CHECK LIST FOR GAS CUTTING SET

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N
Protective valve cap firmly fixed for both cylinder(Check for
1
damage/crack in the valve cap)
Pressure gauges two for each cylinder(inlet & out)are in working
2
condition(both Oxygen & Acetylene gas)
3 Flash back arrestor (FBAs) is provided for acetylene & oxygen cylinders
Non return valves (NRVs) is provided for both acetylene & oxygen
4
cylinders.
5 Tight Crimping of hoses with jubilee clamps.

6 Hose free from damage(cut and cracks )

7 Cylinder secured by chain to the trolley.

8 Trolley tire shall be free from damages.

Availability of industrial type lighter (no match box / commercial
9
lighters).
10 Cutting area Should be barricaded and warning boards to be displayed.

11 Cutting area shall be free from debris and flammable materials.

12 Availability of PPE (Cutting Goggles, Leather gloves Etc.)

Comments If any:

Signature of Safety Dept. Signature of site engineer/incharge

 CHECK SHEET FOR BAR BENDING MACHINE

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Erected in a firm base concrete platform.

2
Machine is grouted properly/ Base wheel stopper provided

3 Body Earthing is provided

Emergency switch is available in working condition ( Front side and back side of the
4
m/c)
5
Power on & off switch with indicator light are available in working condition.

6 Belt and other internal moving parts are covered/Guarded.

7 No oil leakage

8
Both side hand guard is available.

9 Limit switch (Both Side,below the job plate) are in working condition

10 Availability of standard limit switch pin.

Comments If any:

Signature of Rcon safety incharge Sign of Electrical / Maintenance

 CHECK LIST FOR CONCRETE MIXER

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Condition of the base

2 Presence of the mixer round handle stopper

3 Condition of the m/c stand with wheel

4 Presence of guard for rotating parts(pulley & chain)

5 Condition of the sling of the feeder/hopper (free from damage)

6 Cover of the starter

7 Condition of radiator

8 Wire rope/sling of the hopper fixed with the guide only by 'D' clamp.

9 Condition of belt

10 Diesel leakage from the diesel tank

11 Condition of chain

12 Guarding of revolving parts

13 Ensure barricading on both sides of the hopper when the machine in operation

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECK LIST FOR MINI DUMPER

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Physical damage in body of the vehicle and in the bucket

2 Working condition of the vehicle forward and reversed gear

3 Working condition of the hydraulic brakes (4 wheels)

4 Oil leakage from the hydraulic cylinder and from the diesel tank.

5 Starter shaft covered by guard

6 No Damage in Tire ( Crack, cut, air pressure etc).

7 Driver seat hood is available and no damage

8 Head and tail lamps (for night working).

9 Exhaust pipe is bended outside (Not faced on operator)

10 Operator license.

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECK LIST FOR FIRE EXTINGUISHER

PROJECT: LOCATION: DATE:

SL NO Y N

1 Condition of the extinguisher (Clean and Tidy)

2 Physical appearance for corrosion.

3 Safety pin in position

4 Condition of discharge nozzole (any blockage/damage)

5 Conduction of hose ( Any leakage / Broken )

6
Weight of the extinguisher (Should be match with actual weight written
in the body)
7 Availability of visual board.

8 All the indicator gages (where fitted) in green segment (not to be red)

9 Extinguisher is not expired or refilled before refilled date

Comments If any:

Signature of Safety Dept. Signature of site Incharge/Engineer

 CHECK LIST FOR GENERATOR (DG)

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Guard provided for any rotating parts.

2 Hot surface is provided with guard.

3 Rubber mat is provided in operator standing area.( around the D.G)

4 No oil leakage from the oil tank & other parts of the m/c.

5 Wheel stopper in case of vehicle mounted D.G

6 Proper access to the D.G control panel

7 Exhaust smoke pipe faced upwards & outside of D.G shelter.

8 Dip tray for any oil leakage.

9 Drive belt is in good condition (any cut,dent or damage)

10 Adequate ventilation in case of indoor generator

11 Presence of fire extinguisher (ABC type)

Presence of damage free operating switch,Voltage and temperature

12
meter,circuite breaker,Oil level indicator, Emergency switch

13 Earthing is provided with standard earthing pit.

In case of mobile gen set, confirmation of inbuilt acoustic system. (If sound is
14
more than 85 dB)
Comments If any:

Signature of site safety incharge Signature of site

 CHECK SHEET FOR CHERRY PICKER (BOOM LIFT)

PROJECT: LOCATION: DATE:

10 3

4
5
9

7
1
10
6
2

SL NO CHECK ITEMS Y N

1 No Damage in Tire ( Crack, cut, air pressure etc).

2 Platform is securely fastened to platform support.

3 All member in the platform have safety belt

4 Foot pedal in the bucket is in working condition.

5 Outriggers & extendable axles are in smooth working condition.

6 High engine and height drive cutout is in working condition.

7 Any oil leakage in the Hydraulic systems.

8 Warning lamp is in working condition.

The cherry picker movement/ work area is leveled ,compacted and free from all
9
obstructions
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECKLIST FOR CHOPSAW MACHINE

PROJECT: LOCATION: DATE:

2
5

1 7 4 3

SL NO CHECK ITEMS Y N

1 Crack & Damage of the Cutting plate

2 Presence of Cutting plate guard

3 Presence of locking system for the plate & Guard

4 Presence of job clamp and its condition

5 Presence of handel and its condition

6 Cable condition(Any cut,wear etc) and presence of wire top plug

7 Presence cutting dust guard

Comments If any:

Signature of Safety Dept. Sign of Electrical / Maintenance

 CHECK LIST FOR TRACTOR

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Protection (canopies, screens) is provided to shield operator from falling objects.

