SAFETY DEPARTMENT

REQUEST FOR INSPECTION

Department Head
Subcontractor

Date

Time

Location

Equipment to be inspected

Requester Inspected / Approved By Acknowledge By

Participant
H.O.D, Subcontractor Maintenance Depart. Safety Depart.

Name

Signature

Date

Inspection Results :

Inspection passed – Machine allowed to use.

Inspection Failed – Machine was rejected & not allows using.

Inspection accepted – Machine allowed using but comments need to be rectified & comply.

Date Line - From ______________ until ________________ (Close date : _________ )

Remarks / Comments:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

* Please attach copies of :-

a. PMA / PMT e. Safety Construction Certificate

b. Competency Certificate f. Insurance Certificate
c. Certificate of Registry g. Others
d. Crew List

* Whichever applicable

Fr ,Rev 0,01.02.2009
 SAFETY DEPARTMENT YNESB/OSHEF/03

DAILY PLANT SAFETY INSPECTION CHECKLIST

S.No Description Yes No N.A
01 Foremen on job area
02 All employees wearing proper eye/head protection?
03 All wearing hearing protection where necessary?
04 All wearing protective clothing where necessary.
05 All wearing respiratory protection where necessary?
06 All wearing adequate safety shoes/gloves?
07 All overhead workers using safety belts? Line? If required?
08 Is proper permit at job site attained?
09 All provisions on permit satisfied?
10 All hot work/entry permits as required?
11 Is fire watchman on duty alert & knowledgeable of duty?
12 Equipment properly locked out /tagged out?
13 Electrical connections/cords, proper twist lock connections?
14 Welding machines, sand blusters etc properly grounded?
15 All necessary blind installed/blind list ok?
16 Has shoring been done as necessary?
17 Have underground drawing been checked for safe excavation?
18 Roads properly blocked if necessary?
19 Scaffolding properly installed?
20 Ladders properly used?
21 Tools properly used?
22 Proper lifting method s/material handling?
23 Proper/approved lighting in use?
24 Retainer pin or air hose/tools connections?
25 Hose reels or hoses used properly?
26 Compressed gas cylinders secured upright?
27 Good house keeping
28 Special warning posted if necessary
29 Labels affixed to chemical container.

Other Items /Comments

Supervisor : _________________ Safety Officer : _________________

Name : _________________ Name : _________________

Date : _________________ Date : _________________

Signature : _________________ Signature : _________________

SAFETY DEPARTMENT YESB/OSHEF/04/01

Fr ,Rev 0,01.02.2009
LOCATION: WEEKLY PLANT INSPECTION CHECKLIST

Items Inspected Tick Remark Items Inspected Tick Remark

Yes No 2.Hazardous Material Yes No
1. Housekeeping a. MSDS Available
a. Access b. Register Available
b. Stairways c. Signboards Posted
c. Signs d. Proper Storage
d. Lighting e. Labeling
e. Waste Disposal g. Fire Protection

3. PPE 4. Work At Height

a. Safety Helmet a. Working Platform
b. Safety Boots b. Safety harness
c. Eye Protection c. Lifeline
d. Ear Protection d. Tools Secured
e. Gloves e. Barricade area below
f. Overall/Apron f. Fall Arrest Equipment
g. Filter/Dust mask g. Access

5. Lifting Activity 6. Confined Space

a. Crane a. Permit Obtained
b. Lift Permit/Prelift Check b. Gas Test Done
c. Barricade/Signs c. Standby Person
d. Signalman d. Proper Ventilation
e. Taglines e. Lifeline
g. Vehicle Entry Permit g. Explosion-proof
Lights
h. Supervision h. BA (if necessary)

7. Equipments (W/Set, 8. Work Areas

Generator, Compressor) a. Housekeeping
a. Guards b. Ladders/Platforms
b. Emergency Stop c. Hand Tools
c. Fire Extinguisher d. Obstruction
d. Oil Leaks e. Access
e. PMT f. Floor Opening
f. Earthing g. Overhead Works
g. Leads/Cables h. Emergency Exits
h. Oil/Fuel/Radiator Cap

9. Electrical
a. ELCB Functional
b. Industrial Cable
c. Proper Connections
d. Correct Plugs
e. BD Condition
f. Cable Management

SAFETY DEPARTMENT YNESB/OSHEF/04/02

LOCATION: WEEKLY PLANT INSPECTION CHECKLIST

Fr ,Rev 0,01.02.2009
 Items Inspected Tick Comments Items Inspected Tick Comments
Yes No Yes No

11.Weld/Cut/Grind 12.Scaffolding
a. Cylinder Secured a. Tagging Available
b. Flash-back Arrestor b. Access
c. Regulator/Hose/Torch c. Walkways
d. Fire Extinguisher d. Working Platforms
e. Hand Tools e. Handrails/Guardrails
f. PPE f. Toe-boards
g. Hot Work Permit g. Tie-back/Bracing
h. Housekeeping h. Ground Condition

13.Machinery 14.Fire Equipment

a. Inspection Certificate a. Extinguisher(type/qty)
b. Noise b. Hydrant/Hose/Nozzle
c. Oil Leakage c. Smoke/Heat Detector
d. Smoke Emission d. Suppression System

