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Key Report Information…

CURRENT 1 MONTH AGO

> Report Cut Off Date (dd-mm-yy) 17 Jun 05 Date of Previous Reports: 20 May 05

Team or Supplier Name: TEAM NAME

Production Manager: PRODUCTION MANAGER NAME

Project or Sub Project T5 PROJECT NAME

Safety Manager Approval…

Report Status: NOT APPROVED

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2 MONTHS AGO

22 Apr 05
Health & Safety
TEAM NAME: TEAM NAME REPORTING PERIOD: JUNE 2005
PROJECT: T5 PROJECT NAME MANAGER: PRODUCTION MANAGER
NAME
Accident Statistics
INCIDENTS MANHOURS ACCIDENT FREQUENCY RATES
Major >3 Day Dangerous Lost Time Minor Significant Total Total Manhours Minor AFR Lost Time Reportable
Occurrences Accidents Incidents Reportable AFR AFR

MONTH 0 0 0 0 0 0 0 14,400 0.00 0.00 0.00

12 MONTH 0 0 0 0 0 0 0 14,400 0.00 0.00 0.00

Health & Safety Indicators

Reportable AFR
1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Jun 04 Jul 04 Aug 04 Sep 04 Oct 04 Nov 04 Dec 04 Jan 05 Feb 05 Mar 05 Apr 05 May 05 Jun 05
AFR RIDDOR [Monthly] AFR RIDDOR [12 Month Window]

Lost Time Injury AFR

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Jun 04 Jul 04 Aug 04 Sep 04 Oct 04 Nov 04 Dec 04 Jan 05 Feb 05 Mar 05 Apr 05 May 05 Jun 05
AFR LTI [Monthly] AFR LTI [12 Month Window]

Minor Injury AFR

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Jun 04 Jul 04 Aug 04 Sep 04 Oct 04 Nov 04 Dec 04 Jan 05 Feb 05 Mar 05 Apr 05 May 05 Jun 05

AFR MINOR [Monthly] AFR MINOR [12 Month Window]

Balanced Score Card

TOTAL SCORE FOR JUNE 2005 96 %
TOTAL SCORE FOR MAY 2005 00 %
TOTAL SCORE FOR APRIL 2005 00 %

H&S LEADING INDICATOR INPUTS H&S LAGGING INDICATOR OUTPUTS

Safety Leadership 100 % Significant Incidents 100 %
Engaging the Workforce 100 % Minor AFR 100 %
CNS29 Compliance 100 % Reportable/Lost Time Accidents 100 %
Safety Programme Activities 100 %
H&S Committee Meetings 100 %
Safety Management Audits 60 %
TOTAL SCORE 66 % TOTAL SCORE 30 %
TEMPLATE DEVELOPED AND PROVIDED BY T5A CONSTRUCTION SUPPORT
Health & Safety
TEAM NAME: TEAM NAME REPORTING PERIOD: JUNE 2005
PROJECT: T5 PROJECT NAME MANAGER: PRODUCTION MANAGER NA

Key Operations / Works

Key Health & Safety Activities

1.

Safety Leadership Team H&S Directives

1.

Incident Details
DATE CAT. SUMMARY T5 ACTION COMMENTS

Categories: R3D RIDDOR >3 Day NM Near miss T5 Action Types: A - Serious breach of control standards/ procedure: external enforcement possible
RM RIDDOR Major PD Property Damage B - Clear breach of control standards/procedure: internal enforcement action
RDO RIDDOR Dangerous Occurrence MI Minor Injury C - Minor breach of control standards/ procedure: local improvements possible
D - No breach of control standards; awareness and personal responsibility issues only

Enforcement Actions
DATE SUPPLIER INVOLVEMENT (NAME) CIRCUMSTANCES OF BREACH TYPE
16 Jun 05 ENFORCE SUPPLIER 1 CIRCUMSTANCE 1 TYPE 1

