Hse Master Checklist

FIRE EXTINGUISHER
INSPECTION REPORT
Project : Date Inspected Date :

Site : Make :
Item Model :
Month SL NO
(P) Inspected & Satisfactory (X) Required Re-filling/damage
SL NO SL NO SL NO SL NO SL NO
Component Condition/Fault to be checked
Pressure reading within green section
Pressure
Gauge
Gauge clean & legible

Gauge free from damage
Free from damage
Hoses Contents Cylinder
Label clean & legible

Owner clearly identified
Weight within specifications
Cylinder inverted and bumped to loosen

contents (dry chemical only)
Hose free from obstructions, end cap in
position (Where applicable)
Connections checked for tightness
Hose free of cracks and ultraviolet light
deterioration
Inspection Safety
Safety pin secured from accidental

Pin
displacement
Attached and marked by competent person

Tag
within last three months.
Attachment point secure & restrains

extinguisher
Attachment
Points and
Signage
Fire extinguisher sign in place & correct type
Inspected by : Sign :
TO..
red Re-filling/damage
SL NO SL NO SL NO
Remarks
No NAME POSITION
1 ME RAJA AFZAL SUPERVISOR
2 MR.EHSAN KAUSHAR SUPERVISOR
3 MD.RASHID HSE
4 MD.SHAHID HSE
5 Mr Vidyanand HSE
6 Mr Jibin HSE
7 Mr Danish HSE
8 Mr Imran HSE
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
TAKREER CARBON BLACK & DELAYED COKER PROJE
FIRST AIDER REGISTER
COMPANY CONTACT NO. PKG NO.
TAHTAN 563830769 2
TAHTAN 2
TAHTAN 501327105 2
TAHTAN 567990450 2
TAHTAN 4
TAHTAN 4
TAHTAN 4
TAHTAN 4
& DELAYED COKER PROJECT
ER REGISTER
TPC CERTIFICATE NO. EXPIRY DATE STATUS
SWS-BFA-270615-24 6/26/2016 On Site
SWS-BFA-270615-22 6/26/2016 On Site
SWS-BFA-270615-23 6/26/2016 On Site
SWS-BFA-270615-21 6/26/2016 On Site
SWS-BFA-270615-20 11/26/2016 On Site
SWS-BFA-270615-19 11/26/2016 On Site
SWS-BFA-270615-18 11/26/2016 On Site
SWS-BFA-270615-17 11/26/2016 On Site

REMARKS
CARBON BLACK AND DELAYED COKER PROJECT
GENERATOR SET DAILY CH
LocatioDate Inspected Month:

Sr. No. Description 1 2 3 4 5 6 7 8
Is the generator operated or started by
1 authorised personnel?
Is the generator was Color Coded issued by
2 Samsung Electrical Inspectors?
3 Is the generator physical are neat and clean?
Is sorrounding near generator area clean and
4 clear from obstruction?
Is the generator away from loose materials
5 and flammble chemicals?
6 Are safety sign in place?
Are all fighting equipment well place and
7 easy to access?
8 Are the air ducts clear and clean?
Are the radiators, engine and pipe work
9 checked for leaks?
10 Are belts and gurds checked?
11 Is the coolant heater operational?
12 Are the fans, pumps and controls checked?
Are batteries proper installed, filled and
13 connection?
Is the exhaust fan in the diesel generator in
14 condition?
15 Is engine oil change during maintenance peri
16 Is the diesel fuel storage facilities secured?
17 Is diesel tank filled as when required?
Are drip trays provided in order to control
18 the spillages of the diesel?
Is the earthing/grounding is installed in
19 properly?
20 Is manual operation for generator correct?
Are local stop/emegency stop switch control
21 checked and functional?
Inspected By: Electrical Foreman/Supervisor:
COKER PROJECT
RATOR SET DAILY CHECKLIST
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Monthly Safety Harness Inspection C
PROJECT:CBDC
Company: TAHTAN Contracting L.L.C Job No.:
All Stitching
Harness Webbing Or Leather
Manufacture's Serial
Item No. Date Inspected Location No. / Identification
No.
1 2/9/2016 RRE PUMP 44411267

2 2/9/2016 RRE PUMP 2343123
3 2/9/2016 RRE PUMP 109867
4 2/9/2016 RRE PUMP 1567432
5 2/9/2016 RRE PUMP 1567878
6 2/9/2016 RRE PUMP 8976544
7 2/9/2016 RRE PUMP 5346724 0
8 2/9/2016 RRE PUMP 3223642
9 2/9/2016 RRE PUMP 7432739
10 2/9/2016 RRE PUMP 78379820
Additional Comments:
Inspected By: ________________________________________
omments:
Rivets and Eyelets
D-Ring(s) Buckle(s) (Include

Tongue)
Body Pad (if applicable)

Activity
s Inspection Checklist
Lanyard
Lifeline
Contract No.: CBDC/SV/SP003
Hook-Safety Latch
Month: August
Engineered Anchor Points

Remarks
Date Inspected
S / NO. COMPANY TYPE OF LIFTING EQUIPMENT
1 TAHTAN Contracting L.L.C Webbing Sling
3 TAHTAN Contracting L.L.C Nut and Bolt Bow Shackle
4 TAHTAN Contracting L.L.C Screw Pin Bow Shackle
7 TAHTAN Contracting L.L.C Screw Pin Bow Shackle

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Tahtan Ge
CARBON BLACK
HS
LIFTING
REFERENCE NO.
L6-16117,16119
15043052-3001
SO1-2-3-4-5-6-7-8
VP-11-12-13-14
DC5403-01,02,03,04,05
BS BN-001,002,003,004
ZH01-01-02,DC1903,DC-4805 ,E188,BS005
01/15308,15314,15318,15321,15324,15320,15337,15310
01/15336,15333,15326,15330,15334,15323,15335,15313
01/15331,15317,15315,15332,15311,15322,15309,15319
01/15329,15312,15316
02/50963,50965,50955,50950,50966,50957,50958,50968
02/15336,15333,15326,15330,15334,15323,15335,15313
02/50969,50962,50972,50971,50953,50967,50954,50952
02/50959,50951,50956,50964
03/50442,50443,50435,50433,50437,50434,50440
03/51135,51141,51144,51147,51138,51149,51136,51132
04/47394,47400,47411,47402,47401,47403,47428,474397
04/47613,47605,47610,47586,46571,47612,47587,47588
06/38366,38367,38346,38237,38331,38355,38369,38344
08/9743,9744,9745,9746
08/9747,9748,9749,9750
2014/16294
Tahtan General Contracting LLC
CARBON BLACK DELAYED COKER PROJECT
HSE DEPARTMENT
LIFTING/RIGGING REGISTER
SIZE / DIAMETER SWL THIRD PARTY COMPANY
6mm/6mtr 6 Ton Euro Gulf
4mm/6mtr 4 Ton Euro Gulf
7/8"' 6.5 Ton Euro Gulf
7/8"' 6.5 Ton Euro Gulf
1"' 8.5 Ton Euro Gulf
1"'*1.5M 12/30/1899 Euro Gulf
1"'*1.5M 1 Ton Euro Gulf
3"'*6.0 M 3 Ton Euro Gulf


JECT
THIRD PARTY CERTIFICATE

CERTIFICATE NO.
VALIDITY
TATN/LG/6758/07/IQ 6/Dec/16
INSPECTION DATE REMARK
7/Jun/16 Good Condition


TAHTAN Medical Screening
CBDC PROJECT
GENERAL INFORMATION
Name: ________________________________________________________ Age: ________________
Job Position: ___________________________________________________ ID Number: ____________________
Any Work Experience in Construction before: ( ) YES ( ) NO If YES, how many ye
MEDICAL INFORMATION
BP: __________ 0
Weight in Kg: _________ Urination at night: ( ) YES ( ) NO
Loss Weight within a year: __________ Increased thirst: ( ) YES ( ) NO
Gain Weight within a year: __________ BMI: _______________
Height: __________
PERSONAL INFORMATION
Vision: _______________________________________________________________________________________________________
Fear of heights, or confined spaces: ( ) YES ( ) NO
Past Medical History: ( ) Asthma ( ) Hypertension ( ) Joint problems

( ) Epilepsy ( ) Diabetes Mellitus( ) Skin Problems
( ) Tuberculosis ( ) Jaundice ( ) Cardiac Problem
( ) Hepatitis B ( ) Malaria ( ) Allergies to Medicine or othe
Injection Tetanus Toxoid (TT): ( ) YES ( ) NO
Any Other Past Vaccinations? ( ) YES ( ) NO
Remarks: _________________________________________________________________________________________________
_
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Taking Any Medicines: ( ) YES ( ) NO
If YES, please specify: ______________________________________________________________________________________
Family history of any diseases: ( ) YES ( ) NO

