2nd party Safety audit report-

C1 C2
Name of Department / Safety system to be
Sr. No.
Plant Planned Actual Planned Actual audited

1
2
3
Field Safety
4 Compliance, PSR,
5 Training &
6 Performance, Incident
7 Investigation &
Resporting, Change
8 Management, WPS,
9 CSM B and
10 Emergency Planning
11 & Response,
Electrical Safety etc.
12
13
14

Period FS PSR T&P IIR CM EPR WPS CSM B Electrical Average

2020-21 (C1) 0.0 0.0 0.0 0.0 0.0 #DIV/0! #REF! NA NA #DIV/0!
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Audit trend- Plant wise score

Plant wise Audit score (In %) Score color code < 80 % 80 to 95% > 95%
Safety system FS PSR T&P IIR CM EPR WPS CSM B Electrical Plant Average
Plant/ Period C1 C2 C1 C2 C1 C2 C1 C2 C1 C2 C1 C2 C1 C2 C1 C2 C1 C2 C1
0.0 0.0 0.0 0.0 0.0 \ #REF! NA NA NA NA #REF!
Syetem Average 0.0 0.0 0.0 0.0 0.0 #DIV/0! #REF! #DIV/0!
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Audit Protocol for Field Safety Compliance

UPL Site No.: Plant Name P4 plant

Auditor Name : Auditee Name
Period : Date of Audit
Total score
Sr. No. Description Yes/No/NA
331
Safety Talk is being done in all the shift and record is being
1 maintained. 5
Team is aware about Safety vision and Inviolable
2 standard 5
Hazard area classification done and it is maintained as per
3 requirement. 5
Safety signages and notices are displayed at various
4 locations in national/local language. 5
Emergency exits are clearly marked & approach area are
5 free from obstructions and lightened properly. 5
Emergency lights are provided in plant with RED in colour &
6 Power back up (UPS) inspected as per plan. 5
Access to Emergency Equipments like FE/FH/SS/Sand
7 Bucket/SCBA is clear and lightened properly. 5
Shop floor house keeping is maintained in good condition.
8 5
Plant condition is free from leak/spill of any
9 material/water/air/steam etc. 5
10 Spill control kit is available. 5
Shop floor is free of unwanted material for smooth operation.
11 5
Plant floor is free from obstacle and proper walk way is
12 marked on the floor. 5
13 Ladder hand rail and steps are ok. 5
Proper Insulation is available on all hot and cold surfaces.
14 5
Steam or hot pipes (> 50 deg)within 8 feet of the floor or
15 working surface are insulated. 5
Caution display is available for any auto start equipment.
16 5
Safety floor end railing and toe guard are sufficient/provided
17 on each floor. 5
All rorating parts of machines are fully guarded to prevent
18 injury. 10
19 Plant and other area are free from any chemical odour. 5
20 Plant and other area are free from dusting. 5
Noise level found normal and where it higher than 85 db,
21 caution board displayed with PPE requirement. 5

All sample or other container are clean, closed and labelled

22 completely. 5
All glass line/equipments are protected by mechanical
23 guards. 5
Flammable fluid lines are having jumpers across the flanges
24 & earthing ensured for equipments. 3
Hazardous chemical pipelines are having flange guards.
25 5

Equipment Earthing continuity test is carried out yearly and

26 result are within limit. 5
27 No floor opening without hard barrication. 5
Flameproof integrity maintained for all electrical appliances.
28 5
Forklift drivers are properly trained & certified by Godrej or
29 equivalent & aware for safety requirement ? NA
Site is practicing daily operation and maintenance inspection
30 of all fork trucks.SWL marked on fork lift? NA
Non-routine and Semi routine activities identified & Risk
31 assement being done before executing. 10
Pressure vessels,Safety Valves, Rupture Disc, Orifice, Flame
32 Arrestor & Breather Valve are inspected as per schedule 7
and status displayed in field.
 Chemical Compatibility chart displayed at appropriate place
33 & operating team aware for this. 5
MSDS are updated and available for easy access to all
34 5
MSDS abstract displayed at appropriate place in plant &
35 operating team aware for this. 3
All storage Tanks/Vessels NFPA Codes are displayed at
36 appropriate place- visible from road side ? 3
Vent line outlet of hazardous material kept at safe level.
37 5
List of Critical valves-Floor details & It's position during
38 Emergency are displayed ? 2
Critical safety operating parameters are displayed &
39 followed ? 5
Are emergency stops provided at equipments/ machines are
40 tested & are in working condition and readily accessible? 10

