MO
Name of Project
Name of the Project In-charge
Sl No Key Performance Indicator Till Date Jan-25
1 Persons Medically Examined (Workers)
2 Persons Medically Examined (Staff)
3
Occupational Disease
(Unhealthy condition of the person affected)
4 Crèche Facility
Manpower/Manhours Details
5 Average Man Power Strength 728 601
Total Man Hours Worked This month
6
Cumulative Man Hours Worked Up to This month
Safe Man Hours Worked this month
7
Cumulative Safe Man Hours Worked up to this month
Man-Hours lost this month due to accident/incident
8
Cumulative Man Hours Lost due to accident / incident
up to this month.
HSE Performance Indicators
9 Near Miss cases
First Aid injuries( Resumes duty instantly after medical
10
treatment/first aid)
11 Fire incident
12 Dangerous Occurance
Lost Time Injury( Did not resume duty within first 48
13
hours after injury)
14 Fatal cases ( Loss of life)
Frequency rate( No. of LTI*1million/Total manhours
15
worked)
Severity Rate( No. of days lost due to
16
LTI*1million/Total manhours worked)
Training Details
Induction Trainings of worker ( Total numbers of
17
worker)
18 Induction Trainings of staff ( Total numbers of staffs )
JST ( Numbers of Job Specific Trainings)
19
JST ( TotalNumbers of Participant )
Tool Box Talk ( Numbers of Too Box Talk )
20
Tool Box Talk (Total participan in Too Box Talk )
Trainings to staff ( Numbers of staffs Trainings)
21
Trainings to staff (Total Numbers of Participant )
22 Mock Drill / Demonstration
HSE Compliances
23 Legal (BOCWA-1996) & Standards
24 Approved HSE Plan
25 HSE Personnel (Qualified)
26 First Aid Room & First Aider
27 Equipped (Emergency) Vehicle
28 % uses of PPE's by workers & staff
29 % stock of PPE's vs. actual manpower strength
HSE Inspections
HSE Inspection
30 (Scaffolds, Lifting & Shifting, B. plant, Electrical, Lift
shaft / cut out, Fire point etc)
31 No. of Work Permit Issued
32 Labour Camp Inspection
Site NCR Details
33 Carry Forward (From Previous Month)*
34 Issue Raised
35 Issue Closed
36 Issue Open
SRD- Safety Related Deficiencies
37 Carry Forward (From Previous Month)*
38 Issue Raised
39 Issue Closed 218 32
40 Issue Open
HSE Meeting
41 HSE Committee Meeting /Client & Contractor meeting
Motivation / Promotions
Awareness Program
42 (Motivational Program, Safety Day, Environment
Day & AIDS Day)
HSE Penalties
Penalty Imposed against HSE violation- (Amount)
43
Description:-
DG Operation
44 NOC from local Govt. Body
45 Acoustical Enclosure
46 Noise Level
Provision of tray /dyke for controlling the spillage of
47
oil.
Waste Management System
48 Tie-up with approved agency
49 Garbage Bin
50 Hazardous waste Bin
51 Bio Medical Waste Bin
Batching Plant & Other
52 NOC from local Govt. Body
53 Dust Collector(Hopper bay & Silos)
54 Sedimentation Tank
54 Provision of water sprinklers for controlling dust.
55 Material Stacking & Covering
Note: 1) This MHSEPR report (soft copy in excel format) should reach client project manager before 1st of every month.
2) Signed copy of the same shall be maintained at site as Audit requirement .
MONTHLY HSE PERFORMANCE REPORT
Name of Contractor ACIL
Name of the Project HSE In-charge Gyanendr Sri
Feb-25 Mar-25 Apr-25 May-25 Jun-25 Jul-25 Aug-25
HEALTH
SAFETY
850 681 780
61 49 76
ENVIRONMENT*
anager before 1st of every month.
ACIL
Gyanendr Srivastava
Sep-25 Oct-25 Nov-25 Dec-25 Remarks