Remarks: _________________________________________________________________________________________________
Fit to Work: ( ) YES ( ) NO
Remarks: ________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
________________________________________________________________________________________________________
______________________________________________
Name of Physician or Nur
DAT
___________
r: ____________________
If YES, how many years? _______________
) YES ( ) NO
) YES ( ) NO
________________________
es to Medicine or otherwise
_____________________
_
___________________
___________________
_________________________
_____________________
____________________
_________________
_________________
__________________________
___________________________________
e of Physician or Nurse
ELECTRICAL/HANDTOOLS INSP
(TAHT
TAKREER RRE PACKAGE# 02 and 04
INSPECTOR: Mr Regi (SIGN)
SL NO SECL NO. SUBCON NAME EQUIPMENTS NO. TYPE OF HANDTOOLS
1 WM-151 TAHTAN N/A Welding Machine

2 OV-07 TAHTAN N/A ELECTRO HEAT RODE OVEN
6 HEG-74 TAHTAN N/A HEAT GUN
7 HEG-75 TAHTAN N/A HEAT GUN
9 BOD-65 TAHTAN N/A BATTERY OPERATED DRILL.M
10 CSM-32 TAHTAN N/A CHOPPE SAW MACHINE
11 PF-03 TAHTAN N/A PEDESTAL FAN
15 HDM-124 TAHTAN N/A HAMMER DRILL MACHINE
ANDTOOLS INSPECTION REGISTER SEPT 2016
(TAHTAN)
INSPECTION DATE: 10/9/2016
APPROVAL: (SIGN)
INSPECTED BY
CAPACITY MANUFACTURER INSPECTED BY SECL
SUBCON.
220V MILLER TAHTAN OK
220V,250 W TECH WELD TAHTAN OK
230V,2000W BLACK& DECKKER TAHTAN OK
230V,2000W BLACK& DECKKER TAHTAN OK
DEWALT TAHTAN OK
DEWALT TAHTAN OK
3.6A,770 W RPM 2700 AL MANORD TAHTAN OK
3.7A,850W DEWALT TAHTAN OK
REMARKS
SS 015- SOUTH
SS015-EAST
Refresh Training Request Card SECL Refresh Training Request Card SECL
1. Company : 1. Company :
2. Name / Job
Date Inspected 2. Name / Job Title :
3. Date : 3. Date :
4. Location : 4. Location :
5. Observations : 5. Observations :
0
6. Training (Every 18:00 PM ~ 19::00 PM) 6. Training (Every 18:00 PM ~ 19::00 PM)
Sat. Sun. Mon. Tue. Wed. Thur. Sat. Sun. Mon. Tue.
Safety PPE/ Working Lifting Defensive Safety PPE/ Working Lifting
Hot Work
Leadership Basic Rule @ Height Safety Driving Leadership Basic Rule @ Height Safety
7. Confirmed by 7. Confirmed by
7.1 SECL Area HSE 7.1 SECL Area HSE
8. Case Registered by 8. Case Registered by
8.2 SECL HSE Docu. 8.2 SECL HSE Docu.
Refresh Training Request Card SECL Refresh Training Request Card SECL
1. Company : 1. Company :
2. Name / Job Title : 2. Name / Job Title :
3. Date : 3. Date :
4. Location : 4. Location :
5. Observations : 5. Observations :
6. Training (Every 18:00 PM ~ 19::00 PM) 6. Training (Every 18:00 PM ~ 19::00 PM)
Sat. Sun. Mon. Tue. Wed. Thur. Sat. Sun. Mon. Tue.
Safety PPE/ Working Lifting Defensive Safety PPE/ Working Lifting
Hot Work
Leadership Basic Rule @ Height Safety Driving Leadership Basic Rule @ Height Safety
7. Confirmed by 7. Confirmed by
7.1 SECL Area HSE 7.1 SECL Area HSE
8. Case Registered by 8. Case Registered by
8.2 SECL HSE Docu. 8.2 SECL HSE Docu.

Request Card SECL
Wed. Thur.
Defensive
Hot Work
Driving
Request Card SECL
Wed. Thur.
Defensive
Hot Work
Driving
SL No. Name Emp. ID Company
1 Muhammad Rafique TAH-03 TAHTAN
2 Meer Alam TAH-04 TAHTAN
3 Muhammad Akhtar TAH-07 TAHTAN
4 Nisar Ahmad TAH-10 TAHTAN

5 Waseem Sarwar TAH-11 TAHTAN
6 Mushtaq Ahmad TAH-18 TAHTAN
7 Ghulam Bari Saif TAH-44 TAHTAN
8 Sardar Ghani TAH-53 TAHTAN
9 Idress Ahmad TAH-63 TAHTAN
10 Zafar Iqbal TAH-65 TAHTAN
11 Gulzar TAH-69 TAHTAN
12 Muhammad Shafiq TAH-72 TAHTAN
13 Muhammad Asif TAH-73 TAHTAN
14 Sajid Ayoub TAH-75 TAHTAN

15 Khalid Javed TAH-85 TAHTAN
16 Sheikh Munair TAH-105 TAHTAN
17 Ashiq Muhammad TAH-107 TAHTAN
18 Shehzad Ayoub Khurm TAH-108 TAHTAN
19 Abdul Latif TAH-115 TAHTAN
20 Abid Hameed TAH-135 TAHTAN
21 Rashid Mehmood TAH-137 TAHTAN
22 Afzal Mehdi TAH-140 TAHTAN
23 Muhammad Arshad TAH-142 TAHTAN
24 Fakhir Din TAH-145 TAHTAN
25 Khan Muhammad TAH-147 TAHTAN
26 Imran Ghafoor TAH-148 TAHTAN
27 M.Ishaq TAH-151 TAHTAN
28 Hayat Muhammad TAH-152 TAHTAN
29 Farasat Hassan TAH-153 TAHTAN
30 Meer a Tasuf TAH-154 TAHTAN
31 Faheem Shehzad TAH-157 TAHTAN
32 M.Shahid TAH-160 TAHTAN
33 Muhammad Umar Iqbal TAH-161 TAHTAN
34 Shabbir Ahmad TAH-163 TAHTAN
35 Qabil Khan TAH-164 TAHTAN
36 Sajjad Ahmad TAH-170 TAHTAN
37 Niaz Ahmed TAH-179 TAHTAN
38 Roman Ali TAH-185 TAHTAN
39 Priya Panjan Panday TAH-186 TAHTAN
40 Muhammad Ashraf TAH-192 TAHTAN
41 Muhammad Atif TAH-193 TAHTAN
42 Muhammad Rizwan TAH-194 TAHTAN
43 Muhammad Shabbir TAH-195 TAHTAN
44 Javed Ahmad TAH-199 TAHTAN
45 Zeshan Zaheer TAH-200 TAHTAN
46 Muhammad Farooq TAH-201 TAHTAN
47 Muhammad Danish TAH-202 TAHTAN
48 Ghulam Shabbir TAH-216 TAHTAN
49 Muhammad Nasir TAH-219 TAHTAN
50 Pervaiz Ahmed TAH-220 TAHTAN
51 Anoop Nair TAH-221 TAHTAN
52 Din Muhammad TAH-222 TAHTAN
53 Muhammad Ashraf TAH-226 TAHTAN
54 Muhammad Ajmal Juma TAH-228 TAHTAN
55 Muhammad Farooq TAH-230 TAHTAN
56 Omprakash TAH-231 TAHTAN
57 Rabi Sahi TAH-232 TAHTAN
58 Adnan Khan TAH-234 TAHTAN
59 Yasir Mehmood TAH-235 TAHTAN
60 Munir Ahmed TAH-236 TAHTAN
61 Sohrab Khan TAH-237 TAHTAN
62 Qaiser Mehmood TAH-240 TAHTAN
63 Shamshair Khan TAH-243 TAHTAN
64 Zeshan Akram TAH-253 TAHTAN
65 Nand Aaal TAH-254 TAHTAN
66 Gul Nawaz TAH-260 TAHTAN
67 Adnan Naseem TAH-262 TAHTAN
68 Om Parkash TAH-263 TAHTAN
69 Ajit Kumar TAH-264 TAHTAN
70 Nikhil Kumar TAH-266 TAHTAN
71
72
73
74
TAHTAN Contracting L.L.C
Takreer CBDC Project
HSE Induction List of New Employee
As of Date
Designation Date of Training Nationality HSE Induction
Fitter Pak Done
Fitter Pak Done
Fabricator Pak Done
Admin Pak Done
Accountant Pak Done
Helper Pak Done
Site Incharge Pak Done
Admin Manager Pak Done