15.First Aid 16.Hygiene/Welfare

a. First Aid Box a. Toilet Facilities
b. Signage b. Drinking Water
c. Adequate Stock c. Canteen
d. Readily Accessible d. Garbage Disposal
e. Housekeeping
17.Radiography f. Rest Area/Surau
a. Area Barricaded
b. Warning Lights
c. Worker Competency
d. Storage of Isotape
e. Work Permit

Audit Conducted by :

1.
2.
NAME DESIGNATION SIGNATURE / DATE

Audit Attend by : Contractor/ H.O.D

1.
2.
3.
4.
5.
6.
NAME DESIGNATION SIGNATURE / DATE

SAFETY DEPARTMENT YNESB/OSHEF/05

CRANE / SKY LIFT INSPECTION CHECKLIST (INITIAL / QUARTERLY)
Contractor Crane Inspection
Operator Date

Fr ,Rev 0,01.02.2009
Crane Type Crane No. Rated Capacity
DOSH Reg. No. PMA No PMA Expiry
S/No Item Description Tick Remarks
Yes No
1 Tires in good condition and inflated
2 All wheels off the ground
3 Oil leakages
4 Lifting/Rigging equipments acceptable
5 Horn/buzzer/hazard lights functional
6 Valid Road Tax/ Insurance
7 Lights/signals in working condition
8 Any damage to wire ropes
9 Operator registered with DOSH
10 Valid PMA
11 Fire extinguisher available
12 Load chart available
13 Any welds/visible cracks on the boom
14 Outriggers fully extended and pads available
15 Noise/smoke level acceptable
16 Extension jib safely secured
17 Height limit alarm functioning
18 Hoist brakes functioning
19 View from operator cabin not restricted
20 Boom angle indicator accurate
21 Lifting blocks/hooks in good condition
22 Safety latches in good condition
23 Barricades and signs installed
24 Taglines available
25 Signalman available
26 Operator/Signalman familiar with signals
27 Crane crew safety briefed

Attached are true copies of:-

Valid PMA Load Chart

Operator’s Competency Cert. (DOSH/JPJ License) Road / Insurance Tag Reg.

Inspection Result : PASSED FAILED

ACCEPTED WITH COMMENT DATE LINE: …………

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

CRANE SUPPLIER SAFETY OFFICER YARD MANGER

SAFETY DEPARTMENT YNESB/OSHEF/06

CRANE / SKY LIFT INSPECTION DAILY CHECKLIST
Contractor Crane Inspection
Operator Date

Fr ,Rev 0,01.02.2009
Crane Type Crane Rated
No. Capacity
DOSH Reg. PMA No PMA
No. Expiry
S/No Item Description Tick Remarks
Yes No
1 Tires in good condition and inflated
2 All wheels off the ground
3 Oil leakages
4 Lifting/Rigging equipments acceptable
5 Horn/buzzer/hazard lights functional
6 Valid Road Tax/ Insurance
7 Lights/signals in working condition
8 Any damage to wire ropes
9 Operator registered with DOSH
10 Valid PMA
11 Fire extinguisher available
12 Load chart available
13 Any visible cracks on the boom
14 Outriggers fully extended and pads
available
15 Noise/smoke level acceptable
16 Extension jib safely secured
17 Height limit alarm functioning
18 Hoist brakes functioning
19 View from operator cabin not restricted
20 Boom angle indicator accurate
21 Lifting blocks/hooks in good condition
22 Safety latches in good condition
23 Barricades and signs installed
24 Taglines available
25 Signalman available
26 Operator/Signalman familiar with signals
27 Crane crew safety briefed

Remark :

SAFETY DEPARTMENT YNESB/OSHED/07

Date : ___________
DAILY WELDING & CUTING MACHINE CHECKLIST

NO DESCRIPTION YES NO N/A REMARKS

1 STARTER & WIRING SYSTEM IN GOOD CONDITION

Fr ,Rev 0,01.02.2009
2 GAS HOSES AND COUPLING IN GOOD CONDITION
3 FIRE EXTINGUISHER IN PLACE
4 FREE FROM COMBUSTIBLE MATERIAL
5 WELDING MACHINE INSPECTED
6 IS THE MACHINE EARTHED
7 IS THE GAS CYLINDER UPRIGHT AND SECURED
8 IS FLASH-BACK ARRESTOR AVAILABLE
9 RESPONSIBLE PERSON FOR THE INSPECTION OF
WELDING MACHINE AND EARTHING :
NAME:____________________
____
DESIGNATION:_____________
____
10 ARE THESE PPE PROVIDED:
SAFETY GLASSES
FACE SHIELD
GLOVES
11 ARE THE HAND TOOLS IN GOOD CONDITION
12 ARE THE ELECTRICAL CONNECTIONS SAFE
13 ARE THE LEADS / CABLES IN GOOD CONDITION AND
PLACED OVEREAD
14 ARE SCREENS IN PLACE
16 CUT OFFS REMOVED AND PLACED IN DRUMS
17 HOUSEKEEPING ACCEPTABLE
18 IS COMPLETED AND APPROVED JSA AVAILABLE
REMARKS

Responsible Person On site :

_______________ _________________________ ___________

Name Signature Date

SAFETY DEPARTMENT YNESB/OSHEF/08

Date : ___________
QUARTERLY WELDING & CUTING MACHINE CHECKLIST

NO DESCRIPTION YES NO N/A REMARKS

1 STARTER & WIRING SYSTEM IN GOOD CONDITION
2 GAS HOSES AND COUPLING IN GOOD CONDITION
3 FIRE EXTINGUISHER IN PLACE

Fr ,Rev 0,01.02.2009
4 FREE FROM COMBUSTIBLE MATERIAL
5 WELDING MACHINE INSPECTED
6 IS THE MACHINE EARTHED
7 IS THE GAS CYLINDER UPRIGHT AND SECURED
8 IS FLASH-BACK ARRESTOR AVAILABLE
9 RESPONSIBLE PERSON FOR THE INSPECTION OF WELDING
MACHINE AND EARTHING :
NAME:________________________
DESIGNATION:_________________
10 ARE THESE PPE PROVIDED:
SAFETY GLASSES
FACE SHIELD
GLOVES
11 ARE THE HAND TOOLS IN GOOD CONDITION
12 ARE THE ELECTRICAL CONNECTIONS SAFE
13 ARE THE LEADS / CABLES IN GOOD CONDITION AND PLACED
OVEREAD
14 ARE SCREENS IN PLACE
16 CUT OFFS REMOVED AND PLACED IN DRUMS
17 HOUSEKEEPING ACCEPTABLE
18 IS COMPLETED AND APPROVED JSA AVAILABLE
REMARKS

Checked by :
Area :
Name :
Responsible Person On site :
Signature :
Acknowledged By :

_______________ _________________________ ___________

Name Signature Date

SAFETY DEPARTMENT YNESB/OSHEF/09

Date: ____________
QUARTERLY CHECKLIST FOR LIFTING SLING, CHAIN AND WIRE ROPE

Statutory and licensed Non -statutory and licensed

equipment/machinery equipment/machinery
Location : Department/section
Colour code:
Inspected item Visual inspection Remarks

Fr ,Rev 0,01.02.2009
 Yes No N.A
a. Is lifting chain/sling/wire in good working order(visual check)?
b. Is safe working load clearly labeled on individual lifting
chain/sling/wire?
c. Is there a register to encompass all lifting chains/slings/wires?
d. Any signs of worn or frayed slings/wires?
e. Is standard operating procedure for using lifting
chains/slings/wires?
f. Is there clear access to retrieve or return lifting
chains/slings/wires?
g. Any signs of excessive corrosion on lifting chains/wires?
h. All fastening devices intact?
i. Is there any proper storage for lifting chains/slings/wires?
j. Is there a record a proper functional and load testing on lifting
chains/slings/wires?
k. Is there any signs of proper maintenance of lifting
chains/sling/wires?
l. Is there any sign-in or signed-out procedure of
retrieving/returning lifting chains/sling/wires?
m. Are lifting chain/slings/wires appropriate for their use?
Note : Responsible persons must record and maintain the monthly checklist for 24 months

Checked by :
Area :
Name :
Responsible Person On site :
Signature :
Acknowledged By :

_______________ _________________________ ___________

Name Signature Date

SAFETY DEPARTMENT YNESB/OSHEF/10

Date : ____________
DAILY CHECKLIST FOR LIFTING SLING, CHAIN AND WIRE ROPE

Statutory and licensed Non -statutory and licensed

equipment/machinery equipment/machinery
Location Department/section

Fr ,Rev 0,01.02.2009
 Inspected item Visual inspection Remarks

Yes No N.A
a. Is lifting chain/sling/wire in good working order(visual check)?
b. Is safe working load clearly labeled on individual lifting
chain/sling/wire?
c. Is there a register to encompass all lifting chains/slings/wires?
d. Any signs of worn or frayed slings/wires?
e. Is standard operating procedure for using lifting
chains/slings/wires?
f. Is there clear access to retrieve or return lifting
chains/slings/wires?
g. Any signs of excessive corrosion on lifting chains/wires?
h. All fastening devices intact?
i. Is there any proper storage for lifting chains/slings/wires?
j. Is there a record a proper functional and load testing on lifting
chains/slings/wires?
k. Is there any signs of proper maintenance of lifting
chains/sling/wires?
l. Is there any sign-in or signed-out procedure of
retrieving/returning lifting chains/sling/wires?
m. Are lifting chain/slings/wires appropriate for their use?
Note : Responsible persons must record and maintain the daily checklist for 24 months

Checked By :

_____________________ ___________________ __________________

Name Signature Date

BARBENDING,ROLLING & CUTTING MACHINE QUARTERLY INSPECTION CHECKLIST

Company : Type :
Supervisor : Model :
Date : Series No:
Inspection By : Tag No :
Next Inspection :

Fr ,Rev 0,01.02.2009
 Item Description Yes No N/A Remarks

1. Body & Engine Condition

2. Starter & Wiring System

3. Noise

4. Leakage of Oil

5. Radiator & Fuel Cap

6. Belting damage, safety guard

7. Emergency Stop Button

8. Any Modification

9. Rotating part guard & protected

10. Condition of bending & cutting machine

11. Condition of bending & cutting table

12. Surrounding area cleanliness & obstructed

13. Used by trained / competent workers

14. Necessary PPE provided

15. Operating manual provided

16. Manufacturing stickers

17. Series / model stickers

18. Material proper store

Company : Checked by :

Area : Name :

Responsible Person On site : Signature :

Acknowledged By :

_____________ _________________ ___________

Name Signature Date

SAFETY DEPARTMENT YNESB/OSHEF/12

BARBENDING, ROLLING & CUTTING MACHINE DAILY INSPECTION CHECKLIST
Company : Type :
Supervisor : Model :
Date : Series No:

Item Description Yes No N/A Remarks

Fr ,Rev 0,01.02.2009
1. Body & Engine Condition
2. Starter & Wiring System
3. Noise
4. Leakage of Oil
5. Radiator & Fuel Cap
6. Belting damage, safety guard
7. Emergency Stop Button
8. Any Modification
9. Rotating part guard & protected
10. Condition of bending & cutting machine
11. Condition of bending & cutting table
12. Surrounding area cleanliness & obstructed
13. Used by trained / competent workers
14. Necessary PPE provided
15. Operating manual provided
16. Manufacturing stickers
17. Series / model stickers
18. Material proper store

Checked By :

_____________________ ___________________ __________________

Name Signature Date

SAFETY DEPARTMENT YNESB/OSHEF/13

WRITTEN WARNING FOR SAFETY MISCONDUCT

REPORT NO : DATE :

NAME :

DESIGNATION:

Fr ,Rev 0,01.02.2009
 AFTER ISSUING VERBAL WARNING FOR CONTINUOS VIOLATION OF SAFETY
REGULATIONS, IT HAS BEEN DEEMED NECESSARY TO NOW ISSUE AN
OFFICIAL WRITTEN WARNING ANY FURTHER VIOLATIONS WILL RESULT IN
IMMEDIATE REMOVAL OF YOURSELF FROM SITE AND DISMISSAL FROM THE
COMPANY.

REASON FOR ISSUING OF WARNING.

SAFETY OFFICER :

YARD MANAGER :

EMPLOYEE :

SAFETY DEPARTMENT YNESB/OSHEF/14

NOTIFICATION OF OVERTIME AND REST DAY/PUBLIC HOLIDAY WORK
CONTRACTOR: DATE:
Fill the appropriate row

Overtime Works On : _____/_______/_______ Time : From_________To_________

Rest Day Works On : _____/_______/_______ Time : From_________ To_________

Public Holiday Works On : _____/_______/_______ Time : From _________To_________

Specific Location of Work Area : Supervisor in charge

Fr ,Rev 0,01.02.2009
Specific Work To Be Carried Out : No Of Persons

Signature
Contractor On Duty : ______________________ (Name) ________________

Contractor’s Safety Personnel On Duty : ______________________ (Name) ________________

Contractor’s Authorized Personnel : ______________________ (Name) ________________

Approved by
(YNESB PERSONALS) Signature

Production Manager : __________________________(Name) ________________

Safety officer : __________________________(Name) ________________

Safety Instructions:
# To standby vehicle for Emergency Use throughout the working duration

Note :
# Normal day overtime work notification to be submitted to OSHED by or before 1700 hours on the
intended working day
# Rest day/Public Holiday work notification to be submitted to OSHED one (1) day prior to the
intended working day

SAFETY DEPARTMENT YNESB/OSHEF/15

Date :
HEAVY LIFTING PERMIT
SECTION 1
DEPT/CONTRACTOR LOCATION DESCRIPTION OF WORK

SECTION 2
Item Description Purpose of Lift Special Work Instruction
A. Normal lift <6 metric tons
B. Lifting between 6-12metric tons
C. Critical lift exceeding 12 metric tons
(Attach sketch & capacity calculation)
D. Multiple crane lifting (wt..................

Fr ,Rev 0,01.02.2009
 E. Use of overhead crane (wt.................
F. Lifting over unprotected/live equipment
G. Removal or installation of equipment
H. Overhead lift (sling not made of wire rope)
I. Using more than 4 legged sling
J. Lifting inside confined space

Originator/User...................................Designation..............................................Signature........................................
Name of crane operator Signalman........................................... Signature......................................
SECTION 4 : WORKSITE PREPERATION
PRECAUTIONS Yes / No Initial by S’visor SLING SPECIFICATION
A. Valid PMA A. Sling test date
B. Crane inspected (safe for use) B. Sling Assy. SWL
C. Competent crane Operator / Signalman C. Load wt. (mt)
D. Rigging equipments in good condition D. Sling ID No
E. Load weight ascertained E. Size of wire rope
F. Ground condition firm and level (use G. Size of shackle
steel plates if reqd)
G. Pre-job meeting carried out H. Shackle SWL
H. Overhead obstruction/ services checked I. No of shackle used
SECTION 5 : PERMIT VALIDATION
Approved By : Lift Permit No: Date Time
Name Position From
Signature To
SECTION 6 : WORK COMPLETION / SUSPENSION
The work has been completed/suspended on..............................(date) at......................(hrs)
Reason for suspension (if any)....................................................................................................................................
...........................................................................................................................................................................................
................................