Other Issues
TEMPLATE DEVELOPED AND PROVIDED BY T5A CONSTRUCTION SUPPORT
 <<
Accident Statistics
► ENTER THE ACCIDENT STATISTICS FOR THE MONTH
► COMPLETE THIS SHEET BEFORE USING THE SCORECARD

< BACK STEP 2 > MONTH (MM-YY) Jun 04 Jul 04 Aug 04 Sep 04 Oct 04 Nov 04 Dec 04 Jan 05 Feb 05 Mar 05 Apr 05

MAN HOURS (Excluding those off site e.g. WBC)

SITE BASED STAFF [No. of Manhours in the period)

INCIDENTS
DANGEROUS OCCURANCES [No. of Occurances in period)
SIGNIFICANT INCIDENTS [No. of Incidents in period)

HSE, RIDDOR > 3 DAY ONLY

EYES [No. of Accidents in the period)
HEAD [No. of Accidents in the period)
BACK [No. of Accidents in the period)
HAND [No. of Accidents in the period)
LEG [No. of Accidents in the period)
FOOT [No. of Accidents in the period)
OTHER [No. of Accidents in the period)

HSE, RIDDOR MAJOR INJURY ONLY

EYES [No. of Accidents in the period)
HEAD [No. of Accidents in the period)
BACK [No. of Accidents in the period)
HAND [No. of Accidents in the period)
LEG [No. of Accidents in the period)
FOOT [No. of Accidents in the period)
OTHER [No. of Accidents in the period)

OTHER LOST TIME INJURIES (NON RIDDOR)

EYES [No. of Accidents in the period)
HEAD [No. of Accidents in the period)
BACK [No. of Accidents in the period)
HAND [No. of Accidents in the period)
LEG [No. of Accidents in the period)
FOOT [No. of Accidents in the period)
OTHER [No. of Accidents in the period)

Terminal 5 Buildings
Page 7
Design Progress Report
 MINOR ACCIDENTS (NON LOST TIME)
EYES [No. of Accidents in the period)
HEAD [No. of Accidents in the period)
BACK [No. of Accidents in the period)
HAND [No. of Accidents in the period)
LEG [No. of Accidents in the period)
FOOT [No. of Accidents in the period)
OTHER [No. of Accidents in the period)

ACCIDENT TOTALS AND KPIs

TOTAL MANHOURS [Monthly]
TOTAL MANHOURS [12 Month Window]

DANGEROUS OCCURANCES [Monthly]

SIGNIFICANT INCIDENTS [Monthly]
DANGEROUS OCCURANCES [12 Month Window]
SIGNIFICANT INCIDENTS [12 Month Window]

TOTAL RIDDOR > 3 DAY [Monthly]

TOTAL RIDDOR MAJOR [Monthly]
TOTAL RIDDOR ACCIDENTS [Monthly]
TOTAL LTI ACCIDENTS [Monthly]
TOTAL MINOR ACCIDENTS [Monthly]
TOTAL RIDDOR > 3 DAY [12 Month Window]
TOTAL RIDDOR MAJOR [12 Month Window]
TOTAL RIDDOR ACCIDENTS [12 Month Window]
TOTAL LTI ACCIDENTS [12 Month Window]
TOTAL MINOR ACCIDENTS [12 Month Window]

AFR RIDDOR [Monthly]

AFR RIDDOR [12 Month Window]
AFR LTI [Monthly]
AFR LTI [12 Month Window]
AFR MINOR [Monthly]
AFR MINOR [12 Month Window]

Terminal 5 Buildings
Page 8
Design Progress Report
 Generate 12 Week Window

SAFETY STATISTICS Jun 04 Jul 04 Aug 04 Sep 04 Oct 04 Nov 04 Dec 04 Jan 05 Feb 05 Mar 05 Apr 05
53 TOTAL MANHOURS [Monthly]
54 TOTAL PERSONNEL [Monthly]
55 TOTAL MANHOURS [12 Month Window]
56 TOTAL PERSONNEL [12 Month Window]