Fitter 0 Pak Done
Fitter Pak Done
Rigger Pak Done
Fitter Pak Done
Fitter Pak Done
Camp Boss Pak Done
Leadman Pak Done
Helper Pak Done
Site Incharge Pak Done
Driver Pak Done

Leadman Pak Done
Site Manager Pak Done
HSE Pak Done
Supervisor Pak Done
Leadman Pak Done
Foreman Pak Done
Leadman Pak Done
HSE Pak Done
Scaffolder Pak Done
Scaffolder Pak Done
Planning Eng Pak Done
Permit Cordinator Pak Done
Mason Pak Done
HSE Pak Done
QAQC Pak Done
Fitter Pak Done
Welder Pak Done
Transport Sup Pak Done
Fitter Pak Done
Driver Pak Done
HSE Manager Indian Done
Helper Pak Done
Helper Pak Done
Helper Pak Done
Helper Pak Done
Fitter Pak Done
Helper Pak Done
Rigger Pak Done
HSE Pak Done
Electrician Pak Done
Helper Pak Done
Fitter Pak Done
HSE Indian Done
Helper Pak Done
Rigger Pak Done
Welder Pak Done
Scaffolder Pak Done
Scaffolder Pak Done
Rigger Nepal Done
Driver Pak Done
QAQC Pak Done
Helper Pak Done
Helper Pak Done
Driver Pak Done
Helper Pak Done
Helper Pak Done
Helper Pak Done
Scaffolder Pak Done
Fabricator Pak Done
Fabricator Indian Done
Helper Indian Done
Helper Indian Done

Working at height PTW Defence Driving Heat Stress
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done Done
Done
Done
Done
Done DONE
Done
Done
Done
Done
Done
Done
Done
Done DONE
Done
Done
Done
Done
Done
Done
Done
Done DONE
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done DD
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Confined Space Fire Watcher
Sr. No ID No. Serial Number Model Number
1 BL-01 94361 AD 3CX SiteMaster

2 TC-01 351913 MC235B J10-2C
3 TC-02 351565 MC205B-2C
4 TC-03 352919 MC310 K12-2C
5 TC-04 353199 MC205B-2C
6 HC-19 6210098 SR-700L
7 G-01 15561 / 15568 ZLP 630
8 G-02 15542 / 28365 ZLP 630
9 G-03 15573 / 15570 ZLP 630
10 15569 / 15543 ZLP 630
11
12 G-04
13
14
15 TL-01 1840 1999
16 2/91031 AD AFT 110G-5
EQUIPMEN
Manufacturer Certificate No
JCB, England KCK-14-17199

Potain by Manitowoc KCK-15-05242-JNB
KATO, JAPAN KCK-15-07010-JNB
ZLP KCK-15-07609-JNB
ZLP KCK-15-07610-JNB
ZLP JNB-15-07623-BK
ZLP JNB-15-07624-BK
KCK-15-05515-JNB
FAF-15-06276-KCK
FAF-15-06277-KCK
CCC-14-18070-JJ
Mercedes Flat Trailer 40Ft with Unit
TADANO JNB-14-18073-BK
EQUIPMENT TPI Record
DESCRIPTION CAPACITY SWL
Hydraulic Backhoe Loader 01 Ton

Tower Crane TC-01 12.5 Ton 10Ton
Mobile Crane 70Ton 70 Ton 70 Ton
Suspended Working Platform 945 Kgs 600 Kgs
Man Basket (1520 x 1020 x 2000)mm 600 Kgs 600 Kgs
Man Basket (1600 x 1000 x 2050)mm 500 Kgs 500 Kgs
Material Bucket (1020 x 730 x 770)mm 700 KgS 700 KgS
Concrete Bucket (1000 x 1000 x 1720)mm 3.4 Ton 3.4 Ton
36 Ton MBH
Mobile Crane 110 Ton 110 Ton 110 Ton
THIRD PARTY
TPI DATE TPI EXPIRY DATE
COMPANY
TUV 19-Oct-14 18-Oct-15
TUV 16-Mar-15 14-Sep-15
TUV 11-Apr-15 10-Oct-15
TUV 11-Apr-15 10-Oct-15
TUV 11-Apr-15 10-Oct-15
TUV 8-Apr-15 7-Apr-16
TUV 11-Apr-15 10-Oct-15
TUV 11-Apr-15 10-Oct-15
TUV 13-Apr-15 12-Oct-15
TUV 13-Apr-15 12-Oct-15
TUV 18-Mar-15 16-Sep-15
TUV 1-Apr-15 30-Sep-15
TUV 1-Apr-15 30-Sep-15
TUV 3-Nov-15 3-May-16
TUV 5-Nov-13 3-Nov-15

REMARKS
TAHTAN GENERAL CONTRA
WATER COOLER CHECKING L
COOLER
FILTER COOLER AREA
COOLER NO. CAPACITY EARTHING
CONDITION CLEANING
(USG)
ANY OTHER COMMENTS :-

AL CONTRACTING CO.LLC
LER CHECKING LOG SHEET
WATER FILLING
NAME SIGN REMARKS
DATE
SL No. Name of Employee Emp. ID Company
1 Om prakasah 231 TAHTAN
2 Rabi Shai 232 TAHTAN
3 M.Asharf 192 TAHTAN
4 Shaukat Ali 218 TAHTAN
5 Irshad Ahmed 126 TAHTAN
6 Faheem shajad 157 TAHTAN
7 Fizaan 162 TAHTAN

8 Zammer hussain 169 TAHTAN
9 Khurram shazad 204 TAHTAN
10 M Qasim 172 TAHTAN
11 Luqaman 129 TAHTAN
12 Faruq 230 TAHTAN
14 M.Arshad 142 TAHTAN
15 Abdul latif 115 TAHTAN
16 Tanver Ahmed 127 TAHTAN
17 Shabbir 163 TAHTAN

18 Javed 199 TAHTAN
19 Perviz 220 TAHTAN
20 Deen.M 222 TAHTAN
21 Malik did 224 TAHTAN
22 Rifaq 103 TAHTAN
23 Johnson 241 TAHTAN
24 M.Raifique 212 TAHTAN
25 Sohail Parvez 242 TAHTAN
26 Shamsheer khan 243 TAHTAN
27 Bhutto Khan 239 TAHTAN
28 S.K.Tiwari 238 TAHTAN
29 M.Rizwan 194 TAHTAN
30 Irshad Ahmed 126 TAHTAN
31 Allah Baksh 124 TAHTAN
33 Qabil Khan 164 TAHTAN
34 Munir Ahmed 236 TAHTAN
35 Niaz 179 TAHTAN
36 Khan M 147 TAHTAN
37 Ashagr Ali 203 TAHTAN
38 Atef 193 TAHTAN
39 Iftaqar Haider 217 TAHTAN
40 Faheem shajad 157 TAHTAN
41 Gulam Bari Saif 44 TAHTAN
42 Khalid Javed 85 TAHTAN
43 Md.Akhtar 7 TAHTAN
44 Angad kumar 59 TAHTAN
45 Idressh Khan 63 TAHTAN
46 Zafar Iqbal 65 TAHTAN
47 Md.Ashif 73 TAHTAN
48 Mugeesh Ahmed 103 TAHTAN
49 Barkat kahn 118 TAHTAN
50 Naveed Ahmed 176 TAHTAN
51 Md Nasir 219 TAHTAN
52 Md Akmal 228 TAHTAN
53 Feroz Khan N7 TAHTAN
54 Mukesh sha N2 TAHTAN
55 Chintamani N3 TAHTAN
56 Akhilesh Singh N129 TAHTAN
57 Baniu Bkaht 183 TAHTAN
58 Azmat Hayat 191 TAHTAN
59 M.Farooq 201 TAHTAN
60 Guatam Chwan 283 TAHTAN
61 Daya Shankar 292 TAHTAN
62 Nirmal Singh 327 TAHTAN
63 Tasrseem Singh 332 TAHTAN
64 M.Sajjad 333 TAHTAN
65 Surinder Singh 334 TAHTAN
66 Jagjeet Singh 339 TAHTAN
67 Hiraman Chwan 341 TAHTAN
68 Konahya chwan 342 TAHTAN
69 Niraj Kumar 349 TAHTAN
70 Purusottam Bassi 372 TAHTAN
71 Bashir khan 374 TAHTAN
72 Buseer Khan 212 TAHTAN
73 B Purushottam 122 TAHTAN
74 Md Haneef 22 TAHTAN
75 Md Jassimuddin 212 TAHTAN
76 Afzal Hossan Joshim 290 TAHTAN
77 Md Iqram 265 TAHTAN
78 Md Shafir 276 TAHTAN
79 Md Saddam Hussain 101 TAHTAN
80 Nilkanth 198 TAHTAN
81 Saddakat Ali 77 TAHTAN
82 Md Irfan Alam 193 TAHTAN
83 Shahwaiz Majeed TAH-40 TAHTAN
84 Farsat Hassan TAH-153 TAHTAN
85 Zafar Iqbal Ahsan ST TAHTAN