(UNIPHOS) Standard color code displayed at appropriate

41 place & implemented. 3
PPE matrix are displayed at appropriate place & used
42 effectively. 5
PPE identified for hazardous material meets requirement
43 as per MSDS. 5
44 Use and storage of PPE's is in Clean & good condition. 5
Regular cleaning is done and Filters being replaced for
45 Respiratory PPE. 5
Worker have knowledge of right PPE and use it as per
46 requirement. 5
Provision of safety belt/Fall arrestor is available at all tanker
47 loading/unloading/sampling area and it is being used.Work 10
instructions are displayed?
48 Area is free from Slip/ Trip / Fall hazard. 10
Audio -visual alarms provided are working & ensured not put
49 on silent mode. 5
50 Gas leak detectors are working & calibrated as per plan. 5
Smoke & fire detectors provided in control room, VFD room,
51 MCC room, warehouses, server room are working. 10

All drains and pits are cleaned, covered properly and not
52 over flowing. 5
53 Persons operating goods lift are trained. NA
54 Surrounding around lift are covered completely. NA
55 SOP for operation of material lift displayed at location. NA
Material lifts are tested as per plan & its interlocks are in
56 working condition. Test detail including SWL,load test date 5
displayed.
Metallic hoses are used for solvent handling and earthing
57 provided to drums. 5
Dyke walls of tank farm in good condition & drain valve is in
58 5
closed condition.
Plant & pipe rack structure is painted & is in good condition.
59 5
All the instruments items which are in field are calibrated as
60 per plan. 5
Safety control points are identified/displayed and monitored
61 periodically. 10

All PESO licensed area is properly fenced, Unauthorized

entry restricted board and No any dry grass or flammable
62 items nearby.Licensed number, due date etc are dispalyed? NA
Clear space for fire tender movement is maintained with hard
road at least from two side.

63 Fire extinguishers, sand buckets are provided & maintained. 10

Earthing relay interlock or clamp is in healthy condition for
64 tanker earthing. 5
Clamped hoses are not in use, only flanged/ quick coupling
65 10
hoses are used.
Negative scoring for repeated findings. (Minus of repeat point
66 score from total score.) NA
P4 plant
Score in %

Audit score
0
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Audit Protocol for PSR system

P4 plant
UPL Site No.: Plant Name
Auditor Name : Auditee Name
Period : Date of Audit
Sr. No. Description Total score
100
Safety Gemba walk points compliance
1 % of timely closure of Gemba walk points (Target = 90%) 15
Safety abnormality reporting and closure (For Production, ETP,
Engineering 16 abnormalities per month and for other functions
2 10 per month) 10
(Number of abnormality identified and timely closure of CAPA)

Audit points compliance (second party/ third party safety audit)

(% of timely closure of audit points )
3 10

Incident CAPA compliance/ lateral deployment

% of timely closure of incident CAPA points as well as lateral

deployement of CAPA from incidents in other areas where ever
4 applicable. (Here Unit Safety Head will share CAPA points of 15
incidents happened in his unit as well as other units with PSR
team and PSR will ensure lateral deployment whereever
applicable)

