Partner's Safety Audit (FS Execution /Energy)

Customer Name and Location: Maru Gift Center

Date & Time of Audit: 14th June 2019
Explain the task being performed detailing key hazards and voltages:

i) Task being performed: Replacement of switches

ii) Key Hazards: Electric Shock Hazards

iii) Voltage: 440 VAC

Auditors Name:Prashant Kotian

Auditees Name: Ganesh Tati
Name of Contractor/Partner Company: Sk Serivce

Comments

N/A
Yes

No
NA

X
1 NA
Is the lighting adaquate in the work area?

X
Work Area

2 NA
Is the work area free of trip, slip & fall hazards?

X
3 NA
Does the Partner's FSRs have safe access (including to access the top of the switchgears)?.

X
4 NA
Does the FSE assess the risk of contact with energized conductor in nearby area?

X
Has the auditee recieved safety training in the previous 12 months?
5 NA
X
Is all metal jewellery including belt buckles removed?
6 NA
X
Is the auditee wearing all general mandatory PPEs?;
Safety Helmet □ Safety glasses □
7 NA
□
Personal Safety

Safety Shoes
X
Other PPEs as per requirement;

Insulated gloves while Working of Electrical Circuit □

Hearing protection ((if required/during switching/working with live part) □
8 Mechanical gloves when handling sharp objects □ NA
Face shild and Arc flash suit as per the requirement □
safety full body harness and lanyard used if required □

X
Are the tools insulated and in good working order (Insulation not damaged)?
9 NA
X
Has the FSEs used the cords without any cut & joint and with top for plug point?
10 NA
X
Is the appropriate meter for measuring less than 1000 volt used and is calibrated?
11 NA
Tools and Equipments

X
Has the FSE grounded the equipments working on?
12 NA
X
FSE has the Single Line Diagram (SLD) and all sources of energy & hazardous substances identified (secondary supplies,
13 ring main, stored energy, generators, batteries, etc.)? NA
X
Has the FSE made checked and verified for the proper shutdown/isolation of the section/panel on which he has to work
(PTW from Customer)?
14 NA
X
Has the FSE prevented accidential re-connection of the all power sources by applying locks (LOTO)?
15 NA
X

16 Tool Box Talk Loto & Safety Reflector has not carried by Engineer during site intervention

Sign Of Auditor Sign of Auditee(s)