86 Gurjinder Singh Sarwan Singh NFT TAHTAN
87 Azmat Hayat TAH-150 TAHTAN
88 Fakhar Din TAH-145 TAHTAN
89 Muhammad Ishaq TAH-151 TAHTAN
90 Hayat Mohammad TAH-152 TAHTAN
91 Rahib Ali Khawand TAH-117 TAHTAN
92 Muhammad Riaz Amir TAH-32 TAHTAN
93 Touqeer Ahmed Tat TAH-10 TAHTAN
96 Gulzar Shah Sarwar Tah-69 TAHTAN
97 Aziz Abbas Ghulam TAH-35 TAHTAN
98 Nawab Khan Noor TAH-02 TAHTAN
99 Ghulam Shabbir Khan TAH-91 TAHTAN
101 Azmat Hayat TAH-150 TAHTAN
103 Muhammad Ishaq TAH-151 TAHTAN
104 Shahzad ayoub 67 TAHTAN
105 Kaisher 154 TAHTAN
106 Adnan Mir Khan 189 TAHTAN
107 Roman Ali 176 TAHTAN
108 Abid Hameed 159 TAHTAN
109 Munsif Ali 161 TAHTAN
110 Amjad Ali 121 TAHTAN
111 Shala Mir 98 TAHTAN
112 Muqarab Khan 203 TAHTAN
113 Md.Afzal 56 TAHTAN
Takreer CBDC Project
Training List of Employee
As of Date
Designation Date of Training Nationality Hot work Working at height
Scaffolder 7/22/2015 Indian Done
Rigger 7/22/2015 Indian Done
Helper 7/22/2015 Indian Done
Scaffolder 7/22/2015 Pak Done
Steel Fixer 7/22/2015 Pak Done
Fitter 7/22/2015 Pak Done Done

Operator 7/22/2015 Pak Done
Rigger 7/22/2015 Pak Done
Lead man 7/22/2015 Pak Done
Helper 7/22/2015 Pak Done

Helper 7/22/2015 Pak Done Done
Helper 7/22/2015 Pak Done Done
Painter 7/10/2015 Pak
Painter 7/10/2015 Indian
Electrician 7/10/2015 Pak
Fitter 7/2/2015 Pak Done
Welder 7/2/2015 Pak Done
I/C Incharge 6/15/2015 Pak Done
Fabricator 2/11/2015 Pak Done
Fabricator 2/11/2015 Indian Done
Welder 2/11/2015 Indian Done
Helper 2/11/2015 Pak

Helper 6/20/2016 Indian Done
Helper 6/20/2016 Indian
Scaffolding
Done
Inspector 7/2/2016 Pak
Scaffolding
Done
Supervisor 7/2/2016 Pak
Driver 3/12/2016 Pak
Lifting & Rigging Defence Driving Heat Stress
Done
Done Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done Done
Done Done
Done Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Done Done
Confined Space Fire Watcher Flag Man
Done
Done
Done
Done
Done
Done
Done Done
Done Done
Done Done
Done
Done
Done
Done Done
Done
Done
Done
Done
Done Done
Done Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Done
Scaffold Usage
Company Tag/Ref. No
(Type of Activities)
TAHTAN 26 PIPING
TAHTAN 24 PIPING
TAHTAN 30 PIPING
TAHTAN 17 PIPING
TAHTAN 40 PIPING
TAHTAN 14 PIPING
TAHTAN 13 PIPING
TAHTAN 22 PIPING
TAHTAN 1 PIPING
TAHTAN 34 PIPING
TAHTAN 50 PIPING
TAHTAN 51 PIPING
TAHTAN 52 PIPING
TAHTAN 19 PIPING
TAHTAN 15 PIPING
TAHTAN 14 PIPING
TAHTAN 53 PIPING
TAHTAN 44 PIPING
TAHTAN 45 PIPING
TAHTAN 18 PIPING
TAHTAN 34 PIPING
TAHTAN 43 PIPING
TAHTAN 54 PIPING
TAHTAN 55 PIPING
TAHTAN 56 PIPING
TAHTAN 57 PIPING
TAHTAN 58 PIPING
TAHTAN 59 PIPING
TAHTAN 60 PIPING
TAHTAN 61 PIPING
TAHTAN 62 PIPING
TAHTAN 42 PIPING
TAHTAN 41 PIPING
TAHTAN 40 PIPING
TAHTAN 39 PIPING
TAHTAN 38 PIPING
TAHTAN 34 PIPING
TAHTAN 33 PIPING
TAHTAN 32 PIPING
TAHTAN 31 PIPING
TAHTAN 30 PIPING
TAHTAN 29 PIPING
TAHTAN 28 PIPING
TAHTAN 27 PIPING
TAHTAN 37 PIPING
TAHTAN 36 PIPING
TAHTAN 35 PIPING
TAHTAN 1 PIPING
TAHTAN 2 PIPING
TAHTAN 3 PIPING
TAHTAN 26 PIPING
TAHTAN 24 PIPING
TAHTAN 23 PIPING
TAHTAN 22 PIPING
TAHTAN 20 PIPING
TAHTAN 11 PIPING
TAHTAN 7 PIPING
TAHTAN 30 PIPING
TAHTAN 5 PIPING
TAHTAN 25 PIPING
TAHTAN 27 PIPING
TAHTAN 23 PIPING
TAHTAN 29 PIPING
TAHTAN 50 PIPING
TAHTAN 51 PIPING
TAHTAN 52 PIPING
TAHTAN
Tahtan General Contracting LLC
TAKREER CARBON BLACK & DELAYED COKER PROJECT
SCAFFOLD REGISTRY
Scaffold Dimension
Scaffold Type Scaffold Duty (L x W x H)
SLUNG L 14*2*4
SLUNG L 8*2*6
SLUNG L 3*1.5*5
SLUNG L 3*1.5*11
SLUNG L 3*1,5*11
SLUNG L 3*1,5*11
SLUNG L 3*1,5*11
SLUNG L 0
SLUNG L 3*1,5*3
SLUNG L 3*1,5*3
SLUNG L 4*1*3
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 4*4*11
SLUNG L 30*3*7
SLUNG L 30*3*7
SLUNG L 30*3*7
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 18*2*2
SLUNG L 3*3*7
SLUNG L 3*2*6
SLUNG L 3*2*6
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 3*1.5*11
SLUNG L 30*2*6
SLUNG L 30*2*6
SLUNG L 30*2*6
SLUNG L 40*1.5*10
SLUNG L 5*1.5*6
SLUNG L 30*2*6
SLUNG L 15*2*3
SLUNG L 20*2*3
SLUNG L 18*2*6
SLUNG L 18*2*6
SLUNG L 30*2*6
SLUNG L 18*6*7
SLUNG L 24*2.5*10
SLUNG L 30*2*3
SLUNG L 30*2*3
SLUNG L 30*2*3
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 2.5*1.5*7
SLUNG L 2.8*1.5*7
SLUNG L 30*2*3
SLUNG L 2.5*1.5*7
SLUNG L 20*1.5*7
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 25*2*7
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 30*2*3
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 30*2*7
SLUNG L 30*2*7
g LLC
ER PROJECT
STRY
Tag Issuance
Location / Area Inspector
Date
UTILITY 20-Mar-16 DANISH