Compliance of safety devices (RD, Safety Valve, orifice

inspection and maintenance)
5 5

6 Safety equipment upkeepment (safety shower, FE, FH, 5

scrubber, detectors / monitor)
7 Safety interlock inspection and testing 5
8 Machine guarding, rubber mats in electrical panel room 5
9 PPE compliance (PPE as per PPE matrix) 2
10 PTW compliance 5
CM- MOC compliance
Overall compliance of CM-PHA with documentation. (Here if
11 single change has been carried out without CM then whole 5
score of CM will be zero)
HIRA (Routine, Semiroutine, Non routine) and MMI MCI points
Compliance of HIRA (Here expectation is that PSR should
ensure risk assessment of routine, semiroutine and non routine
activities and implement the control measures. Same is in MMI
and MCI points. If implementation of control measures dalayed
due to resource constraint then Unit Head / Group Head in
12 consultation with Unit Safety Head will decide the scoring 5
against this compliance)

Applicable Shopfloor equipment management eg. Glassware

13 management, tools and tackles, MHE, labelling of chemicals) 3

Daily safety talk, safety training

14 Compliance of daily safety talk, monthly training, Level 2 5

trainings (If any person have been given charged without level
2 training then whole score will be zero)
To drive learning initiative identified by ULT under the
mentorship of ULT
15 5
Here ULT will decide the intiative for the month
Score in %
remarks
Audit score
0
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Audit Protocol for Training & Performance

UPL Site No.: Plant Name P4

Auditor Name : Auditee Name Score in %
Period : Date of Audit
Total score Audit score
Sr. No. Description Yes/No/NA
170 0
Plant team is aware about training and performance procedure.
1 5
Monthly theme based Safety Training Calendar is followed at unit.
2 10
All the employees including Addeco are covered in monthly theme
3 based training & validation done. 10
Safety Training needs of the employees are identified by plant
4 Manager. 5
5 All new employee under gone level 0 and level1 training. 10
level 2 training material are covering all the topics as mentioned in
6 the procedure. 10

All new employee & transferred employee (inter & intra) are given
7 level 2 training and validation done before handing over the 10
independent charge to them
Analysis of training evaluation done and re-training conducted for
8 employees where individual score is less than 80%. 5

Level 2 refresher training imparted to all employees once in two

9 year. 10
Employees (apart from HOD/PSR) are encouraged to lead/give
10 training or talk on their section. 10
All the records of trainings conducted in the Unit – which includes
training attendance, training feedback, corrected training
11 evaluation sheets are maintained at respective location (Level 0 & 10
1 - By Safety and Level 2 by HOD's)
Employee who went for external training has conducted a
12 debriefing training within a period of 15 days from the date of 5
external training.
Employees joining after a long vacation/ leave (= or more than 10
13 days) have been given Debriefing Training of all Changes during 10
his absence - by his Supervisor.
Employees are aware of critical safety interlocks of their area.
14 10
15 Employees are aware of Hazards of product / Operations. 10
Employee are aware of PPE requirements of their section and use
16 it as per requirement. 10
Employees have basic knowledge of implemented Safety
17 Systems. 10
18 Employee have basic knowledge of first aid requirement. 10
Employee have knowledge of safety equipments installed/ its
19 location & how to use it. 10
Negative scoring for repeated findings. (Minus of repeat point
20 score from total score.) NA
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Audit Protocol for Contractor Safety Management Process -A

Plant Name
Auditee Name
Date of Audit

Total score
Sr. No. Description
133
Contractor Management Procedure is communicated
1 effectively to all the concerned people/departments. 5

Whether All plants have assigned Field Contract

2 Administrator (FCA) for all plants. 2
SHE Orientation has been given to all the CSS and
3 validation done for all the CSS at site. 5
CSS checks SHE orientation of all new contract
4 employees. No contract employee without SHE 5
orientation & stamping at back.
All contract workers are trained on Safety
requirement of their plant on quarterly basis and
5 training stamp is available on ID card with signator 5

