UNITED INDUSTRIAL SERVICES CO.

LLC

HSE INSPECTION - WORK SHOP

Date:- Location: Workshop area

Inspection done by :-
Activities under Progress :- Welding, Cutting, Fabrication, Blasting and painting.

Sl. Write Yes/No/ Incase of No. write Corrective Action

Description
No. Not Applicable Required

1.0 Tool Box Meeting

Is tool box meeting conducted based on Hazards involved with
1.1
the job and record maintained?
2.0 Personnel
2.1 Have personnel attend Induction program before joining the
work?
2.2 Are personnel attend the Safety training program?
3.0 Vehicle, Equipment & Lifting Appliance

3.1 Do Vehicles and equipments are in good condition?

3.2 Are lifting appliances have valid inspection certificate?
3.3 Are trained riggers for shifting of material and equipment?

4.0 Drivers & Operators

4.1 Are drivers and operators in possession of valid ROP driving

license, for the type of vehicle/equipment being operated?

4.2 Are drivers and operators trained in use of fire extinguishers?

5.0 First Aid

5.1 Are trained First Aiders at whole working time?
5.2 Duly filled first aid box available at work shop?

6.0 Small Tools

6.1 Are portable power tools in good condition and checked?
6.2 Are hand tools in good condition and checked?
7.0 Electric Cables
7.1 Are Electric cables and joints in good condition?
7.2 Are ELCB Checked Weekly and record maintained?
8.0 Working at Height
8.1 Adequate ladder are used to provide safe access to all part of any
work situated 1.5M or move above ground level?
8.2 Is Safety Harness used while working at height greater than 2 M?

9.0 Personal Protective Equipment

9.1 Are adequate personal protective equipment available at Work
shop?
9.2 Are all personal trained in the use of PPE and wearing all PPE
required for the activity?
9.3 Are personal protective equipment checked and record
maintained?
10.0 Fire Fighting
10.1 Are Suitable fire extinguishers having valid inspection stickers
available on the Work shop & Office?
10.2 Are personnel aware of operation of the fire extinguishers?

UNISCO[F]HSE-18 REV-00 01/06/14

 UNITED INDUSTRIAL SERVICES CO.LLC

HSE INSPECTION - WORK SHOP

Date:- Location: Workshop area

Inspection done by :-
Activities under Progress :- Welding, Cutting, Fabrication, Blasting and painting.

Sl. Write Yes/No/ Incase of No. write Corrective Action

Description
No. Not Applicable Required

Is fire pump in good condition and to take auto start incase of

10.3 fire?
11.0 Warning Sign Display
11.1 Are appropriate Notices/Warning signs displayed ?
12.0 House Keeping
12.1 Is housekeeping at workshop, maintained properly?
12.2 Is suitable arrangement for waste collection available?
13.0 Emergency Response
13.1 Are personal aware of emergency telephone numbers and action
to be taken in case of emergency ?
13.2 Is safe access and exit in case of emergency available?
13.3 Are Assembly points clearly located and identified.
14.0 General
14.1 Are Supervisors & Foremen aware of HSE plan?
14.2 Are Noise at work shop under acceptable limits and suitable
protective devices provided ?
15.0 Any other Unsafe condition/Act noticed?
If yes, please write correct action.

Inspected By :

Name : Signature :

Designation : Date :

Reviewed by :

Name : Signature:
Designation : Date:

UNISCO[F]HSE-18 REV-00 01/06/14

 UNITED INDUSTRIAL SERVICES CO.LLC

HSE INSPECTION - SITE

Date:- Location:
Inspection done by :-
Activities under Progress :-

Sl. Write Yes/No/ Incase of No. write Corrective Action

Description
No. Not Applicable Required

1.0 Tool Box Meeting

Is tool box meeting conducted based on Hazards involved with the
1.1
job and record maintained?
2.0 Personnel
2.1 Have personnel attend Induction program before joining the work?

2.2 Are personnel attend the Safety training program?

3.0 Vehicle, Equipment & Lifting Appliance

3.1 Do Vehicles and equipments are in good condition?

3.2 Are lifting appliances have valid inspection certificate?
3.3 Are trained riggers for shifting of material and equipment?

4.0 Drivers & Operators

4.1 Are drivers and operators in possession of valid ROP driving

license, for the type of vehicle/equipment being operated?

4.2 Are drivers and operators trained in use of fire extinguishers?

5.0 First Aid

5.1 Are trained First Aiders are avail?
5.2 Duly filled first aid box available at site?

6.0 Small Tools

6.1 Are portable power tools in good condition and checked?

6.2 Are hand tools in good condition and checked?
7.0 Electric Cables
7.1 Are Electric cables and joints in good condition?
7.2 Are ELCB Checked Weekly and record maintained?
8.0 Working at Height
8.1 Adequate ladder are used to provide safe access to all part of any
work situated 1.5M or move above ground level?
8.2 Is Safety Harness used while working at height greater than 2 M?

9.0 Personal Protective Equipment

9.1 Are adequate personal protective equipment available at Work
shop?
9.2 Are all personal trained in the use of PPE and wearing all PPE
required for the activity?
9.3 Are personal protective equipment checked and record maintained?

10.0 Fire Fighting

10.1 Are Suitable fire extinguishers having valid inspection stickers
available on the site & Office?
10.2 Are personnel aware of operation of the fire extinguishers?

UNISCO[PF]HSE-09 REV-00 15/07/16

 UNITED INDUSTRIAL SERVICES CO.LLC

HSE INSPECTION - SITE

Date:- Location:
Inspection done by :-
Activities under Progress :-

Sl. Write Yes/No/ Incase of No. write Corrective Action

Description
No. Not Applicable Required

11.0 Warning Sign Display

11.1 Are appropriate Notices/Warning signs displayed ?
12.0 House Keeping
12.1 Is housekeeping at site, maintained properly?
12.2 Is suitable arrangement for waste collection available?
13.0 Emergency Response
13.1 Are personal aware of emergency telephone numbers and action to
be taken in case of emergency ?
13.2 Is safe access and exit in case of emergency available?
13.3 Are Assembly points clearly located and identified.
14.0 General
14.1 Are Supervisors & Foremen aware of site HSE plan?
14.2 Are Noise at site under acceptable limits and suitable protective
devices provided ?
15.0 Any other Unsafe condition/Act noticed?
If yes, please write correct action.

Inspected By :

Name : Signature :

Designation : Date :

Reviewed by :

Name : Signature:
Designation : Date:

UNISCO[PF]HSE-09 REV-00 15/07/16