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activity
Avg for
Sl. No. Activities Documents Records Parameters Avg

9
1. Tool box talk / pep talk Permit to work 4 4 4 4 4 5 4 4 4 5 4 4 4 4 4 5 4 4 4 4 4 4 4 4.13
1. Method Statement for 2. Safe to Start Adherence to PPE / unsafe acts 5 3 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4.00 Housekeeping 3.91
Branch fiting and pipe Piping 3. Work permit HIRAC / JHA 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5.00 Permit to work 4.13
1 4.18
instalation 2. HIRAC for Basement 4. Observation Unsafe Conditions 4 4 4 4 4 4 4 4 4 4 4 4 5 4 4 4 4 4 4 4 4 4 4 4.04 HIRAC / JHA 5.00
ceiling piping 5.Housekeeping checklist Housekeeping 3 4 4 4 4 3 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 3.91 Unsafe Conditions 4.04
6.Monitoring checklist Supervision 4 4 4 4 4 4 5 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4.04 Supervision 4.04
1.Tool box talk/Pep talk Permit to work Adherence to PPE / unsafe acts 4.00
1. Method Statement for 2. Safe to Start Adherence to PPE / unsafe acts 4.18
storm water drainage 3. Work permit HIRAC / JHA
Material loading &
2 piping #DIV/0!
unloading 4.Observation Unsafe Conditions
2. HIRAC for storm water
drainage piping. 5. Housekeeping checklist Housekeeping
6. Monitroing checklist Supervision

3
5
5
5 Housekeeping

5.00
3.91

Adherence to PPE / unsafe acts Permit to work

4.00 4.13

0.00

4.04
5.00
Supervision HIRAC / JHA
4.04

Unsafe Conditions

4.5
 LARSEN & TOUBRO LIMITED
BUILDINGS AND FACTORIES INDEPENDENT COMPANY
DAILY MONITORING INDEX CHECKLIST
DATE
SECTION
STRUCTURE / ELEVATION / FLOOR

SL.NO PARTICULARS
Housekeeping Yes / No NA
Clearly identified location for material storage,
description of materials to be stored displayed
100% material stacked in its place as per standard
all employees are aware of where to keep what
walkways are clearly marked and kept clear
Identify the area to be barricaded,
Permit to Work
PTW in place
signed
displayed
understood
being followed
closed
valid, tool box talk done
HIRAC / JSA
HIRA availability at site with concern person
awareness
hazards are adequately identified,
All the recommendation are implemented

Unsafe Conditions
Any unsafe conditions observed. If yes
Describe

is / are unsafe condition (s) communicated to the

concerned
Any unsafe condition rectified on the spot
Supervision
Supervisor present at work
observing
conduct tool box signature and aware of process
Coaches and mentors the team

PPE Adherence and Unsafe Act

No violation seen
properly assessed and documented
PPE provided
Awareness
no of PPE observed without PPE
 Site Safety Index
0 1 2

Materials are
Materials are
scattered, No clear Awareness is not
scattered, No clear
area, haphazard, available, not
Housekeeping personnel are not
area, haphazard,
clearly identified,
personnel are not
aware, repeated walkway clear
aware
finding

PTW written but not

PTW written &
signed, not
Permit to Work No PTW, personnel work
understood by
valid, tool box talk
not done
supervisor

JSA written, not

JSA covers all
covering all activity
No JSA, No detailsof activities, hazards
HIRAC / JSA activity
being done, hazard
are identified
findings are not
inadequate
adequate

Unsafe > 10 findings during > 8 findings during the > 6 findings during
Conditions walk talk the walk

Supervisor present
No supervisor Supervisor identified at work, not
Supervision identified and present. but not present . observing details -
too many activities

> 3 violations
> 5 violations
> 5 violations observed observed
PPE Adherence observed during walk.
during walk, No during walk,
and Unsafe Act awareness of PPEs Personnel are aware
Inadequacy in
of PPE requirement
documentation
te Safety Index
3 4 5

Clearly identified location for

material storage, description
Awareness good, clearly of materials to be stored
Awareness good, clear identified location for displayed, 100% material
identification, barricaded, material storages, stacked in its place as per
few material not stacked barricaded, materials are standard, all employees are
stacked in its place aware of where to keep what,
walkways are clearly marked
and kept clear

PTW written & valid, tool PTW written & valid, tool PTW in place, signed,
box talk not done, not box talk done, signed & displayed, understood, being
displayed displayed but not closed followed, closed

JSA covers all activities,

JSA covers all activities,
hazards are identified JSA covers all activities,
hazards adequately
adequately, hazards are adequately
identified, controls
recommendations identified, recommendations
inadequate, awareness
adequate, awareness adequate, good awareness
poor
need improvement
> 4 findings during the > 2 findings during the
No unsafe condition
walk walk
Supervisor present at Supervisor present at work,
Supervisor present at
work, observing, observing, conduct tool box
work, observing, conduct
conducts tool box and signature and aware of
tool box
aware of process. No process. Coaches and
talk, Lack of awareness
documents mentors the team

PPE provided,
PPE provided, documented, Aware but
No violation seen, properly
documented but not worn not followed as an
assessed and documented
by the operators exception < 3 findings
during walk