LOCATION: PILE NUMBER &DIAMETER: DATE: Time: AM/PM Valid Upto: AM/PM Validity Max 12hrs S.NO DESCRIPTION YES NO NA REMARKS I PILING RIG DETAILS 1 Is Valid green card available for Rig/Vehicle 2 Is Rig Machine tested by competent person & validity of certificate 3 Is rope condition good 4 Is engine condition good 5 Is hydraulic system condition satisfactory 6 Are provided Guards/ Doors/ Swinging alarm/ Light/ Warning devices 7 Are available Fire Extinguisher& first-Aid box in the cabin 8 Is available maintenance details for rig machine 9 Are ASLI and other Display in working condition II OPERATOR& OTHER COMPETENT PERSON DETAILS 1 Is rig machine operator competent 2 Is having fitness of operator 3 Is followed all the precautions (Daily Checklist, Cleaning etc.,) 4 Is Competent Rigger/Signalman available at Site 5 Is Traffic Marshal/Banksman available at site for monitoring the vehicle reversing/ In & Out III PILING DETAILS 1 Is pile location free from Overhead power lines (If available Pl mentioned the distance and any precautionary measures taken) 2 Is pile location free from underground utilities (If available Pl mentioned utility & its distance and any precautionary measures taken)) 3 Is rig M/C swing area barricaded and free from personnel movement 4 Is stable ground condition of rig machine (Bitumen/PQC/MS Plate etc.,) 5 Does available manhole protect with hard barricade and covered by mesh with adequate strength 6 Are materials stacking away from the bore hole 7 Is tag line used properly while handling of cage 8 Is safe Access available to reach work spot 9 Are Collection pit and bund wall arrangements made before starting the piling to prevent the slurry leakages into the public road 10 Are arrangements made available for muck disposal 11 Is Adequate Illumination available at work spot DESIGANTION SITE INCHARGE P&M INCHARGE SAFETY INCHARGE SIGNATURE