Arkad Engineering and Construction Company

Form No. :ARK-P050-HS-FRM-00011 Revision No. A Revision Date: Title: Weekly HSE Deviation Report

Weekly HSE Deviation Report

Project Name
BI No. Week No. 2 Week Inclusive Document No.
From 02 Feb 2018 to 08 Feb 2018

Health / Time frame for Status

Type of Responsible
No. Safety / Description Photo Date Observed Recommendation Corrective Category Location (Open,
Observation Person
Environment Action Closed)

Ample supplies of approved

hearing protection (e.g., earplugs)
Found that some wokers are shall be
Safaniyah
1 Unsafe Act Safety working without ear plugs - NOT AVAILABLE 4-Feb-18 provided at the job site and shall Supervisor Immediately PPE'S Closed
GOSP
Asphalt cutting area be worn in high noise areas (i.e.,
85
decibels [dBA] or higher).

Contractor shall ensure that

personnel requiring sight
correction (as
determined by a vision check)
Observe that surveying group are wear appropriate safety eyewear Safaniyah
2 Unsafe Act Safety NOT AVAILABLE 4-Feb-18 Supervisor A: Immediately PPE'S Closed
not wearing safety glass. (i.e., GOSP
prescription safety glasses with
side protection or safety
overglasses over
standard prescription glasses).

Proper bonding and grounding

Safe Work
Observe that welding works are techniques shall be used for any Safaniya 24''
Unsafe Practices/Perm
3 Safety ongoing without proper NOT AVAILABLE 6-Feb-18 operation Supervisor A: Immediately Header line Closed
Condition its/Work
grounding where static electricity could near fence
Procedure
become an ignition source.

Plan and maintain good

housekeeping in the work
Safaniya 24''
Unsafe Observed that plastics, woods area.Good housekeeping shall be
4 Safety NOT AVAILABLE 6-Feb-18 Supervisor A: Immediately Housekeeping Header line Closed
Condition boxes are scattered on ground maintained to help prevent slips,
near fence
trips and
falls.
 Hard barricades (e.g., concrete or
water-filled plastic “jersey”
barriers, Safe Work
Safaniya
Disorderly barrication in some metal fencing) shall be used to Practices/Perm
5 Unsafe Act Safety NOT AVAILABLE 7-Feb-18 Supervisor A: Immediately plant near Closed
excavated areas keep motor vehicles, cranes and its/Work
fence
heavy Procedure
equipment at the proper distance
away from the excavation.

Crane lift areas shall be

barricaded and secured. Only
authorized personnel
shall be permitted inside the
Found that Lifting operations are Safaniya
Unsafe barricaded area. Warning signs
6 Safety ongoing without proper NOT AVAILABLE 7-Feb-18 Supervisor A: Immediately Lifting plant near Closed
Condition shall be placed
barricades fence
at barricaded perimeters warning
site personnel of the hazards of
overhead
lifting activities

Trash containers shall be of

durable construction and shall be
located as
needed throughout the work area.
Trash containers shall be
covered, clearly Safaniya
Health and
7 Unsafe Act Environment Improper disposal of food scraps NOT AVAILABLE 7-Feb-18 marked and emptied daily. Supervisor A: Immediately plant near Closed
Welfare
Separate trash containers, with fence
suitable
disposable plastic liners, shall be
provided for food scraps and
other
organic matter.

HSE Manager Project Manager

Signature: Signature:
1- DON’T CHANGE THE FORMAT IN ANY WAY. FOR EXAMPLE, FONT AND FONT SIZE.
2- ALWAYS USE THE DROP DOWN LISTS FOR (TYPE OF OBSERVATION, HEALTH, SAFETY, ENVIRONMENT, CATEGORY ,STATUS, TIME FRAME )
3- ALWAYS HAVE COMPLETE INFORMATION, (NAME OF THE PERSON, POSITION & LOCATION)
4- DOCUMENT NO. (JUST ADD THE WEEK NUMBER. e.g., P-100 WBPP – 18).
5- ALWAYS SPECIFY ACTION ASSIGNED TO RESPONSIBLE PERSON.
6- CUT-OFF IS EVERY THURSDAY AND TO BE SUBMITTED EVERY THURSDAY AFTERNOON UNLESS AGREED UPON WITH THE CORPORATE HSE DEPARTMENT.
7- ALWAYS MAKE SURE THAT THE NUMBER OF OBSERVATIONS IS THE SAME IN BOTH WEEKLY HSE DEVIATION REPORT AND WEEKLY HSE PERFORMANCE STATISTICS REPORT .
8- DON’T PUT MORE THAN FOUR OBSERVATIONS IN ONE PAGE.
9- TIME FRAME FOR CORRECTIVE ACTION A: IMMEDIATELY B: WITHIN 2 DAYS C: WITHIN 2 WEEKS.
10- TO ADD A NEW ROW: RIGHT CLICK ON HEADING SELECT " INSERT".
FRAME )
Fall Protection
Trenching/Excavation/Shoring
Scaffolding/Ladders
RATE HSE DEPARTMENT.
KLY HSE PERFORMANCE STATISTICS REPORT .

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