All contract workers are aware of hazards of their

6 working area. 5
All contract workers are aware of PPE requirement of
7 their working area. 5
All contract workers are aware of First aid
8 requirement for hazard of their working area. 5
All contract workers use proper PPE and clothing as
9 per safety requirement. 5
CSS-A conducts job specific training to contract
10 employees. 4
CSS-A captures near miss himself and through
11 contract employees. 4
CSS-A conducts Safety Talk for all contract
12 employees. 4
CSS-A issues Red Card with repeat safety violation.
13 5
 Hand Pallet truck/ drum trolley are inspected by
CSS-A and maintained in good & safe condition.
14 Inspection Status is available on the equipment. 5

CSS-A ensure that PPE's are provided to all contract

15 employees and maintained in good and safe 4
condition.
CSS-A ensures that work is conducted in safe
16 manner. 4

CSS-A ensures that work area house keeping is

17 maintained in good condition and it is free from SHE 4
hazard.
CSS-A furnishes Weekly Safety performance
18 assessment report to FCA. 5
CSS-A furnishes Monthly SHE Performance
19 assessment of Contractor to UPL Site Contract 5
Administrator (SCA) and Safety Manager (SM).
Fortnightly Contractor Field Audit of the Contract is
20 being conducted by all FCA and Safety Manager. 5

All audit findings are closed by taking CA/PA as per

21 time line. 5
Fortnightly Safety Performance review meeting
22 conducted regularly and action plans are complied 5
with in a timely manner
Contract workers understand Emergency Siren
23 Code.Do's and Don'ts during emergency? 4
BCA Test is conducted for all contract Employees
24 once in 15 days/ as per plan wherever applicable. 5

Penalty system as per SHE requirement of

25 contractors is being effectively practiced and 4
contractors penalized for safety violations.

Monthly Assessment of all Contractors is being done

26 as per standard assessment sheet. 5
Contractor employee recognition system is working
27 effectively. ( 10 % nominations and 5 to 6 % 5
awarding.
No Contractor employee below the age of 18 years is
allowed to work in the site. No female worker is
28 allowed to work on factory premises from 7 PM to 6 5
AM.
Contractor pre-employment and routine medical
29 check up done and records are maintained. 4
 Negative scoring for repeated findings. (Minus of
30 repeat point score from total score.) NA
rocess -A

Period
Score in %
0
Audit score
Yes/No/NA Remarks
0
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Audit Protocol for Contractor Safety Management Process- B

Plant Name
Auditee Name
Date of Audit

Total score Audit score

Sr. No. Description Yes/No/NA
189 0
Contractor Management Procedure is communicated
1 effectively to all the concerned people/departments. 5

Check compliance to below statement.

One CSS for strength of 20 and more. If
2 Strength 10 to 20 – One of the current CS will be 5
trained as CSS. Less Than 10 – CS will work as CSS
also. All CSS should be Safety qualified.

Field Contract Administrator (FCA) has been

3 assigned for all contractor of Cat B. 3
Contractor Safety Supervisor (CSS-B) has attended
4 SHE Orientation as required. 3
CSS-B checks SHE orientation to all new contract
new employees. No contract employee without SHE
5 orientation & stamping at back with signator 3