SAFETY DEPARTMENT YNESB/OSHEF/16

PERMIT TO WORK

Work Activity (delete Hot Work Lifting Work Repair/ Confined Space Blocking OTHERS
as applicable) Maintena Entry Access
nce
Machine

A. Application ( to be completed by H.O.D, Contractor, )

Requesting Request by Date
Dept/Cont
Plant Area Description of work (attach drawing / sketch as necessary)

Time Date To Time Date

Fr ,Rev 0,01.02.2009
 Permit is required
From:

B. Precautions to be taken prior to commencement and during the work (delete/add as appropriate)
Hot Work
Is Approved Method Statement and
Risk Assessment available
Area cleared of Flammable Waste
Fire Extinguisher available
Overhead work to have area below barricaded
Pipelines etc free of gas/liquid
Fire blanket provided to arrest spark / flame
Welding screens in use to protect others
Appropriate PPE available
Cylinders secured & flash-back arrestor fitted
Lifting Work Repair/Maintenance
No lifting machine shall be operated except Machine
by an authorized person. All lifting
equipment must be examined by the Is Approved Method Statement &
supervisor and operator before use. Protect Risk Assessment available,
wire rope or chain sling from sharp edges PPE available. Log In and Log Out
and corner with padding. The centre of sign display.
gravity for the load must be determined for
proper balancing of the load. The chain
opening angle shall not exceed 60%.Stay
clear from any suspended load.

C. REQUEST (PRODUCTION TEAM)

Permission is given for the work to proceed subject to the conditions specified above
Signed ( Permit Sign Print Date Time Company
Controller)

D. Performing Authority Acceptance (SAFETY PERSONAL)

I certify that I have read and understood this permit and that the work will be carried out in accordance with the requirements

Signed : Sign Print Date Time Company

E. Completion of work (PRODUCTION TEAM)

I hereby declare that all work for which this permit was issued has been complete, all personnel under my control have been withdrawn
and the work area and all associated equipment has been left in a safe condition.
Signed : Sign Print Date Time Company

F. Cancellation (SAFETY PERSONAL)

This permit is cancelled
Signed : Sign Print Date Time Company

SAFETY DEPARTMENT YNESB/OSHEF/17

ELECTRICAL TOOLS / EQUIPMENT QUATERLY INSPECTION CHECKLIST
Company : Type :
Supervisor : Model :
Date : Series No:
Inspection By : Tag No :
Next Inspection :
Item Description Yes No N/A Remarks

B 1. Casing – damage / crack

O
D 2. Handle – installed securely
Y
3. Handle – damage / crack
P

Fr ,Rev 0,01.02.2009
 A 4. Switch – damage / no function
R
T 5. Trigger lock – faulty / damage

6. Main dead switch – faulty / damage

7.Power cord defect – cracking / frying

8. On / Off switch – faulty / damage

9. Guardrail / shield / hazard part protection provided

C 10. Damages of wire

A
B 11. Proper Connection
L
E 12. Earth, properly grounded
/
W 13. Plug – crack, loose, missing
I
R 14. Use 3 prong plug (faulty prongs)
E
15. Check earth leakage
/
P 16. Broken wire insulated
L
U
17. Wire cable / quality
G
O 18. Used by trained / competent workers
T
H 19. Necessary PPE provided
E
R 20. Operating manual provided
S
21. Manufacturing stickers

22. Series / model stickers

23. Proper store

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

MAINTENANCE/ FACILITY DEPT. SAFETY PERSONAL STOR SUPERVISOR

SAFETY DEPARTMENT YNESB/OSHEF/18

ELECTRICAL TOOLS / EQUIPMENT DAILY INSPECTION CHECKLIST
Company : Type :
Supervisor : Model :
Date : Series No:
Inspection By : Tag No :
Next Inspection :
Item Description Yes No N/A Remarks

B 1. Casing – damage / crack

O
D 2. Handle – installed securely
Y
3. Handle – damage / crack
P
A
R 4. Switch – damage / no function

Fr ,Rev 0,01.02.2009
 T 5. Trigger lock – faulty / damage

6. Main dead switch – faulty / damage

7.Power cord defect – cracking / frying

8. On / Off switch – faulty / damage

9. Guardrail / shield / hazard part protection provided

C 10. Damages of wire

A
B 11. Proper Connection
L
E 12. Earth, properly grounded
/
W 13. Plug – crack, loose, missing
I
R 14. Use 3 prong plug (faulty prongs)
E
15. Check earth leakage
/
P 16. Broken wire insulated
L
U
17. Wire cable / quality
G
O 18. Used by trained / competent workers
T
H 19. Necessary PPE provided
E
R 20. Operating manual provided
S
21. Manufacturing stickers

22. Series / model stickers

23. Proper store

Checked By :

_______________________________
Name/

SAFETY DEPARTMENT YNESB/OSHEF/19

GROUND EQUIPMENT INSPECTION CHECKLIST(INITIAL/ QUARTERLY)
Signature/ Date

( GENERATOR, WELDING MACHINE, AIR COMPRESSOR, ETC)