58 DANGEROUS OCCURANCES [Monthly]

59 SIGNIFICANT INCIDENTS [Monthly]
60 DANGEROUS OCCURANCES [12 Month Window]
61 SIGNIFICANT INCIDENTS [12 Month Window]

63 TOTAL RIDDOR > 3 DAY [Monthly]

64 TOTAL RIDDOR MAJOR [Monthly]
65 TOTAL RIDDOR ACCIDENTS [Monthly]

Terminal 5 Buildings
Page 9
Design Progress Report
 66 TOTAL LTI ACCIDENTS [Monthly]
67 TOTAL MINOR ACCIDENTS [Monthly]
68 TOTAL RIDDOR > 3 DAY [12 Month Window]
69 TOTAL RIDDOR MAJOR [12 Month Window]
70 TOTAL RIDDOR ACCIDENTS [12 Month Window]
71 TOTAL LTI ACCIDENTS [12 Month Window]
72 TOTAL MINOR ACCIDENTS [12 Month Window]

74 AFR RIDDOR [Monthly]

75 AFR RIDDOR [12 Month Window]
76 AFR LTI [Monthly]
77 AFR LTI [12 Month Window]
78 AFR MINOR [Monthly]
79 AFR MINOR [12 Month Window]

Terminal 5 Buildings
Page 10
Design Progress Report
May 05 Jun 05 Jul 05 Aug 05 Sep 05 Oct 05 Nov 05 Dec 05 Jan 06 Feb 06 Mar 06 Apr 06 May 06 Jun 06 Jul 06 Aug 06 Sep 06 Oct 06

14,400

0
0

0
0
0
0
0
0
0
30 Dec 99

0
0
0
0
0
0
0

0
0
0
0
0
0
0

Terminal 5 Buildings
Page 11
Design Progress Report
 30 Dec 99
0
0
0
0
0
0
0

14,400
14,400

0
0
0
0

0
0
0
0
0
0
0
0
0
0

0.00
0.00
0.00
0.00
0.00
0.00

Terminal 5 Buildings
Page 12
Design Progress Report
May 05 Jun 05
14,400

14,400

0
0
0
0

0
0
0

Terminal 5 Buildings
Page 13
Design Progress Report
 0
0
0
0
0
0
0

0.00
0.00
0.00
0.00
0.00
0.00

Terminal 5 Buildings
Page 14
Design Progress Report
Nov 06 Dec 06 Jan 07 Feb 07 Mar 07 Apr 07 May 07 Jun 07 Jul 07 Aug 07 Sep 07 Oct 07 Nov 07 Dec 07 Jan 08 Feb 08 Mar 08 Apr 08

Terminal 5 Buildings
Page 15
Design Progress Report
Terminal 5 Buildings
Page 16
Design Progress Report
 May 08 Jun 08 Jul 08 Aug 08 Sep 08 Oct 08 Nov 08 Dec 08 Jan 09 Feb 09

Terminal 5 Buildings
Page 17
Design Progress Report
Terminal 5 Buildings
Page 18
Design Progress Report
 TEAM: TEAM NAME
TERMINAL 5 REPORT DATE: 17 Jun 05
HEALTH AND SAFETY BALANCED SCORECARD
SHEET 1 - LEADING INDICATOR INPUTS INPUTS SCORE: 66%

1. Safety Leadership Score = 16

Answer the questions below relating to Safety Leadership. Note that if a SLT meeting was not held, all the scores will be set to zero.