6 Vertigo test being done for height worker. 5

CSS-B conducts job specific training to contract
7 employees. 3
CSS-B captures near miss himself and through
8 contract employees. 3
CSS-B issues Red Card with repeat safety violation.
9 5
CSS-B ensure that PPE's are provided to all contract
10 employees and maintained in good and safe 5
condition.
CSS-B ensures that work is conducted in safe
11 manner. 5
CSS-B ensures that work area house keeping is
12 maintained in good condition and it is free from SHE 2
hazard.
CSS-B furnish Weekly Safety performance
13 assessment report to FCA. 5
CSS-B furnish Monthly SHE Performance
assessment of Contractor to UPL Site Contract
14 Administrator (SCA) and Safety Manager (SM) on 5
5th of every month.
Fortnightly Contract Field Audit of the Contract is
15 being conducted by FCA. 5
All audit findings are closed by taking CA/PA as per
16 time line. 5
Fortnightly Safety Performance review meeting
17 conducted with the CSS and CS by the FCA's for all 5
Contracts
Contract workers understands Emergency Siren
18 Code. 5
Record is maintained of Onsite Contractor SHE
19 performance Statistics 2
Contract employees injury & illness logs related to
20 contractors are maintained by the Field Contract 5
Administrator.
All SHE requirements as per job Plan / Permits are
21 adhered throughout the execution of job. 5
Signboard, labels & instructions are displayed in
22 local/national language and at least 15 Signboards 2
are provided by each contractor
FCA / CSS are conducting safety tool box meeting
23 each shift/day. 5
Monthly Assessment of all Contractors is being done
24 as per standard assessment sheet by SCA/FCA 10
every month
 Field Contract administrators, PSR’s, HOD’s, Safety
Manager and Site Contract Administrator issues red
25 card for safety violation during their regular field 10
round.
26 Red card system is effective and followed. 5
Penalty system as per SHE requirement of
27 contractors is being effectively practiced and 5
contractors penalized for safety violations.
Contractor employee recognition system is working
28 effectively. ( 10 % nominations and 5 to 6 % 5
awarding)
No Contractor employ below the age of 18 years
allowed inside the site. No female worker is allowed
29 to work on factory premises from 7 PM to 6 AM. 5

BCA Test is conducted for all contract Employees

30 once in 15 days/ as per plan wherever applicable. 5

Arc welding machine inspection is being done as per

31 standard check list.Lugs are provided to welding 5
cables?
Portable grinding machine inspection is being done
32 as per standard check list. 5
Gas cutting set inspection is being done as per
33 standard check list. 5
Hydra inspection is being done as per standard
34 check list. 5
TPI of all the lifting tools & tackles done & records
35 maintained. 5
Contractor pre-employment and routine medical
36 check up done and records are maintained. 3
Pressurized gas cylinders kept intact in upright
37 position and with safety cap.Cylinder Standard color 5
codes followed?
Safety guards are available for rotating machines.
38 5

39 Work area is managed well in terms of good house 10

keeping, proper segregation of work, proper path
way, daily removal of scrap from their work area.
Negative scoring for repeated findings. (Minus of
40 repeat point score from total score.) NA
 Period
Score in %
0.0
Remarks
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Audit Protocol for Incident Investigation & Reporting

UPL Site No.: Plant Name

Auditor Name : Auditee Name
Period : Date of Audit
Total score Audit score
Sr. No. Description Yes/No/NA
113 0
Team is aware of IIR Procedure and different
1 categories of incidents. 10
In case of any incident, FIR is sent by shift in charge
2 to SSH through Safety Software. 10
Safety manager has communicated all LTI/ RWC
/MTC /FA & Dangerous occurrence within 4 hrs. to
3 the concerned members of the organization through 10
safety software.
Final investigation report in PDF is forwarded within
4 96 hrs. of the incident. 10
All CA/PA from IIR recommendation are closed in a
5 timely manner and have been physically verified by 10
Safety
Safety manager circulates final IIR to all SM of other
6 units within 24 hrs. 5
Safety manager circulates final IIR to all plant HOD's
7 of site & Unit Head. 5
8 All plant HOD's shares the IIR in daily safety talk. 5
Safety manager identifies opportunities for lateral
9 deployment & to track the implementation. 5
Personnel department has forwarded all reportable
10 incidents to the relevant legal authorities. 10

Incident investigation team consists of multifunction

team members (Plant Manager, Mechanical,
Electrical, Instrumentation & Safety for RWC / MTC
and FAC and Unit Head, Safety Head, Group Head
11 5
(Wherever applicable, Plant Manager, Engg Head,
Unit Safety Head & R&D Head (Wherever applicable)
for LTI and DO)

Top Five Near Misses reported in Suraksha Kawach

are analyzed using Fish bone diagram and other
12 Near Miss using “Why-Why analysis” tool. 10

Photographs of the location and incident are

13 uploaded in Suraksha Kawach with incident report. 5

14 Incident report is closed in Suraksha Kawach. 4

Past year incident records are available with
15 complete details. 4
Off-the Job LTI injury to UPL Employees are reported
16 and investigated. 5
If same type of incident repeated because of not
17 implementating the CAPA, negative marking will be NA
done.
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Audit Protocol for Change Management Process

UPL Site No.: Plant Name

Auditor Name : Auditee Name
Period : Date of Audit
Total score Audit score
Sr. No. Description Yes/No/NA
125 0
Change Management Procedure is communicated effectively
1 to all the concerned people/departments. 10
Change management form is filled in standard format with
2 complete details. 10
3 Purpose of the change is clearly identified. 5
4 Scope of the change is clearly mentioned. 5
Change management no. is complying with the change
5 management procedure. 4
All approvals are taken from authorised persons before
6 starting of CM process. 10
PHA has been done for all Change Management and it has
been done with participation of Plant Manager, Mechanical,
7 Electrical, Instrumentation, Safety and R&D 10

PHA is covering all the hazards arises due to new changes.

8 10
All PHA recommendation is closed in a timely manner before
9 the startup of the changed system 5
PSSR is done and all Cat A Recommendations are closed
10 before starting of modified system/process. 8
All Cat B & C PSSR recommendation are closed within 30
11 days from the date of PHA 5
Temporary operation Instruction (TOI) prepared or SOP is
12 updated with new changes. 10
Training on the changed system is conducted for concerned
13 persons. 10
All design related records i.e. P &ID, Equipment layout,
14 block flow diagram are updated as per change 5
made.Attached to CM
All interlocks and alarms are updated as per modified
15 system/process. 5
All required legal records are updated i.e. test certificates,
16 calibration certificates, training records etc. 10
Change management close out form is appropriately
17 completed. 3

If there any instance observed any changes done

18 without having authorised CM procedure, whole score of
CM audit will be ZERO.
Negative scoring for repeated findings. (Minus of repeat
19 point score from total score.)
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Audit Protocol for Emergency preparedness and response

UPL Site No.: \ Plant Name P4

Auditor Name :\ Auditee Name \ \
Period : \ Date of Audit 10.12.2020 \
Total score Audit score
Sr. No. Description Yes/No/NA
139 0
Plant team is aware about EPR procedure with clear role &
1 responsibility. 8
Environment Aspect-Impact study is done for all the
2 operation activities. 5
Hazard identification and Risk Assessment (HIRA) is carried
3 out for all the activity. 5
4 Maximum credible loss scenario (MCLS) is identified. 3
Mock drill/ Table top excercise done monthly/ quarterly
5 considering Maximum credible loss scenario (MCLS). 5
6 Mock drill effectiveness report is prepared. 5
7 Gaps identified in mock drill are tracked and closed. 5
Plant team participated in wet drill at least once in a quarter
8 10
Training imparted to ERT members and are attending
9 refresher training also. 5
10 Plant is having ERT member in each shift. 5
TREM card copy is being handover to driver with the
11 dispatch document. 2
Dedicated PPE kit is available to handle emergency
12 effectively in shortest time. 3
Plant is having sufficient no. of emergency exit.in opposite
13 direction 2
Emergency exit path is properly illuminated all the time with
14 emergency light. 3
Sufficient no. and type of fire extinguisher fixed at all the
15 floor. 3
Sufficient no. of safety shower and eye wash station are
16 available at all the floor. 3
Path way towards fire extinguisher and safety shower are
17 unobstructed and illuminated properly. 3
18 Emergency spill control procedure is available 3
Plant team is aware of Emergency response
19 equipment/system installed in the plant. 10
Emergency Contact details are displayed with plant, security
20 and in ECC. 3
ECC is equipped with Emergency communication systems.
21 NA
ECC is equipped with all the records i.e. Plot plan of the site,
22 MSDS, Antidote details for toxic chemicals etc. NA
23 First aid box are available at Plant area & inspected. 3
Fire fighting team is experienced and available all the time.
24 3
25 Male nurse is available in the OHC all the time. NA
Male nurse is having sufficient knowledge of toxic hazards of
26 different chemicals and first aid in case of exposure. NA