Fr ,Rev 0,01.02.2009
Company : Type of Inspection : INITIAL / QUARTERLY / RENEWAL
Type of Equipment :
Serial / Equipment No : Inspection Certificate No.:
PMT No.(air compressor) :
Expiry Date : Expiry Date :
Item Description Yes No N/A Remarks

A. Is wiring in good condition

B. Is insulation in good condition

C. Is information plate visible

D. Is ELCB in good condition

E. Is safety guard in place

F. Is radiator cap fired

G. Is fuel cap fitted

H. Is exhaust spark arrestor fitted

I. Is air induction control valve fitted

J. Is drive belt cover fitted

K. Is there any evidence of fuel leakage

L. Are pressure regulators in good condition

M. Are gauges in good condition

N. Are the leads and hoses in good condition

P. Is Emergency Stop button available and

clearly marked
Q. Is earthling system available

R. Is equipment fitted with fire extinguisher

S. Is copy of PMT displayed on the equipment

NAME & SIGNATURE NAME & SIGNATURE NAME &SIGNATURE

MAINTENANCE SUPERVISOR SAFETY PERSONAL STOR SUPERVISOR

GROUND EQUIPMENT DAILY INSPECTION CHECKLIST

Fr ,Rev 0,01.02.2009
Company : Type of Equipment :
Serial / Equipment No : Inspection Certificate No.:
PMT No.(air compressor) :
Expiry Date : Expiry Date :
Item Description Yes No N/A Remarks

A. Is wiring in good condition

B. Is insulation in good condition

C. Is information plate visible

D. Is ELCB in good condition

E. Is safety guard in place

F. Is radiator cap fired

G. Is fuel cap fitted

H. Is exhaust spark arrestor fitted

I. Is air induction control valve fitted

J. Is drive belt cover fitted

K. Is there any evidence of fuel leakage

L. Are pressure regulators in good condition

M. Are gauges in good condition

N. Are the leads and hoses in good condition

P. Is Emergency Stop button available and

clearly marked
Q. Is earthling system available

R. Is equipment fitted with fire extinguisher

S. Is copy of PMT displayed on the equipment

( GENERATOR, WELDING MACHINE, AIR COMPRESSOR, ETC)

NAME POSITION SIGNATURE / DATE

SAFETY DEPARTMENT YNESB/OSHEF/21

MONTHLY CHECKLIST - FIRE EXTINGUISHERS

Statutory and licensed Non -statutory and licensed

equipment/machinery equipment/machinery
Location Department/section

Fr ,Rev 0,01.02.2009
 Visual inspection and
Inspected item functional test Remarks
Yes No N.A
Is fire extinguisher conspicuously located?
.Is there any proper space demarcation for fire extinguisher.
Is trigger pin intact?
Is wire seal of fire extinguisher unbroken?
Is standard operating procedure for using fire extinguisher
displayed?
Is there clear access to fire extinguisher?
Is discharge hose and horn in good working condition and
free from cracks and surface grazing?
Is pressure indication gauge within the green zone?
Is the body of fire extinguisher free from corrosion?
Is the fire extinguisher close to hazard area (i.e 1.5 m apart
at high fire hazard area)
Is the fire extinguisher affixed with approved labels?
Is the fire extinguisher inspected by licensed fire
extinguisher contractor annually?
Is the fire extinguisher appropriate for the area served?
Note :
Responsible persons must record and maintain the monthly checklist for 36 months

Inspected By :

NAME POSITION SIGNATURE / DATE

SAFETY DEPARTMENT YNESB/OSHEF/22

QUATERLY CHECKLIST - EXIT LIGHTS

Statutory and licensed Non -statutory and licensed

equipment/machinery equipment/machinery
Location Department/section

Inspected by Date of inspection

Fr ,Rev 0,01.02.2009
 Area manager in-charge Reviewed by and date

Visual inspection and

Inspected item functional test Remarks

Yes No N.A
a. Batteries of exit lights properly charged
b. Exit lights are ‘No’ when conducting inspection.
c. Light bulbs are intact and working order.
d. Supplementary electricity supply to exit lights is intact and
normal.
e. Any signs of missing or damaged hardware, such as,
wires, screws and lamps.
f. Any sign of obstruction to lamps.
g. Any signs of worn or frayed cables.
h. Any sign of improper support to exit lights
i. Any inventory of all exit lights in the facility.
j. Any obstruction to gain access to exits?
Note :
Responsible persons must record and maintain the quarterly checklist for 36 months

Inspected By :

NAME POSITION SIGNATURE / DATE

SAFETY DEPARTMENT YNESB/OSHEF/23

QUATERLY CHECKLIST - FIRE DOORS

Statutory and licensed Non -statutory and licensed

equipment/machinery equipment/machinery
Location Department/section

Inspected item Visual inspection Remarks

Yes No N.A
a. Are fire doors conspicuously located?
b. Is there any proper space demarcation for fire doors?
c. Are rivets, bolts or screw intact?