2 Effective, working horn and reverse alarm

3 Moving parts, shafts, sprockets, belts, etc.are guarded.

4 Protection against contact with hot surfaces, exhaust, etc.is provided.

5 Safe means of access (steps, grab bars, non-slip surfaces) to the cab is provided

6 No Damage in Tire ( Crack, cut, air pressure etc).

7 No Leakage of oil from the vehicle and vehicle oil tank.

8 Vehicle rear view mirror

9 Head light,Tail lamp are in working condition (for night work)

10 Brake, accelerator, clutch are in good working condition

11 Lock of the back door (traile) in good condition

12 Inter locking system between the tractor and the trailer

13 Operator license (LMV atleast) & I.D card.

14 Vehicle valid insurance

15 Visualization of Check sheet and Operator details with photo in the vehicle itself.

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECKSHEET FOR DISTRIBUTION BOARD / PANEL BOARD

PROJECT: LOCATION: DATE:

2 4

3 8

9 14

5 7
1
6
15
13

Y N
SL NO CHECK ITEMS

1 Firm Base with grouting & Easily accessable panel (height of the leg is equal to 1m)

2 The Housing & connections of D.B is weather proof. (minimum of IP 44 type)

3 Authorized Operator Name Photo, Contact No.on DB panel (Confirmation)

4 Visualization of voltage, current and type of tools to be used in the socket & Panel.

5 Identification of input and output cables

6 Confirmation of LOTO availability

7 Separate MCB for every socket

8 Safety sign / isolate flammable Fire Hazard

9 Double Earthing System of MDB / DB panel with Std earthing pit

10 Separate ELCB with tripping current of 30 mA & in working condition.

11 Hylem sheet to be provided over live bus bars

12 Presence & Condition of Bus bar/ Terminal

13 Condition of Cable,Power Socket and Plug without damage

14 Color coding to be followed (RYB) for all cables/wires

15 Presence of rubber mat infornt of the D.B (Operator standing Location)

16 Plug-Socket should be Industrial type (IP 44 type)

Comments If any:
Signature of Safety Dept. Sign of Electrical / Maintenance
 CHECKLIST FOR MAGNETIC DRILL MACHINE

PROJECT: LOCATION: DATE:

2
5 1

4
3
6

7 4

Y N
SL NO CHECK ITEMS

1 Fore handle in good operating condition

2 Presence of Cord strain reliever (glands).

3 Presence of Drilling trigger switch lock.

4 Drilling Bit should be in good condition.

5 Electric wire without cuts and joints.

6 Condition and presence of the On/off switch

7 Monthly inspection sticker

8 Presence of dust cleaning brush near the equipment

Comments If any:

Signature of Safety Dept. Signature of site engineer/incharge

 CHECK SHEET FOR EXCAVATOR

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Front & reverse horn

2 Head & tail lamps(for working at night)

3 Lakage of oil(in hydraulic & pneumatic systems)

4 Loose bolts /connecting pins(bucket)

5 Back view mirror

6 Roller-crawler / tyre condition (check for damaged / missing idle rollers)

7 Structure beem condition(damage,cut,crack)

8 Diesel, oil and grease spillage.

9 Licensed operator (heavy licence)

10 Fire extinguisher in operator cabin

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECK LIST FOR FORK LIFT

PROJECT: LOCATION: DATE:

SL NO CHECK ITEMS Y N

1 Front & reverse horn

2 Head & tail lamps(for working at night)

3 Leakage of oil(in hydraulic & pneumatic systems)

4 Loose bolts /connecting pins(bucket)

5 Back view mirror

6 Tyre condition

7 Structure beem condition(damage,cut,crack)

8 Diesel, oil and grease spillage.

9 Licensed operator (heavy licence)

10 Fire extinguisher in operator cabin

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECK LIST FOR PORTABLE GRINDING MACHINE

PROJECT: LOCATION: DATE:

2 1
1
4
4
5 5

6
7 8 7

2
3 8 6
3

SL NO CHECK ITEMS Y N

1 Fore handle without damage.

2 Wheel guard (covering 3/4th area).
3 Grinding wheel without any crack.
4 Rear handle without any damage.
5 Presence of Cord strain reliever (glands).
6 Trigger switch without damage.
7 Presence of Switch lock.
8 Electric wire without cuts and joints.
Comments If any:

Signature of Safety Dept. Sign of Electrical / Maintenance

 CHECK LIST FOR JCB

PROJECT: LOCATION: DATE:

7 1
10
4
5
6 3

SL NO CHECK ITEMS Y N

1 Head & tail lamps(for working at night)

2 Front & reverse horn
3 Leakage of grease or oil(in hydraulic & pneumatic systems)
4 Clutch / brake / Hand brake
5 Back view mirror
6 Tyre condition
7 Seat Belt
8 Operators fitness
9 Licensed operator (heavy licence)
10 Fire extinguisher in operator cabin
11 Any other Points

Signature of site safety incharge Sign of Electrical / Maintenance

 CHECK LIST FOR LADDER

PROJECT: LOCATION: DATE:

9
2
1
3 4 0
16
6

4
4
1
15 0
20 21 22
Extension 1
Ladder 14
10 8

SL NO CHECK ITEMS Y N

1 All the rungs, cleats, or steps are in good condition (Broken,missing,bend rungs)
2 Side rails is intact without any cracks, bends, or breaks.
3 The rungs, cleats, or steps is fit into the side rails without damage.
4 Ladder is free from corrosion.
5 Side rails and steps are free of oil or grease.
6 Rungs are placed at regular intervals (30 cm gap between two rungs)
7 Projection of loose nails, screws, bolts, or other metal parts
8 At the time of using, the ladder should be placed at 65-75 degree angle (1:4 ratio)
9 Ladder is extended at least 1 m above the landing platform (3 Rungs)
10 Ladder is secured either at top or at the bottom
11 Ladder rungs should not be painted.
12 Reinforcement rod should not be used as ladder rungs
13 The surface of the rungs should not be smooth
14 Rubber feet for firm grip (in case of Aluminum ladder)
Comments If any:

Signature of site safety incharge Signature of site engineer/inc

 CHECK LIST FOR MOBILE CRANE (Hydra)
PROJECT: LOCATION: DATE:

2
1
8 10
11
3

9
6

SL NO CHECK ITEMS Y N

1 Safety latch in hook.

2 Hoist limit switch (Or presence of plate).

3 SWL marked in crane.

4 Automatic safe load indicator

5 Wire rope and slings free from tolerable damage( No kinks, broken wires more than 10% is N.G).

6 No oil leak in hydraulic parts (piston drums).

7 No Damage in Tire ( Crack, cut, air pressure etc.).

8 Head and tail lamps (for night working).

9 Front and reverse horn.

10 Four outrigger are in good working condition

11 Fire extinguisher in operator cabin.

12 Operator license (heavy duty).

Comments If any:

Signature of Safety Dept. Signature of site engineer/inchar

 CHECK LIST FOR HYDROULIC ROTARY MIXER

PROJECT: LOCATION: DATE:

3 10
8
6

5 7

SL NO CHECK ITEMS Y N

1 Operator should pose a valid license.

2 Driver has completed site-specific induction

3 Hose – any leakage

4 Engine & Chassis Condition

5 No oil leak in hydraulic parts.

6 Fire extinguisher fitted any fully operational

7 Working condition of the Emergency Lever in the Operator Cabin.

8 Guarding of revolving parts

9 Warning horn fully operational

10 No cracks in windscreen

11 Availability of the Head and tail lamps (for night working).

12 Signal man
Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECK LIST FOR MOBILE CRANE

PROJECT: LOCATION: DATE:

11

SL NO CHECK ITEMS Y N

1 Safety latch in hook.

2 Hoist limit switch (Or presence of plate).

3 SWL marked in crane.

4 Wire rope and slings free from tolerable damage( No kinks, broken wires more than 10% is N.G).

5 No oil leak in hydraulic parts (piston drums).

6 No Damage in Tire ( Crack, cut, air pressure etc).

7 Head and tail lamps (for night working).

8 Front and reverse horn.

9 Boom structure condition while full expansion (damage, crack and jamming while extending).

10 Fire extinguisher in operator cabin.

11 Four outrigger and flotpat are in good working condition

12 Automatica safe load indicator

13 Third party certificate(Form 32)

14 Operator license (heavy duty).

15 Vehicle valid insurance

16 Road tax document

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge

 CHECK SHEET FOR SCISSOR LIFT
PROJECT: LOCATION:

SL NO CHECK ITEMS PHOTOS Y N

Level adjustment is
4 in good working
condition

Access lader to the

platform is with out
5 any
defects,missing
rungs.

Availability of limit
6 switch for the
platform extension

Mechanical stoper
7 for the platform
lifter is in

SL NO CHECK ITEMS PHOTOS Y N

Operator and
Scissor lifter working
scissor lifter
platform is provided
1 8 capacity details
with hand rail and
displayed in the
midrail
liftefr.

Availability of four All hazards signs

outrigger in four and operating
2 9
sides (Depends on instruction
type of lifter) displayed .

3
All wheels are in
good

Comments If any:

Signature of site safety incharge Signature of site engineer/incharge