OG/HSE-CHK-001 (00)
Oil Gas Development Company Limited
HYGIENE CHECKLIST
Insp. Date: ____________
Location: _Rig N-55__(Well ----------------)___
Next Due:_____________
1. Inspected the hygiene conditions on ___________ (date) at __________ (time) and noted the
following.
Officers Mess Workers/ Staff Mess
a) Dining hall cleanliness a) Dining hall cleanliness
Good Good
Satisfactory Satisfactory
Poor Poor
b) Officers living rooms b) Assistant living rooms
Good Good
Satisfactory Satisfactory
Poor Poor
c) Officers bathroom c) Assistant bathroom
Good Good
Satisfactory Satisfactory
Poor Poor
d) Officers cook house/kitchen d) Assistant cook house/kitchen
i. Arrangement (place/ building) i. Arrangement (place/ building)
Permanent Adhoc Permanent Adhoc
Adequate Inadequate Adequate Inadequate
ii. Number of burner/ Tandoor (oven) ii. Number of burner/ tandoor (oven)
Adequate Inadequate Adequate Inadequate
iii. Exhaust iii. Exhaust
Exist Do not Exist Exist Do not Exist
Functioning Not functioning Functioning Not functioning
iv. Utilities iv. Utilities
Clean Not Clean Clean Not Clean
v. Lighting arrangement v. Lighting arrangement
Adequate Inadequate Adequate Inadequate
vi. Hand washing arrangement vi. Hand washing arrangement
Exist Do not Exist Exist Do not Exist
vii. Storage of food items vii. Storage of food items
Satisfactory Unsatisfactory Satisfactory Unsatisfactory
viii. Drinking water viii. Drinking water
Safe Unsafe Safe Unsafe
ix. Personal hygiene of cooks/ waiters ix. Personal hygiene of cooks/ waiters
Satisfactory Unsatisfactory Satisfactory Unsatisfactory
x. Medical examination/ clinical investigation of x. Medical examination/ clinical investigation of
cooks/ waiters/ room attendants cooks/ waiters/ room attendants
Done Not done Done Not done
2. Ration Store
i) Condition of Store
Satisfactory Unsatisfactory
ii) Storage of food items (meat, vegetables, fruits, etc.)
Temperature controlled (refrigerated) Yes No
Properly packed/ covered Yes No
iii) Fly proofing
Yes No
iv) Ventilation
Adequate Inadequate
3. General Area Cleanliness/ Sanitation
Satisfactory Unsatisfactory
4. Disposal of Refuse/ Waste
Within premises Outside premises
Satisfactory Unsatisfactory
5. Insecticide/ Anti Malaria Spray/ Dengue Spray
Carried out Not carried out
6. Checked the following
Hospitalization record, if any
Infectious Diseases Register
Blood group Register
7. General Remarks:
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8. Recommendations/ Suggestions for compliance
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Inspected by
Endorsed by
F.M.O. / Admin Area/ Location In-Charge for remedial
Field I/C HSEQ
Officer action(s)
Date: Date: