Doc No:
EMPLOYEES FOR/ENGG/KMDP/SFTY/01
INDUCTION Rev No:00
FORMAT Date:07/12/2023
Date:
Name of Employee: __________________________________Employee code: _______________
Department: _________________________________
The Induction covered the following topics and understand by Safety
dept.:
Topics Yes/No Remarks
1.Emergency Preparedness
Plan
2.Personal protective
Equipment
3.Fall Protection
4.Electrical safety
5.Fire Prevention
6.Environment safety Plan
7.Lockout/Tag out
8.Traffic Safety
9.Vehicle driving safety
10.Emergency Evacuation
Plan
11.Emergency Contact Details
Note: If No put remark
Employee signature
Safety Officer
Doc No:
Occupational Health & Safety Incident FOR/ENGG/KMDP/SFTY/02
Report Rev No:0
Date:07/12/2023
“Score Zero” Page No-1 of 2
Sub
Business Unit Unit Location Date
Safety incident includes the following : Reportable Incidents (Fatality, Permanent Disability, Away from duty more than 48 hours), First
Aid &/Medical (Only if it could have turned into an reportable), Near miss, Occupational Health Illness, Other Incidence (Fire, Property
Damaged etc.)
A. Event Time & Date :-
Incident Date Incident Reported
Incident Time Fatality Date
B. Event Type :-
a. Fatality : d. First Aid &/Medical only : Anything other than point # a. to f.
b. Permanent Disability : e. Occupational Health Illness : Brief narration if applicable/required
c. Away for More than 48 hrs : f. Near miss :
C. Injured Person Details :-
Name of Employee :-
Employee Number :- Job Title :-
Employment Type :- Temporary : Permanent : -
D. Property damaged cost estimation
In INR : 10k to 50k In INR : 1 Lac to 10 Lac
In INR : 50k to 1 Lac In INR : 10 Lac & Above
External Agency Notification?
If Yes, Enter the name of the Applicable agency. (Press, Fire Brigade, Factory Inspectorate, Police etc.)
E. Location on Site :-
F. Incident Description & Existing Control Measures :- ( add separate sheet if require )
G. Why-why Analysis :- ( add separate sheet if required )
H. Incident Drawings, or Photo/s :
I. Corrective Action Classification :-
a. Eliminate :
b. Substitution :
c. Engineering (Includes redesign, separate and isolate ) :
d. Administration (Includes training and procedures ) :
e. PPE :
J. Cost of an Incident: (Tangible & Intangible)
FIRE Doc No:
FOR/ENGG/KMDP/SFTY/04
FOR/ENGG/KMDP/SFTY/03
HYDRANT SYSTEM
EXTINGUISHER Rev No:00
INSPECTION FORMAT
INSPECTION
Date Of Date:07/12/2023
Next
Date:07/12/2023
S Extinguisher FORMAT
Capacit inspecti due
NoProject
Project
ID site:
site: Location Type
Month: y on Month:
Date Status/Remarks
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Check Point:
Fire Extinguishers Body condition
Handle Condition
Pressure Gauge Condition
Pressure Gauge in Green Zone
Discharge Hose/Home Condition
Extinguishers Hanging? Stand Condition
Checked By HOD
(Name & Signature) (Name &
Signature)
S Hose
No Hydra 15 Date Of Next
nt Hose Mtr/30 Nozzl inspectio due
Location Point reel Mtr e n date Remarks
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Water Pressur
Level e Gauge Date of Next
S Pump Name Oil Diesel of Conditio inspecti due Remark
No & No Level Level Tank n on date s
1
2
3
4
Checked By Safety Officer
(Name & Signature) (Name
& Signature)
Doc No:
FIRST AID BOX FOR/ENGG/KMDP/SFTY/05
INSPECTION Rev No:00
FORMAT Date:07/12/2023
Project site: Month:
S No Location Date of Inspection Status
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Remarks:
Checklist:
Antiseptic Liquid
Antiseptic Lotion
Bandage/Paper Tape
Banded
Absorbent Cotton
Expiry Date of Material
Yes Ok
Checked By
Not
Safety Officer No Ok
(Name & Signature) (Name
& Signature)
Doc No:
ONSITE SOP/KMDP/SFTY/01
EMERGENCY Rev No:00
PLAN Date:07/12/2023
THE KRISHNA DISTRICT MILK PRODUCERS
MUTUALLY
AIDED CO-OP UNION LTD
MILK PRODUCTS FACTORY
VIJAYAWADA-520001
KRISHNA DISTRICT.AP.
Doc No:
HAZARD SOP/KMDP/SFTY/02
ANALYSIS & RISK Rev No:01
ASSESSMENT Date:20/02/2021
THE KRISHNA DISTRICT MILK PRODUCERS
MUTUALLY
AIDED CO-OP UNION LTD
MILK PRODUCTS FACTORY
VIJAYAWADA-520001
KRISHNA DISTRICT.AP.
ANNEXURES-1
LIST OF FORMATS
Sl. No TITLE Doc. Ref. No. LOCATION
1 EMPLOYEES INDUCTION FORMAT Doc No: FOR/KMDP/SFTY/01 Project Site
2 ACCIDENT/ NEAR MISS Doc No: FOR/KMDP/SFTY/02 Project Site
INVESTIGATION
3 MOCK DRILL REPORT Doc No: FOR/KMDP/SFTY/03 Project Site
4 FIRE EXTINGUISHER INSPECTION Doc No: FOR/KMDP/SFTY/04 Project Site
5 HYDRANT SYSTEM INSPECTION Doc No: FOR/KMDP/SFTY/05 Project Site
6 FIRST AID BOX INSPECTION Doc No: FOR/KMDP/SFTY/06 Project Site
8 ON SITE EMERGENCY PLAN Doc No: SOP/KMDP/SFTY/01 Project Site
9 HAZARD ANALYSIS & RISK Doc No: SOP/KMDP/SFTY/02 Project Site
ASSESSMENT
10 GENERAL WORK PERMIT1 Doc No: FOR/KMDP/GEWP/01 Project Site
11 COFINED SPACE WORK PERMIT Doc No: FOR/KMDP/CSWP/01 Project Site
12 HOT WORK PERMIT Doc No: FOR/KMDP/HOWT/01 Project Site
13 EXCAVATION WOK PERMIT Doc No: FOR/KMDP/EXWP/01 Project Site
14 HEIGHT WORK PERMIT Doc No: FOR/KMDP/HEWP/01 Project Site
15 ELECTRICAL WORK PERMIT Doc No: FOR/KMDP/G/01 Project Site