Male nurse is having knowledge of Antidote required for

27 different chemicals. NA
Sufficient stock of Antidote and other medicines are
28 maintained in OHC. NA
29 OHC is maintained in good condition. NA
Sufficient stock of PPE's and other emergency equipments
30 are maintained. 10
Fire tender/Fire hydrant system/Sprinkler system/Fire Alarm
31 system is maintained in good condition with all accessories. NA

All emergency equipments are inspected and maintained in

32 good condition. 10
33 Fire pump starts automatically if pressure goes down. NA
Ambulance is maintained in good condition with all
34 accessories. NA
35 All assembly points are Cleary marked. NA
Directive board are placed at various location for reaching to
36 assembly point. 3
Windsock are installed at various locations. It is visible in
37 fluorescent color. 3
Emergency siren code is defined and plant persons are
38 aware of it. 3
39 Emergency siren is audible at all locations in plant. 3
Leak arrest kit (NH3/ Chlorine/ MeCl) is available and
40 inspected for toxic chemicals and people are aware how to 10
use it.
Mutual aid aggreement is in place with nearby industries/ Fire
41 department NA
Negative scoring for repeated findings. (Minus of repeat point
42 score from total score.) NA
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Audit Protocol for Electrical safety

UPL Site No.: Plant Name

Auditor Name : Auditee Name
Period : Date of Audit
Total score
Sr. No. Description
228
First aid board is available in Electrical control room (ECR).
1 5
All Electrical members are aware of CPR and how to perform
2 it. 10
All Electrical members are aware of Emergency shut down
3 procedure.. 10
4 Updated Single line diagram is displayed in the ECR. 5
5 All the panel and feeder are clearly labeled. 5
All panels and feeders are marked with voltage level and
6 hazard label displayed. 5
Qualified electrical team member is available in all the three
7 shifts. 3
All electrical feeders are with provision of applying physical
8 lock. 3
Lock out practice is in place for doing any repair work on any
9 line or equipment. 3
Proper insulated tools are available for maintenance work.
10 3
Measuring and testing instruments are in good and safe
11 condition. 5
Measuring and testing instruments are calibrated every year.
12 5
All earth pits are tested periodically and record is maintained
13 for the same. 2
Transformer oil testing and filtration is done as & when BD
14 voltage drops below the desired level (30KV for 1 minute). 5

Preventive maintenance (PPM) program is in place for all the

15 equipment's. 5
16 PPM done for all the equipment as per PPM plan. 5
Electrical incident is investigated and all the CA/PA are
17 closed as per timeline defined. 5
Only insulated ladder (FRP) is used for all electrical work.
18 7
All temporary connections are taken safely and warning sign
19 displayed. 5
Electrical safety training is arranged for employees and
20 workers. 3
All electrical safety interlocks are tested and in working
21 condition. 3
22 Safety talk is done during starting of each shift. 2
Daily plant round is taken by qualified team member to
23 ensure electrical installations are in safe condition. 3
Entry restricted for unauthorized person' board displayed on
24 entrance of all the ECR. 3
25 All panel boards are properly closed with bolts. 5
26 Electrical work permit system is in place. 2
Is jewelry or conductive articles prohibited when working on
27 or near energized electrical circuits? 5
Are portable equipment, power tools, and appliances
28 equipped with ELCB (30mA) or double insulated? 5
29 Voltage rated PPE's are available for electrical work. 3
Overall house keeping is good near electrical installation.
30 2
Voltage rated rubber mat are place in front and back side of
31 all the panel. 3
32 Emergency lighting are available in all ECR. 3
Proper fire extinguishers are available near electrical
33 installation. 5
All electrical operated portable tools are inspected and in
34 safe condition . 2
35 Arc flash boundary is calculated for each electrical panel. 2
36 PPE selected as per arc flash boundary requirement. 2
37 PPE's are available as per Arc flash boundary requirement 2
Interrupting ratings and short-circuit current ratings are
38 adequate for the conditions of the installation. 2
Unused openings have been effectively closed in all
39 electrical installation. 2
Secure mounting and adequate ventilation space available
40 for all installation. 2
Arc flash protection warning signs are available on each
41 panel. 2
Adequate working clearances, dedicated spaces and
42 headroom around equipment.(Clearance to be specified) 2
 Unwanted material are not stored near electrical installation.
43 2
Adequacy of entrance to and egress from working space is
comfortable and spaces containing large equipment have at
44 least two entrances/exits or the equivalent. 2

