SAFTEY INSPECTION REPORT

SL.NO. I 1 2 3 4 II 1 2 3 4 5 6 7 III 1 2 3 4 5 6 7 8 IV 1 2 3 V 1 2 3 4 5 6 VI 1 2 3 4 5 DATE TIME NO.

INSPECTION DETAILS
INSPECTING OFFICER SITE/OFFICE INSPECTED HEAD OF OFFICE SAFETY OFFICER

PERSONAL PROTECTIVE DEVICES

ITEMS HELMETS SAFETY BELTS SAFETY SHOES GOGGLES GLOVES RAIN COAT OTHERS TOTAL USABLE

SAFETY WORKER TOOLS AND EQUIPMENTS

ITEMS EARTHING RODS EARTHING EARTHING CHAIN EARTHING PIPE EARTHING KIT !ARNING TAPE LADDER CA TION BOARDS TOTAL USABLE TYPE

TOOLS AND DEVICES

ITEMS TOOL KITS CRIMPING TOOLS CHAIN BLOCKS TOTAL USABLE

METERS AND TESTING INSTRUMENTS

ITEMS TEST LAMP CLIP ON METER MEGGER VOLTMETER AMMETER OTHERS TOTAL USABLE

SAFETY DOCUMENTS
ITEMS SAFETY AND ACCIDENT REGISTER SAFTEY MAN EL HT SLD DISPLAYED HT INTERLINK AB STAT S BOARD LT INTERLINK STAT S BOARD REMARKS

VII 1 2 3 4 5 VIII 1 2 3 4 5 IX 1 2 3 4 5 6 7 8 X 1 2 3 4 5 XI 1 2 3

DETAILS OF REGISTERS
ITEMS HT INTERR PTION REGISTER $ LT INTERR PTION REGISTER $ COMPLAINT REGISTER $ PPE ISS E REGISTER $ LINE PATROLING REGISTER $ REMARKS

LINE STAFF STRENGTH

DESIGNATION ASSISTANT ENGINEER S B ENGINEER OVERSEER LINE MAN !ORKER SANCTIONED WORKING ONLEAVE

SECTION DATA
ITEMS NO. OF CONS MERS NO.OF DISTRIB TION TRANSFORMERS HT LINES LT LINES NO.OF LINE AB%S NO. OF TRANSFORMER AB%S NO.OF TRANSFORMER !ITHO T AB%S AAC/AAAC COND CTORS NCHANGED DETAILS

WORK PRACTICES
ITEMS S NRISE MEETING DONE REG LARLY $ TOOL BO& TALKS DONE RO TINELY $ SAFTEY TRAINING DONE $ NO.OF FATAL ACCIDENTS $ NO.OF NON FATAL ACCIDENTS $ REMARKS

MAINTENANCE PRACTICES
WORK LAST TREE PR NING $ LAST AB S!ITCH MAINTENANCE $ LAST TRANSFORMER MAINTENANCE $ DONE BY REMARKS

GENERAL REMARKS
XII

EXECUTIVE ENGINEER#SAFETY(NORTH" (CUG:9446008 !4"

"SIGNAT RE#