Was a Safety Ledership Team meeting held during the reporting period? ● 2Yes No1

Did your nominated representative attend that meeting? ● Yes 1 No

Did you complete and close out all your actions arising from the previous SLT Meeting? ● Yes 1 No

If a SMART project wide safety directive was set for the reporting period, did you implement it? ● Yes
1 No

2. Training and Competence Score = 14

Complete the results of the audit undertaken against the training requirements of CNS 29 during the reporting period. If the person audited has completed 50% or more of
the required training award 1 point, if they have completed 100% award 2 points.
Level: Name: 01 1
50% 100%
Senior Manager John Birchall ● 3
Middle Manager David Woods ● 3
Supervisor Richard Swallow ● 3
Operative No. 1 Daniel Priest ● 3
Operative No. 2 Robert Diamond ● 3
Operative No. 3 John Nicholson ● 3
Operative No. 4 Ian Pattison ● 3
2
3. Engaging the Workforce Score = 10
How many employee engagement tours were undertaken by senior management?

Level: 01 1 2+1
Supplier Project Director ●
3
Supplier Senior Manager ●
3
Did your supervisors attend the Production Leader's monthly safety review held ● Yes No1
during the reporting period?

4. H&S Committee Meetings Score = 6

Answer the questions below relating to H&S Committee Meetings. Note that if a H&S Committee Meeting was not held, all the scores will be set to zero.

When was the last Project H&S Committee meeting held (DD-MM-YY) ? 1 13-06-05
2
Did your nominated representative attend that meeting? ● Yes 1 No

Did you complete and close out all your actions arising from the previous H&S ● Yes 1 No
Committee Meeting?

5. Safety Programmes Score = 14

Answer the questions below relating to H&S Programmes

What is the number of activities/site inspections required by your month's Safety 20

Programme?
What is the number of activities/site inspections in this Safety Programme that have 20
been completed and closed?

6. Safety Management Audits Score = 6

Answer the questions below relating to Safety Management Audits

Do you maintain a fully up to date audit schedule for your suppliers’ SMS and T5 ● 1Yes No1
Standards?
Were scheduled audits undertaken during the reporting period? ● Yes 1 No

● Yes No
Have all items (within your control) from previous audits been closed out within 30 Yes 2 No
days of the audit findings?
TEMPLATE DEVELOPED AND PROVIDED BY T5A CONSTRUCTION SUPPORT
ON SUPPORT
 TEAM: TEAM NAME
TERMINAL 5 REPORT DATE: 17 Jun 05
HEALTH AND SAFETY BALANCED SCORECARD
SHEET 2 - LAGGING INDICATOR OUTPUTS OUTPUTS SCORE: 30%

7. HSE, LTI/ RIDDOR >3day or Major Injury Accidents Score = 8

The shaded boxes have been automatically generated using the accident statistics entered in the ACCIDENTS sheet and the Report Date specified in the Control Panel

Man-hours worked 14,400

Includes all personnel working on the project based on the project site/location. It does not include persons employed in
offices off site at Longford House/WBC but does include persons working within site compounds.

The following accidents or incidents have occurred during the reporting period:

HSE, RIDDOR >3day or major injury 0

Lost Time Injuries (LTI's) 0

The number of accidents that have resulted in a person missing any working shift, not counting the shift of the accident and
includes HSE RIDDOR >3day and major injury accidents.

How many of the LTI's/HSE RIDDOR >3day or major injury accidents above have a
fully completed investigation report submitted to date?
(Applies to reports for incidents that have occurred within the reporting period, not to those from a previous period).

8. Minor Accidents Score = 10

The shaded boxes have been automatically generated using the accident statistics entered in the ACCIDENTS sheet and the Report Date specified in the Control Panel

Minor Accidents Total 0

Minor accidents are those injury accidents that are recorded in the accident book (exclude RIDDOR/LTIs in the number or
they will be double counted).

Minor Accidents AFR C -

Suppliers that have a monthly Minor Month AFR of 15 or less will be awarded 2 points, less than 10 will be awarded 5 points.
Suppliers that improve on the previous months Minor Month AFR, or remain at zero, will be awarded a further 5 points. (P =
Previous Month AFR; C = Current Month AFR)

9. Significant Incidents Score = 12

Answer the questions below relating to Significant Incidents

No. Significant Incidents

Those incidents that have occurred during the reporting period recorded in the T5 Significant Incident Register.