Each panel is labelled with Input source and all out going
45 feeders with rating. 2
All under ground cables are properly covered and caution
46 board available for that. 2
Electrical raceways and cable trays are used exclusively for
47 electrical conductors. 2
48 Switches and receptacles are used within their ratings. 2
Safe Clearances of electrical installation maintained from
49 building openings, grade, roadway, roofs etc. 2
Panel boards supplying or supplied by feeders are installed
50 with overcurrent protection, grounding, and proper 2
enclosures.
All outside feeders are installed with adequate supports,
51 clearances, and mechanical protection. 5
Transformer installations are with adequate ventilation and
52 spacing from walls and obstructions. 2
Hazardous Area classification done and displayed including
53 zone and group. 2
Electrical safety signage/poster/boards are displayed at
54 various location. 2
55 All indicating lamps are in working condition. 5
All MCC & PCC are equipped with smoke & fire detectors
and are in working conditions.Smoke detectors panel is
56 located at safe location and alarms audiable 5

57 Thermography done of PCC, MCC & Electrical equipments 10

as per plan & record available.
Fencing around HT yard is in good condition. Caution board
58 for unauthorised entry restriction displayed. No dry grass 10
observed in yard.
59 Stretcher available in MCC room 10
Negative scoring for repeated findings. (Minus of repeat point
60 score from total score.) NA
 Period
Electrical
Score in %
0
Audit score
Yes/No/NA Remarks
0
Document No. Document Title

Revision No. Review Date

Next Review
Prepared by
Date
Approved by Page No.

Audit Protocol for Pre Start Up Safety Review

UPL Site No.: Plant Name

Auditor Name : Auditee Name
Period : Date of Audit
Total score
Sr. No. Description
100
Detailed PSSR (as per std PSSR checklist) done for the New
1 Facility or after CM of Major Modifciation in the Plant 15

Whether all relevent members (Process, Electrical,

2 Mechanical, Instrumentation, Projects) participated in PSSR. 15

All the necessary records are checked during PSSR as per

4 checklist requirement. 10
Category A recommendations are completed before start-up
6 of plant. 10
Category B recommendations are completed within 15 days
7 of plant start-up. 10
Category C recommendations are completed within 30 days
8 of plant start-up. 10
PSSR closure report issued by plant HOD confirming all the
9 recommendations are implemented. 10
PSSR reports with approval from all concerned authorised
10 persons available with plant. 10
Final Sign off by UH that all the Cat A recommendations
11 have been complied before the startup available 10
Negative scoring for repeated findings. (Minus of repeat point
12 score from total score.) NA
Review

Score in % Score in % Score in %

0.0 0.0 0.0
Audit score Audit score Audit score
Yes/No/NA Yes/No/NA Yes/No/NA
0 0 remarks 0
Score in % Score in % Score in % Score in % Score in %
0.0 0.0 0.0 0.0
Audit score Audit score Audit score Audit score
Yes/No/NA Yes/No/NA Yes/No/NA Yes/No/NA
0 0 0 0
Score in % Score in % Score in %
0.0 0.0
Audit score Audit score Audit score
Yes/No/NA Yes/No/NA
remarks 0 0 remarks