Fr ,Rev 0,01.02.2009
 d. Are wires (Connected to counter weights)disconnected or
broken?
e. Are warning sign “Not to damage fire door “ printed on fire
doors?
f. Are fusible links intact?
g. Is there any signs of cracks or dents on fire doors?
h. Is there any “ fire rating” sign on fire doors?
i. Are fire doors free from oil and grease?
j. Is any standard operating procedure on operating fire door
displayed near the affected area?
k. Is there an inventory of all fire doors?
l. Are fire doors free from obstruction?
m. Is fire door/fire shutter closed completely during functional
testing?
n. Is there any warning signal or audio alarm associated with fire
door/fire shutter when there is an activation?

Note :
Responsible persons must record and maintain the monthly checklist for 24 months

Inspected By :

NAME POSITION SIGNATURE / DATE

SAFETY DEPARTMENT YNESB/OSHEF/24

QUARTERLY CHECKLIST - MAIN SPRINKLER CONTROL AND HYDRANT

Statutory and licensed Non -statutory and licensed

equipment/machinery equipment/machinery
Location Department/section

Inspected item Visual inspection Remarks

Yes No N.A
Are fire sprinkler control valve/hydrant isolation valves
conspicuously located?
Is there any proper space demarcation by hydrant isolation
valve?

Fr ,Rev 0,01.02.2009
Is there a proper means of securing the main fire sprinkler
control valves?(i.e straps & locks)
Are straps and locks of sprinkler control valve intact.
Is wire seal if hydrant isolation valve unbroken?
Is there any standard operating procedure and drawing of
operating sprinkler control valve intact.
Is there clear access to sprinkler control valves.
Are local alarms /bells of deluge control valve of sprinkler
system in good working condition order and free from cracks
of surface glazing
Are pressure indication gauges and in good working
conditions?
Is there any ‘open or shut’ indicator for hydrant isolation
valve?
Is the body of sprinkler control valve or deluge valve free from
corrosion?
Are fastening bolts, nuts or gaskets for sprinkler control valve
or deluge valve intact and in good working conditions?
Are there signs of leaks of sprinkler valves/deluge
valve/hydrant isolation valves?
Is there an inventory of sprinkler control valves deluge
valves/hydrant isolation valves?
Note :
Responsible persons must record and maintain the monthly checklist for 24 months
Inspected By :

NAME POSITION SIGNATURE / DATE

SAFETY DEPARTMENT YNESB/OSHEF/25

Rules and Regulations

1. I have been instructed and understood the OSHE rules and regulations and
agree to abide by them.

2. I have been instructed and understood that if I have any questions or concerns
then I should consult with my immediate supervisor. If he is unable to give a
solution then I have a right to seek higher assistance from the Safety Personals.

Fr ,Rev 0,01.02.2009
 Name of employee : ______________________________________________

Designation: ______________________________________________

Project badge no.: ______________________________________________

NRIC/Passport No. ______________________________________________

Employee signature:_____________________________________________

Date inducted: _____________________________________________

SAFETY DEPARTMENT YNESB/OSHEF/26

WORKER PARTICULAR

Company :________________________________________

Date :________________________________________

Post :________________________________________

Name Of Employee :________________________________________

I/C No. :________________________________________

(To be contacted during emergency)

Next Of Kin :___________________________________________

Address :___________________________________________

____________________________________________

Fr ,Rev 0,01.02.2009
Tel No. : ____________________________________________

H/P No. :_____________________________________________

I have been given the following P.P.E.

Safety Helmet

Safety Shoe

Safety Goggles

Gloves

Dust Mask

Welding Shield

Grinding shiled

Incase any accident happen and being traced me not wearing the above P.P.E
Provided to me than I shall not to blame the company as it will be considered as my own carelessness.

Employee Signature

* I/C or Passport photocopy attached

________________________

SAFETY DEPARTMENT YNESB/OSHEF/27

MEDICAL HISTORY

_________________________________ __________________
NAME IC/Passport No.

__________________________ _______________ MALE / FEMALE

D.O.B AGE

EMERGENCY CONTACT : ___________________________________________________

NAME PHONE#

Fr ,Rev 0,01.02.2009
 ALLERGIES: ___________________________________________________________________________

________________________________________________________________________________________

PAST MEDICAL HISTORY (ie,HEART,LUNG,LIVER , ETC.:APPENDECTOMY,

TONSILECTOMY, HYSTERECTOMY, ETC. )
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

MEDICATIONS TAKEN
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

IF NOT TAKING ANY MEDICATION OR DO NOT HAVE A PAST MEDICAL HISTORY NOT
ALLERGIES, PLEASE WRITE IN N/A.

ALL MEDICAL INFORMATION WILL BE CONFIDENTIAL.

THIS IS TO BENEFIT YOU IN CASE OF AN EMERGENCY INJURY OR ILLNESS.