How many of the significant incidents recorded above have had a fully completed
investigation report submitted to date?
(Applies to reports for incidents that have occurred within the reporting period, not to those from a previous period). 1

SUMMARY
HEALTH AND SAFETY LEADING INDICATOR INPUTS SCORE PERCENTAGE
1 Safety Leadership Compliance 16 100 %
2 Training and Competence Compliance 14 100 %
3 Engaging the Workforce Compliance 10 100 %
4 Health & Safey Committee Meetings Compliance 6 100 %
5 Safety Programmes Compliance 14 100 %
6 Safety Management Audits Compliance 6 60 %

TOTAL FOR LEADING INDICATOR INPUTS (INCLUDING SECTION WEIGHTING 66%

HEALTH AND SAFETY LAGGING INDICATOR OUTPUTS SCORE PERCENTAGE

7 HSE, LTI/ RIDDOR >3day or Major Injury Accidents Compliance 8 100 %
8 Minor Accidents Compliance 10 100 %
9 Significant Incidents Compliance 12 100 %
TOTAL FOR LAGGING INDICATOR OUTPUTS (INCLUDING SECTION WEIGHTING 30%

TEMPLATE DEVELOPED AND PROVIDED BY T5A CONSTRUCTION SUPPORT

ON SUPPORT
 Key Operations / Works

Key Health & Safety Activities

Terminal 5 Buildings
Page 27
Design Progress Report
 SUMMARY

Terminal 5 Buildings
Page 28
Design Progress Report
 SUMMARY

Terminal 5 Buildings
Page 29
Design Progress Report
 SUMMARY

Terminal 5 Buildings
Page 30
Design Progress Report
 SUMMARY

Terminal 5 Buildings
Page 31
Design Progress Report
 SUPPLIER INVOLVEMENT (NAME) CIRCUMSTANCES OF BREACH

ENFORCE SUPPLIER 1 CIRCUMSTANCE 1

Terminal 5 Buildings
Page 32
Design Progress Report
 SUPPLIER INVOLVEMENT (NAME) CIRCUMSTANCES OF BREACH

ENFORCE SUPPLIER 1 CIRCUMSTANCE 1

Terminal 5 Buildings
Page 33
Design Progress Report
 SUPPLIER INVOLVEMENT (NAME) CIRCUMSTANCES OF BREACH

ENFORCE SUPPLIER 1 CIRCUMSTANCE 1

Terminal 5 Buildings
Page 34
Design Progress Report
 SUPPLIER INVOLVEMENT (NAME) CIRCUMSTANCES OF BREACH

ENFORCE SUPPLIER 1 CIRCUMSTANCE 1

Terminal 5 Buildings
Page 35
Design Progress Report
 <<
Historic Scorecard Values
► MINOR AMENDMENTS CAN BE DONE HERE

DATE OVERALL INPUTS OUTPUTS INPUT 1 INPUT 2 INPUT 3 INPUT 4 INPUT 5 INPUT 6 OUTPUT 7 OUTPUT 8 OUTPUT 9
17-06-05 96 % 66 % 30 % 16 14 10 6 14 6 8 10 12
20-05-05
22-04-05

17-06-05 96 % 66 % 30 % 16 14 10 6 14 6 8 10 12
20-05-05
22-04-05

Terminal 5 Buildings
Page 36
Design Progress Report
DATA A DATA B DATA C DATA D DATA E DATA F DATA G DATA H DATA I
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
DATA J DATA K DATA L DATA M DATA O
DATA A DATA B DATA C DATA D DATE E
01

02

03

04

05

06
DATA F
DATA A DATA B DATA C
01

02

03

04
DATA D DATA E