Doc No.

AP/SFT/410/DSR-PM

ADVENT PROJECTS & CONSULTANCY SERVICES PVT. LTD.

Rev 01
DAILY SAFETY REPORT TO PM

Site Name : Date & Time:

Name of Project Engineer: Name of Safety Officer:

Report by : Report to :

Yesterday’s report:

A – SAFETY TRAININGS B – MANPOWER ON SITE

No. of person Inducted (staff and
No. of workmen (contractor )
worker) Contractor
No. of person Inducted (staff and
No. of Staff (contractor )
worker) PMC/Client
Total no. of inducted No. of Staff ( Client /PMC)
Job Specific Training / No. of
Total no. of Manpower on site
Participant
Mass Training if any

C – ACCIDENT / INCIDENT D – WORK PERMIT ISSUED

No. of Near Miss General Work (A Bldg. + B Bldg.)
No. of First-Aid Height Work (A Bldg. + B Bldg.)
No. of Minor Accident Hot Work (A Bldg. + B Bldg.)
No. of Major Accident / Dangerous
Night Work (A Bldg. + B Bldg.)
Occurrence
Persons Hospitalised Electrical Work (A Bldg. + B Bldg.)
Name of Persons Hospitalised Excavation Work (A Bldg. + B Bldg.)
Confined space Work (A Bldg. + B
1)
Bldg.)
2)

E – HAZARDS OBSERVATION
No. of Hazards Observed
No. of Hazards Closed
No. of Hazards Pending for Closing

Open
Open
Sr. Hazards Responsible
Description of Hazard / Remarks
No. closed Persons
Close
on

Advent Projects and Consultancy services Pvt. Ltd. Pune|India

 Doc No. AP/SFT/410/DSR-PM

ADVENT PROJECTS & CONSULTANCY SERVICES PVT. LTD.

Rev 01
DAILY SAFETY REPORT TO PM

Today’s report (up to 10:30 AM):

Name Responsible Persons

Sr.
Description of Work & Start Time Location of Work (supervisor/Engineer/ Remarks
No.
Permit safety officer)

F – MANPOWER ON SITE G – WORK PERMIT ISSUED

No. of workmen (contractor )
No. of Staff (contractor )
No. of Staff ( Client /PMC)
Total no. of Manpower on site
Recommendation if any,
General Work (A Bldg. + B Bldg.)
Height Work (A Bldg. + B Bldg.)
Hot Work (A Bldg. + B Bldg.)
Night Work (A Bldg. + B Bldg.)
Electrical Work (A Bldg. + B Bldg.)
Excavation Work (A Bldg. + B Bldg.)
Confined space Work (A Bldg. + B
Bldg.)

Prepared by Checked & Report by

Signature Signature

Advent Projects and Consultancy services Pvt. Ltd. Pune|India