SAFETY DEPARTMENT YNESB/OSHEF/28

BOOKING LIST FOR OSHE INDUCTION

Contractor Name : ___________________

Induction Date Booked : ___________________ Time Booked : __________________

Remarks
S/N Name Passport/IC No. Designation
Absent Present
1
2
3
4
5
6
7
8
9

Fr ,Rev 0,01.02.2009
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Total For This Page :

Verified By Submitted By Received By

Name / Signature / Date Name / Signature / Date Name / Signature / Date

SAFETY DEPARTMENT YNESB/OSHEF/29

WARNING FOR SAFETY VOILENCE

1ST WARNING
2ND WARNING
3RD WARNING
NAME : _______________________________________

CONTRACTOR: _______________________________________

PLACE: _____________ DATE: _____________ TIME: _____________

VOILENCE : ______________________________________________________________

______________________________________________________________

______________________________________________________________

FEATHER ACTION : ______________________________________________________________

TAKEN
______________________________________________________________

Fr ,Rev 0,01.02.2009
DEMIRIT POINTS:

ACCUMULETE DEMIT POINTS:

GIVEN BY:-

NAMA :____________________________________________

SIGNATURE:_____________________________________________

RECEVED BY:-

NAME : ___________________________________________________

EMP. NO : ___________________________________________________

DESIGNATION: _______________________________________________

SIGNATURE: _____________________________

DATE : _____________________________

Cc: Mr. M.S.Han – Senior Manager

Mr. Yusufirashim - Admin& HR Manager
Mr. Samuel Wong –Yard Manager
Sub- Contactor
• Picture as attached

SYSTEM DEMERIT
The demerit system provides penalties and disqualification for staff and
workers who contravene safety rules within a three (3) month period.

1. PERSONAL PROTECTIVE EQUIPMENT

1.1 Working without safety helmet 10
1.2 Working without safety shoe 10
1.3 Working without eye protection 10
1.4 Working without ear protection 10
1.5 Working without hand protection 10
1.6 Working without dust mask 10
1.7 Working without safety harness above 3 meters 30

2. UNSAFE ACTS AND CONDITION

2.1 Off all electrical equipment when not using 10
2.2 Absent from Tool Box Meeting 10
2.3 Close all gases valve when not using 10
2.4 Working without proper access 10
2.5 Poor house keeping 20

Fr ,Rev 0,01.02.2009
2.6 Eating / sleeping during working hours at workshop 20
2.7 Blocking emergency access or fire fighting equipments 20
2.8 Dumping of waste or scrap at unauthorized areas 20
2.9 Failure to report accidents, near misses and incident 20
2.10 Smoking inside plant 20
2.11 Throwing of tools 20
2.12 Using matches or lighter to light cutting torch 20
2.13 Unauthorized person doing heavy lifting 20
2.14 Violating gas cylinder procedures and incorrect storage 20
2.15 Using foul language against superior 20
2.16 Horseplay 25
2.17 Misuse of fire fighting equipment 25
2.18 Under influence of drug or alcohol, gambling, fighting, stealing, vandalism, illegal 50
workers.

3. TRAFFIC
3.1 Riding motorcycle to around workshop area without approval 20
3.2 Speeding or dangerous driving around workshop area 20
3.3 Parking unauthorized area 20

PENALTY

30 Points Suspension for 3 days

40 Points Suspension for 7 days
50 points above Dismissal and bar from entering factory
Value of every one demerit point equal to RM 1.00.
Penalty will be double for above foreman level.

Prepared By:- S.ESWARAN - Safety Officer

Approved By:

______________________ ______________________
Mr. S.K. SIAU MR.SADIR MOHAMMED
Executive Director Director

Effective Date: September 2008

C.C. Mr K. C. Seow – General Manager

Mr M.S.Han – Senior Manager
Mr. Yusufirashim - Admin& Safety Manager
Mr. Samuel Wong –Plant Manager

Fr ,Rev 0,01.02.2009
 Mr. They.H.S- Production Manager
Mr. Mandy Lua – Account Manager
All Dept. Heads and Sub- Contractors.

SAFETY DEPARTMENT YNESB/OSHEF/03

Block :
Work Shop :
DAILY PLANT SAFETY INSPECTION CHECKLIST
S.No Description Yes No N.A
01 Foremen on job area
02 All employees wearing proper eye/head protection?
03 All wearing hearing protection where necessary?
04 All wearing protective clothing where necessary.
05 All wearing respiratory protection where necessary?
06 All wearing adequate safety shoes/gloves?
07 All overhead workers using safety belts? Line? If required?
08 Equipment properly locked out /tagged out?
09 Electrical connections/cords, proper twist lock connections?
10 Welding machines earth properly connected?
11 Extension cables is properly lay.
12 Gas hoses in good condition?
13 Flash back arrestor installed?
14 Gas hoses properly installed and properly lay.
15 Firefighting equipment in place and good condition.
16 Roads properly blocked if necessary?
17 Any obstruction on the access way?
18 Scaffolding properly installed? Properly tagging?
19 Ladders properly used?
20 Hand tools properly used?
21 Proper lifting method safe material handling?
22 Over head crane in good condition?
23 Lifting sling in good condition? Inspected?
24 During lifting, padding in use cover the Sharpe edges?
25 Rubbish and scrap bins in place?

Fr ,Rev 0,01.02.2009
 26 Good house keeping
27 Special warning posted if necessary
Remark:

Supervisor : _________________ Safety Officer : _________________

Name : _________________ Name : _________________

Date : _________________ Date : _________________

Signature : _________________ Signature : _________________

Fr ,Rev 0,01.02.2009