SHO Monthly REPORT Style

SAFETY & HEALTH OFFICER REPORT MONTH OF

To :

Date :

From: 1

1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 2

2.1 2.1

Safety & Health lth statistic. ic. (Regulation 19 sub clause c) Man-hours work (No. LTI) : LTI case :   No LTI (minor injury) In-plant contractor accident : In-plant near miss : In-plant fire/smoke incident : Traffic accident (out-plant & in-plant) : Others incident : Frequency rate (LTI). : Frequency rate (No LTI) : Severity rate (LTI) :

References/Comment

:

Mach Machin iner ery, y, equ equip ipme ment nt,, proc proces esse sess with with hav havee the the potential to cause an injury to employees. (Regulation 19 sub clause d ) Mach Machin inee tran transf sfer er & new new mach machin inee inst instal alla lati tion on::-

3

Acc Accide ident occ occurr urred in in the the wor work pla placce. (Regulation 19 sub clause c)

4

Work Work condu conduct cted ed relat related ed to Occu Occupat pation ional al Healt Health h & safe safety ty to improve the safety & health at the work place. (Regulation 19 sub clause g)

5

To Esta Establ blis ish h & Mai Maint ntai ain n heal health thy y & saf safee wor worki king ng condition. (Regulation 19 sub clause b)

6

Prop Propos osal al for for arr arran ange geme ment nt the the wor works ks plac placee and and structure to improve the safety & health for the workers. (Regulation 19 sub clause f)

7

Acti Action on by the the emp emplo loye yerr to to com compl ply y wit with h law law and and regulations. (Regulation 19 sub clause a)

8

Outsta Outs tand ndin ing g matt matter erss aris arisin ing g from from pre previ viou ouss repo report rt.. (Regulation 19 sub clause h)

9

OTHERS. (Regulation 19 sub clause i)

10

CEO/MD/ COMMENT & RECOMMENDATI RECOMMENDATION  ON 

PREPARED BY :

CEO/MD/ COMMENT &  RECOMMENDATION 

Signature:………………………… Date :

[ As refered in Occupational Safety and Health Act 1994 under OSH(Safety and Health Officer) Regulation 1997 1997 Part Part V Sub Sub Reg Regul ulat atio ion n 20(1 20(1), ), 20( 20(2) 2) and and 20( 20(3) 3).. ]