UTILITY 17-Mar-16 DANISH
UTILITY 3-May-16 DANISH
UTILITY 9-Feb-16 DANISH
UTILITY 16-May-16 DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
OIL MOVEMENT 12-Mar-16 DANISH
UTILITY 19-Apr-16 DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
UTILITY DANISH
OIL MOVEMENT DANISH
UTILITY DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT 17-Apr-16 DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT DANISH
OIL MOVEMENT DANISH
EASMENT 16-Jan-16 DANISH
EASMENT 21-Mar-16 DANISH
EASMENT 28-Feb-16 DANISH
EASMENT 7-Apr-16 DANISH
EASMENT 1-May-16 DANISH
Status
(Active/Dismantled/Date)
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
ACTIVE
ACTIVE
ACTIVE
ACTIVE
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
RED TAG
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
RED TAG
RED TAG
RED TAG
RED TAG
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
ACTIVE
Health Sa
Client: Samsung Project Name: CBDC P
Month Accrued Man-hours

Lost Time Injuries (LTI) 0
LTI Days 0
Restricted Work Injuries (RWI) 0
RWI Days 0
Medical Treatment Injuries 0
First Aid Cases 0
Accident / Incidents 0
Property Damage 0
Near Miss 0
Safety Meeting 1
Tool Box Talk Conducted 35
Safety Induction 9
Indirect
Number of Manpower on Site: Direct
Others
TOTAL
Number of Vehicle on Site: 3

Total kilometers run for this week: 2295
1) Hot work 2) Work at height 3) Use of proper ppe 3) How
Housekeeping 9) Manual Handling 10) Fire extinguisher 11
Toolbox Talk Topics:
Name
Mr Anoop
Mr Vidyanand
Nos. of HSE (06) Mr Imran
Mr Rashid
Mr Sahid
Mr Danish
Number of Construction Equipments
Capacity
Crane 70 Ton
Crane 70 Ton
Crane 50 Ton
Crane 50 Ton
Boom Truck 10 Ton
Trailor 25 Ton
Trailor 25 Ton
Prepared By:
Name: P.Pandey
Designation: HSEM
Date: 8/17/2016
Signature
Health Safety and Environment PAGE
Weekly HSE Report REV
Date Inspected
Project Name: CBDC PKG # 04 Month Ending : Sep 201

Cumulative Man-hours to
123,100 Overall Total Cumulative to Date
Date
Lost Time Injuries (LTI) 0
LTI Days 0
Restricted Work Injuries (RWI) 0
RWI Days 0
Medical Treatment Injuries 0
First Aid Cases 0
Accident / Incidents 0
Property Damage 0
Near Miss 0
Safety Meeting 17
Tool Box Talk Conducted 1145
Safety Induction 196
36 Indirect
160 Number of Manpower on Site: Direct
0 Other
196 TOTAL
Overall Number of Vehicle on Site: 15

Overall Total kilometers runs up to Date: 422637
ht 3) Use of proper ppe 3) How to use ladder 4) General Safety 5) Lifting , Loading un loading activities 6) Electrical Safety 7) Emeregncy P
andling 10) Fire extinguisher 11) Hand safety
Name Location RRE RRW

Mr Anoop Utility
Mr Vidyanand Easement
Mr Imran Laydown
Mr Rashid Crude
Mr Sahid Neptha
Mr Danish SK
Operator Name Type Comments

Razzak Mobile
Khurshid Mobile
Jahagir Alterrain
Mujjafar Alterrain
Afzal
Ali
Mukarab
Checked By:
P.Pandey Name: Mubashar Ahmad Khan
HSEM Designation: A/CM
8/17/2016 Date:
Signature:
PAGE 1
REV 0
h Ending : Sep 2016
123,100
36
160
0
196
Safety 7) Emeregncy Procedure 8)
RRW
Comments
har Ahmad Khan
A/CM
Toilet Cleaning Checklist (Oct. 2016) Toilet Cleaning Checklist (Nov
Toilet No. Toilet No.
SR # Time SIGNATURE SR # Time
1 Date Inspected 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
Toilet Cleaning Checklist (Dec. 2016) Toilet Cleaning Checklist (Jan

Toilet No. Toilet No.
SR # Time SIGNATURE SR # Time
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
ng Checklist (Nov. 2016)
SIGNATURE
12/30/1899
ng Checklist (Jan 2017)
SIGNATURE
FRIDAY/HO
Date Inspected
SUBCONTRACTOR:
S/N Area
PROJECT NAME-
S/N Area
2
2
Role and Responsibilities

1. TBM Participation & Working Area Inspection Befire Starting Work
4. Full Time Management of Workers in Working Area
FRIDAY/HOLIDAY WORK PL
Work Description Position
Manager
Engineer
Supervisor
HSE
Manager
Engineer
Supervisor
HSE
Work Description Position
Manager
Engineer
Supervisor
QA/QC
HSE
Manager
Engineer
Supervisor
QA/QC
HSE
ibilities
ation & Working Area Inspection Befire Starting Work
nagement of Workers in Working Area
Y WORK PLAN (Date : . )
Site Manager :
Working Time
Name
In Out
Working Time
Name
In Out
2. Check All Workers PPE
5. Housingkeeping Control
TAHTAN CM/Manager :__________________________________

.
Manager : (sign)
Total No. of Total No. of

Mobile No. Workers Equipment
Mobile No. Remarks

3. Inspecting Equipment & Tools
____________________________________(Sign)
DATE
PERMIT NUMBER
PERMIT TYPE
PROJECT TITLE CBDC
AREA LOCATION
CREW MEMBERS DETAIL
S/N NAME DESIG.
1 Mr.Asiq I/C Incharge
2 Abdul Latif Lead Man
3 Rufiquee Fitter
4 Niaz Fitter
5 Javeed Fitter
6 Luqman Fitter
7 Tanveer Helper
8 Malik dad Helper
9 Din.M Helper
10 M.Sahid Helper
11 M.Farooq Scaffolder
12 Om Prakash Scaffolder
13 Virendra Ram Rigger
14 M.Asger Helper
15
16
17
18
19
20
21
22
23
24
25
26
GENERAL REMARKS:
JP NAME & SIGNATURE
(The TOOLBOX shall be conducted by the Job Performer/ Site Supervisor/ or Site in-charge
presence of TAHTAN Safety officer. All TOOL BOX reports will be recorded and submitted fo
and monitoring.)
TOOL BOX TALK FORM
TOPIC:
MBERS DETAIL
EMPL. NO. COMPANY SIGNATURE
T-107 Tahatn
T-113 Tahatn
T-03 Tahatn
T-179 Tahatn 0
T-199 Tahatn
T-120 Tahatn
T-127 Tahatn
T-224 Tahatn
T-222 Tahatn
T-109 Tahatn
T-230 Tahatn
T-231 Tahatn
T-348 Tahatn
T-225 Tahatn
HSE SITE INCHARGE SIGNATURE
e Supervisor/ or Site in-charge in

ll be recorded and submitted for review
TAHTAN GENERAL CONTRACTING LLC
CARBON BLACK & DELAYED COKER PROJECT
DAILY CHECKLIST - DISMANTLING OF SLIPFORM
Status
Sr. Description
Satisfactory
1 TBT done
2 Crane daily inspection done
3 Proper tools available
4 Inspection of tools (if required)
5 Colour coding of tools
6 Area barricaded
7 Workers are using full body harness
8 Workers are Third Party Certified (if necessary)
9 No loose material at deck
10 No loose tools at deck
11 Tools are latched
12 No unauthorized person at site
13 Wind Speed 32km/hr
TAHTAN S/V TAHTAN HSE

CONTRACTING LLC
LAYED COKER PROJECT
MANTLING OF SLIPFORMS
Status
Remarks
Unsatisfactory
SECL HSE
Summary of First Aider and Authorized Gas Tester for RREast Area and RRWest Are
RRE RRW
Location
First Aider AGT First Aider AGT
Utility Area Anoop S Nair Anoop S Nair
Easement Mahendra Singh
Crude Area Md Rashid Md Rashid
Naptha Area Md Sahid Iqbal Md Sahid Iqbal
Oil Movement /Pump

Md Danish
House Area
Summary of Trained AGT & First Aider
Sr. No. Employee Name Training Date
1 Anoop S Nair RRE Basic First Aid 2/20/2016
2 Md Arshad RRE Basic First Aid 2/20/2016
Authorized Gas
3 Marshal CBDC 2/3/2016
Tester
Authorized Gas
4 Anoop S Nair RRE 2/3/2016
Tester
Authorized Gas
5 Md Rashid RRW 2/3/2016
Tester
Authorized Gas
6 Md Danish RRE 2/3/2016
Tester
Authorized Gas
7 Md Khalid RRW 12/7/2015
Tester
Authorized Gas
8 Mahendra Singh RRE 12/7/2015
Tester
Authorized Gas
9 Md Sahid RRW 12/7/2015
Tester
10 Mr. Raja Afzal RRW First Aider 6/27/2015
11 Md Ehshan CBDC First Aider 6/27/2015
12 d Rashid RRW First Aider 6/27/2015
13 Md Sahid RRW First Aider 6/27/2015

rea and RRWest Area
Remarks
3rd Party
ID No.
Name
Euro Gulf 5071352-6
Euro Gulf 2421908-3
Safe World SWS-AGT-

Specialists 030216-121
Safe World SWS-AGT-

Safe World SWS-AGT-

Safe World SWS-AGT-

Safe World SWS-AGT-

Safe World SWS-AGT-

Safe World SWS-AGT-

Safe World SWS-BFA-

Safe World SWS-BFA-

Safe World SWS-BFA-

Safe World SWS-BFA-

No Week Date Area
1 143 22-Sep-16 CCU SILO
4 143 22-Sep-16 SITE OFFICE
10 143 22-Sep-16 CCC SILO
11 143 22-Sep-16 WORKSHOP

14 143 22-Sep-16 OFFICE AREA
17 143 22-Sep-16 Silo

18 143 22-Sep-16 Fabrication
19 143 22-Sep-16 site offices
20 143 22-Sep-16 RRE Easement
21 143 24-Sep-16 RRE Utility
29 143 24-Sep-16 STEEL STORAGE

35 143 24-Sep-16 Steel stroge

46 143 25-Sep-16 work shop
47 143 25-Sep-16 Silo
48 143 25-Sep-16 RRE Utility

56 143 25-Sep-16 Silo
57 143 25-Sep-16 Back side office
58 143 25-Sep-16 Silo
59 143 25-Sep-16 Silo
60 143 25-Sep-16 Silo
61 143 25-Sep-16 Silo
64 143 26-Sep-16 Silo
65 143 26-Sep-16 Silo
69 143 26-Sep-16 office area

74 143 26-Sep-16 Silo
75 143 26-Sep-16 Silo
76 143 26-Sep-16 Silo

78 143 26-Sep-16 RRE Laydown

94 143 27-Sep-16 chamical stroge area
95 143 27-Sep-16 office area

100 143 27-Sep-16 CCU SILO
101 143 27-Sep-16 CCU SILO
102 143 27-Sep-16 CCU SILO
103 143 27-Sep-16 CCU SILO
104 143 27-Sep-16 CCU SILO
105 143 27-Sep-16 CCU SILO
106 143 27-Sep-16 CCU SILO
107 143 27-Sep-16 CCU SILO
108 143 27-Sep-16 CCU SILO
110 143 27-Sep-16 Silo

111 143 27-Sep-16 CCC SILO

115 143 28-Sep-16 CCU SILO
116 143 28-Sep-16 CCC SILO

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HSE OBSERV
Subcontractor










HSE OBSERVATION RE
Observation Type of HAZARD
One skip found overflowing need to remove ENVIRONMENT
Concrete debries lying in area need to remove HOUSEKEEPING
welding activite going and fire watch man not present SLIPS & TRIPS
Poor housekeeping observed area the store SLIPS & TRIPS
Light bulb is damaged SLIPS & TRIPS
Off loading matierials of scaffolding tube sling not properly use SLIPS & TRIPS
load unbalance
cable management not good west site silo SLIPS & TRIPS
Rigger give tha signal of tower crane opprater catch tha bucket
SLIPS & TRIPS
at a time no usr tha tag line
found many loose material on working platform HOUSEKEEPING
Electrical distribution board without fire extenguisher Co 2 FIRE PROTECTION
Concreet waste area not baricate HOUSEKEEPING
0 SLIPS & TRIPS

De-shackles witout color code COLOR CODE
Genertor without barricade WORK PERMIT
Helper without reflective jacket PPE
Crane checklist ot availbe at site WORK PERMIT
Extension cable found multipal connection FIRE PROTECTION
Poor cable managments SLIPS & TRIPS

found during hot work activity not good Housekeeping and Fire SUPERVISION
Protection protection system
Improper cable management in scaffold platform. SLIPS & TRIPS
Scaffolding materials need to be stacked properly. SLIPS & TRIPS
Observed unwanted scaffolding materials scattered on the SLIPS & TRIPS

scaffolding platforms.
FALL PROTECTION
Scaffolding tag was not updated in some ladder
Drinking water not available on Product silo HEALTH
Found safety harness with damage hook FALL PROTECTION
Power cable lying on ground and not burried ELECTRICAL
Scaffolding errection was in progress without putting red tag on FALL PROTECTION
iit
Bus was parked on the road that block the access ACCESS
Errection of scaffold was in progress while no barrication of

FALL PROTECTION
area
Genertor without barricade WORK PERMIT
Broken electric socket FIRE PROTECTION
Found good cable mangment system WORK PERMIT
Poor lighting in west side of stairs WORK PERMIT
Temprory hand rail is partially miss FALL PROTECTION
found during hot work activity good Housekeeping and Fire POSITIVE
Protection system
found during hot work activity not good Housekeeping and Fire
SUPERVISION
Protection protection system
Face shield not using during steel plate cutting. SLIPS & TRIPS
concreet bucket not mension SWL . SLIPS & TRIPS
scaffolding plateform wooden planks fising banding wear wear SLIPS & TRIPS
damage
vibrater not insepction and not color code SLIPS & TRIPS
Some wokers not using chin strip while working at height SLIPS & TRIPS
drinking water botal use chemical SLIPS & TRIPS
tower crane hook not color code SLIPS & TRIPS
silo up side D.P no singe for DANGER and electrion phone no SLIPS & TRIPS
scaffolding matiral not proper arange and barication missing SLIPS & TRIPS
silo up side D.P no singe for DANGER and electrion phone no FIRE PROTECTION
Fall Protection matiral not proper arange and barication HOUSEKEEPING

missing
Poor cable management in ground level, PWHT cable laying SLIPS & TRIPS
ground improperly.
Grinding machine used without guard CUT
Lifting was going on without barrication LIFTING
One worker observed taking tea in the working area SUPERVISION

Fall Protection material properly segregated and stacked HOUSEKEEPING
found during hot work activity good houskeeping and fire

POSITIVE
protection system
I observe lose matiral (bollts) shefting old vist SLIPS & TRIPS
Material lying in area not properly stacked SLIPS & TRIPS
welding activite going and Fire Protection watch man not

FIRE PROTECTION
present
Poor housekeeping observed area the store HOUSEKEEPING
Light bulb is damaged FIRE PROTECTION
Off loading matierials of Fall Protection tube sling not properly

FALLING OBJECTS
use load unbalance
During the painting silo no 1 down side area not barricated HOUSEKEEPING
Rigger give tha signal of tower crane opprater catch tha bucket FALLING OBJECTS
at a time no usr tha tag line
Worker found not using safety goggle with face sheild PPE
I observe lose matiral (bollts) shefting old vist FALL PROTECTION
Material lying in area not properly stacked HOUSEKEEPING
Found receptical damage with drill machine HOUSEKEEPING
Face shield not using during steel plate cutting. PPE
FALL PROTECTION
Falling Objects work was carried out without tag line
STRUCK / HIT
Bus was parked on the road that block the access
ACCESS
Sharp edges found at the access to main deck at silo no. 2
Good Housekeeping in workshop POSITIVE
During tha welding activity not use proper fire blanket welding FIRE PROTECTION
sports fell down
Not signaller is available with JCB SUPERVISION
Bus was not parked on designated place STRUCK / HIT
Toe board found in a scaffold not properly tied FALL PROTECTION
Accumulated Metal scrap was ideal on site HOUSEKEEPING

Welding area found satisfactory POSITIVE
Toilet condition is very poor and smeel WELFARE FACILITIES
Some people were taking breakfast on pipe rack WELFARE FACILITIES
Toilet checklist not updated WELFARE FACILITIES
acces to the office area found blocked SLIPS & TRIPS
No hand wash liquid or soap in the toilet HEALTH
Falling Objects of material with sharp edges without using FALLING OBJECTS
softener
One grander found without inspecton at silo no. 3 FIRE PROTECTION
upside silo avalible first add box and eye washers SUPERVISION
steel rebar storage area sign installed SUPERVISION
Some worker standing under suspending load FALLING OBJECTS
observed the rigger Falling Objects steel box with out using
FALLING OBJECTS
softner
found one websling in very poor condition FALLING OBJECTS
Electrical cable in proper at site ELECTRICAL
Two worker working wit out gloves PPE

Found one worker not using safety glasses PPE
Some food items found lying in the area ENVIRONMENT
Some chemical found in the area with no proper identification ENVIRONMENT
One worker observed taking tea in the working area ENVIRONMENT
Scaffolding material properly segregated and stacked SUPERVISION
One skip found overflowing need to remove HOUSEKEEPING
Found good cable management in silo POSITIVE
Rebar storage area not properly barricaded SLIPS & TRIPS
Patrol cain was found near welding plant and Electrical D B HOUSEKEEPING
Some worker observed taking breakfast at site HOUSEKEEPING
One worker observed wearing damage safety helmet HOUSEKEEPING
found barrication not propery concreet wast yard and no signs HOUSEKEEPING
Signal man doing the job with out flags SUPERVISION
Updated color code for lifting equipments COLOR CODE
FALLING OBJECTS
I observe lose matiral (bollts) shefting old vist
PPE
found one worker not using proper PPE
HOUSEKEEPING
found some concrete and debris waste at work place
drinking water botal use chemical ENVIRONMENT
tower crane hook not color code COLOR CODE

Unprotected cable lying across the way SLIPS & TRIPS

De-shackles witout color code COLOR CODE
Unprotected cable lying across the way SLIPS & TRIPS

TION REPORT
Risk Level Status Closed Date Observer
LOW Close 22-Sep-16 Vidyanand
LOW Close 22-Sep-16 IMRAN
LOW Close 22-Sep-16 RASHID MAHMOOD

LOW Close 22-Sep-16 Marshal
MEDIUM Close 22-Sep-16 Vidyanand

LOW Close 22-Sep-16 DANISH
MEDIUM Close 24-Sep-16 Vidyanand
LOW Close 24-Sep-16 ANOOP


MEDIUM Close 25-Sep-16 Marshal
LOW Close 25-Sep-16 Akhtar
LOW Close 25-Sep-16 Akhtar
MEDIUM Close 26-Sep-16 IMRAN

Close 26-Sep-16 IMRAN

Close 26-Sep-16 IMRAN




Corrective Action Preventive Measures
informed to the admin to arrange for the
TBT and Close Supervision
removal of skip
informed to area supervisor to clear the

debries from area
stop tha work and infome area

superviseor arange tha fire watch man TBT and Close Supervision
then start tha work
informed to store supervisor for

housekeeping the area around the store
informed o electrician to change the

bulb
Adviced to rigger on tha sports should TBT and Close Supervision

be load balance
Informed to welding supervisor proper TBT and Close Supervision
arangment
I infome tha rigger to use tha tagline not TBT and Close Supervision
catch by hand any load
informed engg/ foreman to remove all TBT and Close Supervision

loose material from working material
informed the foreman to immediately TBT and Close Supervision

provide tah fire estengusher Co2
informed foreman to immediately TBT and Close Supervision
barricated
Need to be fix TBT and Close Supervision
Need to update TBT and Close Supervision
To be provide barricade TBT and Close Supervision
Ensure to be provide daily basis TBT and Close Supervision
Provide more extension connection TBT and Close Supervision

To be arrange cable TBT and Close Supervision
Informed to supervisor to be amaintin TBT and Close Supervision
100% safe activity
infomed tha workers use tha face sheet TBT and Close Supervision
cutting & granding time.
informed to tha rigging supervisor SWL
past in concreet basket
informed to tha scaffolding superviser

wear proper fixing
informed to electrician for the inpectoion
of DB
informed the admin to arrange the

drinking water at site
Removed the harness and mark it as

rejected
informed the elctrician to burried the
cable
informed the scaffolding supervisor to
put red tag
informed the driver to be park only
designated area of parking
informed the scaffold supervisor to

provide barricade
informed to electrician to be removed
from site
informed to supervisor to be maintain
daily basis
advise to electrican to be provide extra

light during night work activity
advise to supervisor to be fix hand rail TBT and Close Supervision
Infomed tha supervisor to be maintian TBT and Close Supervision

100% safe activity
informed to tha rigging supervisor SWL
past in concreet basket
informed to tha scaffolding superviser

wear proper fixing
infomed tha Electrical supervisor

insepction tha vibrater
informed to all workers to use chin strip

all time at height
infomed tha all workers do not use water
botal in camicals
informed to rigger supervisor to chak tha

all rirring tools insepction and couler TBT and Close Supervision
code
infome tha electrical depart post tha

singe and phone no day and night sheft
informed to scaffolding supervisor to

arange tha scaffolding matiral properly TBT and Close Supervision
and barication
infome tha Electrical depart post tha

singe and phone no day and night sheft
informed to Fall Protection supervisor to

arange tha Fall Protection matiral TBT and Close Supervision
properly and barication
informed to area engineer to clear the

access
Informed and provide the guard
immediately
informed to the welder to wear properly
the welder hood
informed to the worker not to bring the

food stuf at site area
appriciation given to the Fall Protection
team in next morning TBM

100% safe activity
not allow matiral shifting only lifting bag
informed to supervisor to arrange the
material
stop tha work and infome area

superviseor arange tha Fire Protection TBT and Close Supervision
watch man then start tha work
informed to store supervisor for

housekeeping the area around the store
informed o electrician to change the

bulb
Adviced to rigger on tha sports should TBT and Close Supervision

be load balance
Informed to supervisor barricated the TBT and Close Supervision
area
I infome tha rigger to use tha tagline not TBT and Close Supervision
catch by hand any load
advice given to worker to wear safety
goggle
not allow matiral shifting only Falling TBT and Close Supervision
Objects bag
informed to supervisor to arrange the
material
informed to electrician to replace the
damage receptical
strictly instructed the rigger to use
tag line
informed the driver to be park only TBT and Close Supervision

designated area of parking
informed the foremanto remove the TBT and Close Supervision
debris workplace
To be maintained TBT and Close Supervision
informed to welding superviser propre
fixing tha fire blanket
Informed and depute the signaller TBT and Close Supervision

Informed to driver and parked at designated
place

informed to scaffold supervisor to tie the
toe board properly
Need to remove TBT and Close Supervision
To be maintained TBT and Close Supervision
Informed to assigned person and cleaning
done
Informed not eating outside of rest shelter TBT and Close Supervision
Update the checklist TBT and Close Supervision

informed to area engineer to clear the
access
informed to admin to arrange the soap
or hand wash liquid
informed to rigging foreman and riggers
to use sotner
informed to electrician for the inspection
of the grander
hse area supervisor TBT and Close Supervision
informed to the rebar supervisor sign

rebar stroge area
remove tha workers and morning diskis TBT and Close Supervision
to TBM
instructed him nicely to use softner
informed the rigger and the crane TBT and Close Supervision
operator to avoid using
Infomed tha electrion make it propely
Infomed to supervisor provide working TBT and Close Supervision
gloves
informed him to use safety glasses TBT and Close Supervision
informed to supervisor any kind of food

ia not allow to site
informe the supervisor to be put proper

identification
Infomed tha superviosr to be stop this
kind of activity
Informed to be maintian good practice TBT and Close Supervision
keep it maintained TBT and Close Supervision
Infomed tha supervisor to be maintian TBT and Close Supervision
informed to area supervisor to provide
proper barricades
informed tha area superviser imegetly

remove tha patrol cain and sheft tha TBT and Close Supervision
chamical stroge area
informed to that worker that no food stuff

allowed to bring at site
informed to worker to replace the

damage helmet
informed the fore man to install the TBT and Close Supervision
barricate properly
Provide and advise him to work with TBT and Close Supervision
flags
Informed to be maintian good practice TBT and Close Supervision
not allow matiral shifting only Falling TBT and Close Supervision
Objects bag
instructed him to wear proper PPE
removed it by HSE helpers
infomed tha all workers do not use water
botal in camicals
informed to rigger supervisor to chak tha

all rirring tools insepction and couler TBT and Close Supervision
code
barricated
Need to update TBT and Close Supervision


barricated
SAMSUNG ENGINEERING CO.,
TAKREER CARBON BLACK & DELAYED COKER (CBDC) PRO
CONFINED SPACE SIGN-IN / SI
Supervisor Name: Sign: Hole Watchman Name:
Confined Space Permit No: Area: Date:
COMPANY NAME ID# TIME IN TIME OUT TIME IN TIME OUT
O2
Gas Test 19.5% <
H2S <1ppm CO <25ppm LEL <1%
In case of emergency O2
please contact me: < 23.5%
Mr.praveen Mishra 052-
733-9526
MSUNG ENGINEERING CO., LTD.
DELAYED COKER (CBDC) PROJECT, AL RUWAIS, ABU DHABI
ACE SIGN-IN / SIGN-OUT FORM
Hole Watchman Name: Sign:
Other Permit No:
TIME IN TIME OUT TIME IN TIME OUT TIME IN TIME OUT TIME IN TIME OUT
Time Name Sign

SIGNATURE
Sign
CAR
Contract
or/Comp
S.NO. Date Time Observer Location Area/Dept
any
Name
4066 ### 09:00 AM P.Harris COLD FLARE HSE AJES

4067 ### 09:15 AM P.HarrisLAYDOWN YARD HSE MGS
4068 ### 09:26 AM P.Harris TAHTAN HSE TAHTAN
4069 ### 09:41 AM P.HarrisLAYDOWN YARD HSE NSH
4070 ### 09:45 AM P.Harris
COMMUTING ROUTE HSE SECL
4071 ### 08:34 AM P.Harris SS 105 HSE MGS
4072 ### 08:58 AM P.Harris LAYDOWN #2 HSE SECL
4073 ### 09:05 AM P.Harris LAYDOWN #2 HSE SECL
4074 ### 09:28 AM P.HarrisLAYDOWN (RRE) HSE AMB HERTEL
4075 ### 09:44 AM P.Harris
BLAST YARD (RRE)HSE XERVON
CARBON BLACK AND DELAYED COKE
SOR REGISTER
Observation
Housekeeping Required : Rubbish pile and loose material need removal

Concrete and Wood scrap need removal
Metal @ concrete waste need removal
Great Progress on Cleaning Waste / Debris Pile
Good traffic flow during peak times
Worker without safety glasses
SE Corner - Cable drums ans wood scrap need removal - FIRE HAZARD
SE Corner - Rebar, metal scrap and paint cans need removal
GENERAL HOUSEKEEPING needed Wood scrap, cable trays,etc
BLAST AREA - Need Housekeeping against South Fence
ELAYED COKER PROJECT
EGISTER
Lack of Training
Lack of Belief
Action
Positive/Negative Describe
Status
Describe
ImmediateAction
Corrective
to
Describe
Prevent
Action
Indirect
Recurrence
Cause
(Yes/No)
Negative Y OPEN N/A N/A N/A

Positive N CLOSED N/A N/A N/A
Positive N CLOSED N/A N/A N/A
Lack of Resources
Others
SOR
SOR
Remarks Reported Note
(Closed
Date
Date)
5/29/2016
5/29/2016
5/29/2016
5/29/2016
5/29/2016
5/29/2016
5/29/2016
5/29/2016
5/29/2016
5/29/2016
TAKREER Carbon Black & Delayed C
GAS MONITORING
Date Inspected
Flammable Oxygen
Location Time
(%LEL) O2(%)
Date : Model:
Prepared By: Position:

Carbon Black & Delayed Coker (CBDC) Project
MONITORING REPORT
Oxygen Toxic
Remarks
O2(%) AMMONIA H2S(PPM) SO2(PPM) CO(PPM)
Serial No:
Position: Signature:
Remarks
CARBON BLACK & DELAYED COKER PROJECT

WRITTEN WARNING LETTER
Date Inspected
NAME OF OFFENDER :
DESIGNATION :
AGE :
Supervisor :
YEARS OF EXPERIENCE :
DATE OF ISSUE :
LOCATION OF OFFENCE :
DESCRIPTION OF OFFENCE :
:
ISSUED BY : NAME
DESIGNATION : SIGNATURE
SIGNATURE OF OFFENDER
NOTE:
ISSUE OF WARNING LETTER FIRST TIME
ISSUE OF 2ND WARNING LETTER OFFENDER WILL BE SENT FOR RE-ORIENTATION

ISSUE OF 3RD WARNING LETTER OFFENDER WILL BE REMOVED FROM SITE
ED COKER PROJECT
ing L.L.C
NG LETTER
SR.NO./.:
EMPLOYEE :
SEX
SIGNATURE
DATE-
RE-ORIENTATION
FROM SITE
Indent Reque
Indent No. _____________________
Quantity
Sr. No. Material Description Unit
Requested
1 FILE CABINET Nos 1
2 OFFICE CALCULATER Nos 1
3 WHITE BOARD Nos 1
4 MARKER (BLACK ) Nos 2
5 MARKER (RED ) Nos 2
6 DUSTER Nos 1
7 PRINTER CATRIDGES (BLACK & WHITE) Nos 2
8 PRINTER CATRIDGES (COLOUR) Nos 2
9 FILE FOLDER Nos 10
10 GLUE STICK Nos 1
11 PLASTIC COVER FOR FILLING PKT 2
12 FILE DIVIDER PKT 2
13 HIGHLIGHTER (GREEN,RED,YELLOW) PC 2E
14 WHITNER PC 1
15
16
17
18
19
20
P.PANDEY
Requested By Recommended B
Name: PRIYARANJAN PANDEY Name:
DesignaLEAD HSE Designation:
Indent Request Form
Date: _____06-01-2016____
Quantity Requirement Purchase

Approved Date Location
Recommended By
_06-01-2016____
Remarks
Approved By
Site Manager

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FIRE EXTINGUISHER

Project : Date Inspected Date :

Gauge clean & legible

Label clean & legible

Cylinder inverted and bumped to loosen

Safety pin secured from accidental

Attached and marked by competent person

within last three months.

Attachment point secure & restrains

Fire extinguisher sign in place & correct type

1 ME RAJA AFZAL SUPERVISOR

2 MR.EHSAN KAUSHAR SUPERVISOR

COMPANY CONTACT NO. PKG NO.

TPC CERTIFICATE NO. EXPIRY DATE STATUS

SWS-BFA-270615-24 6/26/2016 On Site

SWS-BFA-270615-22 6/26/2016 On Site

SWS-BFA-270615-23 6/26/2016 On Site

SWS-BFA-270615-21 6/26/2016 On Site

SWS-BFA-270615-20 11/26/2016 On Site

SWS-BFA-270615-19 11/26/2016 On Site

SWS-BFA-270615-18 11/26/2016 On Site

SWS-BFA-270615-17 11/26/2016 On Site

LocatioDate Inspected Month:

1 2/9/2016 RRE PUMP 44411267

D-Ring(s) Buckle(s) (Include

Body Pad (if applicable)

Engineered Anchor Points

S / NO. COMPANY TYPE OF LIFTING EQUIPMENT

1 TAHTAN Contracting L.L.C Webbing Sling

2 TAHTAN Contracting L.L.C Webbing Sling

3 TAHTAN Contracting L.L.C Nut and Bolt Bow Shackle

4 TAHTAN Contracting L.L.C Screw Pin Bow Shackle

5 TAHTAN Contracting L.L.C Nut and Bolt Bow Shackle

6 TAHTAN Contracting L.L.C Nut and Bolt Bow Shackle

7 TAHTAN Contracting L.L.C Screw Pin Bow Shackle

8 TAHTAN Contracting L.L.C Webbing Sling

9 TAHTAN Contracting L.L.C Webbing Sling

10 TAHTAN Contracting L.L.C Webbing Sling

11 TAHTAN Contracting L.L.C Webbing Sling

12 TAHTAN Contracting L.L.C Webbing Sling

13 TAHTAN Contracting L.L.C Webbing Sling

14 TAHTAN Contracting L.L.C Webbing Sling

15 TAHTAN Contracting L.L.C Webbing Sling

16 TAHTAN Contracting L.L.C Webbing Sling

18 TAHTAN Contracting L.L.C Webbing Sling

19 TAHTAN Contracting L.L.C Webbing Sling

20 TAHTAN Contracting L.L.C Webbing Sling

21 TAHTAN Contracting L.L.C Webbing Sling

22 TAHTAN Contracting L.L.C Webbing Sling

23 TAHTAN Contracting L.L.C Webbing Sling

SIZE / DIAMETER SWL THIRD PARTY COMPANY

6mm/6mtr 6 Ton Euro Gulf

4mm/6mtr 4 Ton Euro Gulf

7/8"' 6.5 Ton Euro Gulf

7/8"' 6.5 Ton Euro Gulf

1"' 8.5 Ton Euro Gulf

1"' 8.5 Ton Euro Gulf

1"' 8.5 Ton Euro Gulf

1"'*1.5M 12/30/1899 Euro Gulf

1"'*1.5M 1 Ton Euro Gulf

1"'*1.5M 1 Ton Euro Gulf

1"'*1.5M 1 Ton Euro Gulf

2"'*1.5M 2 Ton Euro Gulf

Job Position: _______________________________ ID Number: