number: Date:
2 1
1
4
4
5 5
7 6 8 7
3 8 6
3
S No. Description Yes No Remarks
1 Fibre handle without damage & condition is ok.
whether Wheel guard available & (covering 3/4th
2
area).
whether Grinding wheel having any crack/
[Link] Grinding wheels’ expiry date & its
3
RPM match with the machine RPM” has been
checked.
4 whether Rear handle is having any damage.
whether Presence of Cord strain reliever
5
(glands).are available & ok
6 whether Trigger switch is having any damage.
whethe Presence of Switch lock is ok. And in
7
working condition.
whether Electric wire having any cuts and joints.
8 Double earthing has been provided in m/c to
avoid shock.
Unfit/Reject Need
Fit for use
ed improvement
Inspection feedback
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Chopsaw Cutting Machine
Contractor: Location :
Doc. No : Date:
S No. Description Yes No Remarks
Cutting wheel having any crack/ damage. And
1 cutting wheels’ expiry date & its RPM match with
the machine RPM” has been checked.
Presence of Cutting plate guard. Double earthing
2
has been provided in m/c to avoid shock.
Presence of locking system for the plate & Guard
3
is available
4 Presence of job clamp and its conditions ok
Presence of fibre body handle and its condition is
5
ok
Cable condition(Any cut, wear etc.) and presence
6
of wire 03Pin Industrial top plug is ok
7 Presence of cutting dust guard is available
Unfit/Reject Need
Fit for use
Inspection feedback ed improvement
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Check List for Hand Tools
Name of Contractor: Date:
Type of tool Location :
Nicks, cracks, breaks,
Excessive Missing or Other conditions that cause
Defects/ gouges, stretch, bends, Throat opening
[Link] [Link] Capacity Wear & Tear pitting or illegible doubt as to continued safe use
Welds discoloration due to of hooks
corrosion identifications of the tool.
excessive heat
Comments
Contractor's HSE PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
EARTH LEAKAGE CIRCUIT BREAKER ( ELCB )
Name of Contractor: [Link]
Rating(mA) /
Location of ELCB Defects/
[Link] ELCB [Link] Type( 2pole/ Sensitivity Test Date of Test Status Corrective Action Taken
Installed Welds
4pole )
R Y B N
Comments
Contractor's HSE PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Register for Fire Extinguisher
Name of Contractor: Location :
Doc. No : Date:
Year of Annual Pressure Date of Due for Monthly
S No. Type Capacity Location Refilled on Remarks
Manfacture Insp. Dt. tested on Discharge Refilling Inspection Dt.
Remarks
Contractor's Representative PMC Representative Client's Representative
Signature:
Name:
Date:
Project Name
Full body Harness.
Name of Contractor: Date:
Type of Harness Doc. No :
Identification No. of full body Harness
Description Of Check Points Remark.
[Link] 1 2 3 4 5 6 7
Hard wares - (D-Rings, Buckles, Back Pad) Any damage, distortion, sharp
1 edges, burrs, cracks and corrosion
Webbings – Any cuts, burns, tears, abrasion, frays, excessive soiling and
2 discoloration.
3 Stitching – Any pulled or cut stitches.
Lanyards (Double)
a) Hard wares - (D-Rings) Any damage, distortion, sharp edges, burrs,
1 cracks and corrosion
2 c) Stitching – Any pulled or cut stitches
d) Synthetic rope – Any pulled or cut yarns, burns, abrasion, knots, excessive
3 soiling and discoloration
Anchoring Hook
a) Hard wares – (D-Rings) Any damage, distortion, sharp edges, burrs,
1 cracks and corrosion
b) Physical damage – Any cracks, sharp edges, deformities and locking
2 operation
3 c) Excessive corrosion – Any corrosion which effects the operation
4 d) Fasteners – Any corrosion, tightness, damage or distortion.
5 RESULT (A: ACCEPTED ,R : REJECTED )
Need
Fit for use Unfit/Rejected
Inspection feedback improvement
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Motor Vehicle( Car )
Contractor: Doc. No :
Driver Name: Date:
S No. Description Yes No Remarks
1 Tyre condition
2 Wiper
3 Left indicator
4 Right indicator
5 Headlight
6 Brake light
7 Parking light
8 Brake condition
9 Reverse horn
10 Rear view mirrors
11 Speedometer
12 Self starting
13 First aid box
14 Fire extinguisher
15 Spare bulbs
16 Stepney
17 Tools kit / lifting jack
18 Cleanliness
19 Oil leakage
20 Periodic Vehicle Servicing
21 Driver licence
22 First aid training
23 Fire Training
24 Pneumatic Door condition
25 Other Points
Unfit/Reject Need
Fit for use
Inspection feedback ed improvement
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Housekeeping
Contractor: Doc. No :
Date: Location :
S No. Description Yes No Remarks
Plant operations area :
1 Floor clean, no pools/spillage of condensate/ oil/chemicals/water
2 Platform/Grating ok
3 Tag Nos. painted as per standard on equip./machines
4 Plant area free of superfluous material
5 Escape routes marked
Access to fire extinguishers/MCP/Emergency exit etc. unobstructed.
6
7 Scrape and refuse bins provided & cleaned.
8 Solid/liquid disposal area marked drums labeled
9 All columns & chimneys skirts are kept clean
10 Torn/No wind sock
Temporary floor opening without barrication caution/sign boards "Do
11
not enter without permit".
12 High noise area properly marked
13 Drains and vents are plugged/capped/blinded
14 Is insulation in good condition
15 Guards- Machine/Railing/Ladders/platforms ok
Colour Coding and Sign Boards
16 Colour coding of pipelines done & displayed conspicuously
Adequate Nos. of caution /hazard boards & displayed conspicuously
17
-appropriateness of display locations
18 Tanks identification as per standards
Personal protective Equipments :
19 Designated space for PPE & kept properly
20 PPEs are kept clean & maintained
21 SCBA sets are maintained in working condition
Storage Area ;
22 Aisles and storage marked
23 No over stacking. No spillage/over flow
Chemical drums labeled/stored properly & separate storage for in
24
compatible chemicals/Material
Illumination and Ventilation
25 Lighting fixtures Lighting fixtures working and cleaned
26 A/C, Exhaust fan working. Lighting sufficient.
Road
27 Swept , No dust , No debris ,Road in good condition
Drains :
Plant drains having proper cover and surrounding area of OWS pit
28
clean. Pits not over flowing
Storm water channels -free from hydrocarbon and debris. No
29
vegetation growth. Pass ways over channels.
Fire Equipments
30 Identification Nos. painted properly & in good condition
31 Extinguishers & hose boxes at their proper location
32 Not obstructed
33 Hydrants/Monitors/Deluge not leaking
Work shop
34 Tools/spares stacked properly at designated places
35 Properly identified
36 Floors clean
Sub-station/PIB
37 properly locked
38 Fire/safety equipment in position/FM-200 procedure followed
39 Floor clean /No loose material
Garden and Beautification :
40 Condition of lawn & shrubs
41 Trimmed & lively plants
42 Overview of whole plant
Electrical :
43 Portable electrical connection with plug top/with earthing/
44 Proper insulation. Electrical cables in good condition.
45 Condition of flame proof fittings
Gas Cylinders :
46 Cylinders in stand/chained/stacked vertically
47 Empty and filled cylinders are segregated
First Aid Box
48 Proper location , Properly maintained
Hoses
All the types of hoses in use specified for the service/properly
49
clamped.
50 Damaged/scattered in the area
51 Rolled/kept at designated places
Hygiene
52 Mirrors/sink/urinals/WC clean
53 Taps not leaking
54 Exhaust fan in operation and clean also not making noise
55 Domestic sewer not over flowing
56 Water cooler/Vending m/c and area cleaned. Dining facilities clean - No flies
Unfit/Reject Need
Fit for use
Inspection feedback ed improvement
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
TITLE : Vehicle Inspection Tag
Name of Contractor: Report No:
Doc. No : Date:
Work Description: Location :
S.N.
Vehicle Type
Registration No
Operator Name
Training date
Company
License No
PMC Engineer Client's Safety Manager
Authorised by
Date
Do not use mobile
while driving
SPEED LIMIT AT SITE
15KM/H
Security
not use mobile
while driving
D LIMIT AT SITE
Project Name
Hammer drill machine
Contractor: Doc. No :
Equipment Number: Date:
7 1
6 9
8
2
5
10
3
S No. Description Yes No Remarks
1 Is the equipment have double insulation
2 Presence of cable protecter (flexible)
3 Is standard cable available for power tapping.
4 Is the On/Off switch in working condtion.
5 Is the handle placed properly and firm
6 Does the handle in proper condition
7 Is drill bit hole free from damages and obstruction
8 Is drill holders in proper condition
9 Is function select switch in proper condition
10 Is duct collection cap available
Inspection feedback Need
Fit for use Unfit/ Rejected
improvement
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Battery operated Hammer Machine
Contractor: Doc. No :
Equipment Number: Date:
S No. Description Yes No Remarks
Is drill holders in proper condition and free from
1
damage
2 Is the handle placed properly and firm
3 Is the On/Off switch in working condtion.
4 Is function select switch in proper condition
5 Is the indicator light in working condition
6 Is the battery holder in healthy condition
7 Is the body of machine in healthy condition
8 Is the speed control switch in working Condition.
9 Dust Collection Attachment for a hammer Machine
Inspection feedback Need
Fit for use Unfit/ Rejected
improvement
Remarks
Contractor's JLL Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Battery operated drill machine
Contractor: Doc. No :
Equipment Number: Date:
S No. Description Yes No Remarks
Is drill holders in proper condition and free from
1
damage
2 Is the speed control switch in working Condition.
3 Is the rill drive control switch in working condition
Is the torque in working condition and free from
4
damage
5 Is the indicator light in working condition
Drill driver is operated using the speed control
6
trigger
7 Is the battery holder in healthy condition
Is the machine holder/handing in healthy
8
condition and free from damage
9 Is the machine body free from damege
Inspection feedback Need
Fit for use Unfit/Rejected
improvement
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Battery operated Circular Saw Machine
Contractor: Doc. No :
Equipment Number: Date:
1
9
S No. Description Yes No Remarks
1 Is the hysical condition of body in healthy condition.
2 Is the on/off switch working and in healthy condition.
3 Is the main guard available in free from damage.
4 Is the wheel rotating path free from obstruction
5 Is the wheels RPM is greater then the machine RPM
6 Is the blade free from damage and good to use.
Is the moving 360 guard in place and in healthy
7
condition. .
Is the wheel properly fixed and the wheel lock is free
8
from damage.
Is the tool handle wedged tightly and free from
9
damage
Is the vacuum hose connecting area free from
10
damage
Inspection feedback Unfit/ Need
Fit for use
Rejected improvement
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date:
Project Name
Vacuum machine
Contractor: Doc. No :
Equipment Number: Date:
S No. Description Yes No Remarks
1 Is the operating switch in working condition
Is the overall condition of the machine good and
2
healthy
Is connecting hose and handle fromm from
3
damage
Is the operator trained on the safe operational
4
proceedures
Is the cable free from damage and good in
5
condition
Is the power looped safety and following the
6
standard
Inspection feedback Need
Fit for use Unfit/ Rejected
improvement
Remarks
Contractor's PMC Client's
Representative Representative Representative
Signature:
Name:
Date: