UltraTech Cement Limited
Dhar Cement Works
Sl. No Description
1 Inspection of Vehicles
2 Inspection of Tower cranes
3 Inspection of Mobile Crane/Hydra
4 Inspection of full body harness
5 Inspection of welding machine
6 Inspection of Electrical hand tools
7 Safety Observation Report
8 CFSA Compliance & Audit
9 Inspection of Portable Ladder
10 Gas cutting set & Grinding machine
11 Lifting tools & tackles
12 PPEs Inspection
13 Bar bending Machine/Cutting machine
14 Boom Placer
15 Transit Mixure & Concrete Pump
16 Batching Plant
17 Labour Camp
18 Scaffolding Inspections
19 Weekly Contractor Safety Meeting
20 Apex Project safety Committee Meeting
21 Induction Training
22 HRC-Ground Disturbance & Hole Cover
23 HRC-Scaffolding & Working at Height
24 HRC-Electrical Safety
25 HRC-Rigging and Lifting Lowering
26 HRC-Health & Hygiene
UltraTech Cement Limited W3
Dhar Cement Works
Inspection Frequency Sunday, April 11, 2021 ###
Weekly by Supervisor & Safety
Daily by operator, weekly by supervisor & monthly by Engineer & Safety
Daily by operator, weekly by supervisor & monthly by Engineer & Safety
Quarterly by safety team
Inspection of
Monthly by Electrical Department welding
machine
Weekly by supervisor & Monthly by Electrical Department
Daily, weekly and monthly in PPT by Safety Officer
Weekly by Safety Officer & Line Function
CFSA
Weekly by supervisor & Safety
Weekly by supervisor & Monthly by Safety Team
Monthly by concern department & safety team
Weekly by Safety Officer PPEs Inspection
Monthly by concern department & safety team
Monthly by concern department & safety team
Monthly by concern department & safety team
Monthly by concern department & safety team
Weekly
Weekly
Weekly
Monthly
Daily
Fortnightly
HRC-Ground
Disturbance
& Hole Cover
Fortnightly
Fortnightly
Fortnightly
Fortnightly
W3 W4
### ### ### ### ### ### ### ###
Inspection of
Vehicles
Inspection of
Tower cranes
Inspection of
Mobile
Crane/Hydra
Inspection of
full body
harness
Inspection of
Electrical
hand tools
CFSA CFSA CFSA CFSA CFSA CFSA
Inspection of
Portable
Ladder
Gas cutting set &
Grinding
Lifting tools &
tackles
PPEs Inspection
Bar bending
Machine/Cutti
ng machine
Boom Placer
Transit Mixure
& Concrete
Pump
Batching Plant
Labour Camp
Inspection
Scaffolding
Inspections
CSC Meeting
HRC-
Scaffolding &
Working at
Height
HRC-
Electrical
Safety
HRC-Rigging
and Lifting
Lowering
HRC-Health &
Hygiene
W4 W5
### ### ### ### ### ### ### ###
Inspection of Inspection of
Vehicles Vehicles
Inspection of
full body
harness
CFSA CFSA CFSA CFSA CFSA CFSA
Inspection of
Portable
Ladder
PPEs Inspection
Apex Project
safety
Committee
Meeting
Labour Camp
Inspection
Scaffolding
Inspections
CSC Meeting
HRC-Ground
Disturbance
& Hole Cover
HRC-
Scaffolding &
Working at
Height
HRC-
Electrical
Safety
W5
### ### ###
CFSA CFSA
Inspection of
Portable
Ladder
Labour Camp
Inspection
Scaffolding
Inspections
CSC Meeting
HRC-Rigging
and Lifting
Lowering
HRC-Health &
Hygiene
Date
tivity
Location/Ac
mical
Hazards
Physical/Cha
High)
(Low,
Degree if
Medium,
Exposure
Safety Goggles
Welding shield and Cutting goggles
Chemical Splash goggles
Head
Face sheild
Safety Helmet
Hearing Protection
Half-face (Mouth and Nose)
Full-Face(air purifying via cartridge)
Appendix- B
Dust Mask
Resporatory
SCBA (Self –contained breathing
apparatus)
Full Body protection (Jacket / apron
(rubber, neoprene-suits)
Fire –Retardant Clothing
Health and Safety Hazard evaluation sheet , PPEs
Body
Arc Flash Suit with Hood
Fall protection – Safety harness
Feet
Safety shoes
Di-electric rubber shoes
Cut resistance gloves
Hands
Chemical resistant gloves
High voltage gloves
Fire Retardant gloves
Remarks
UltraTech Cement Limited
Dhar Cement Works
Vehicle Inspection Checklist
Checklist Serial No. : Date :
Name of Transporter : Vehicle Reg No.
Driver Name / DL No : Mobile No
Norms S.N. Description of Check Point YES/NO Comments
1 Driver having Valid License
Driver 2 Driver passed the Alcohal Test (Based on Breath Analyser result)
3 Driver having and using Safety Helmet /Safety Shoes/Reflective Jacket
4 RC Book/Fitness Certificate/Insurance and PUC available and valid
VEHICLE 5 Head Light / Rear Light Working /Horn & Reverse Horn working and Audible
CONDITION/ 6 Brakes and Hand brakes in working order
ROAD
WORTHINESS 7 Rear view mirror available /Windscreen wipers in working condition
8 No hazardous good kept inside cabin (Stove, kerosene, Chemicals etc)
RESULT Vehicle Acceptable for Entry
OTHER
DEVIATION
COMMENTS
CHECKED BY
& SIGNATURE
UltraTech Cement Limited
Dhar Cement Works
Tower Crane Daily Operational Checklist
Sl.No Description Monday Tuesday Wednesday Thursday Friday Saturday Sunday
1 Hoisting Pulley healthiness
2 Emergency Swing Brake
3 Boom light condition
4 Hoist Limit Switch
5 Travel Limit Switch
6 Lowering Limit Switch
7 Overload Limit Switch
Swing alarm is in working condition
8
and audiable
9 Tie Rod Split Pin Checking
10 All Electrical connector checking
11 Checking Panel Board
12 SLI function check
13 Hoist Wire Rope Condition
14 Trolley Wire Rope Condition
Hoist Motor Brake Liner & Brake Coil
15
Checking
Trolley Motor Brake Liner & Brake
16
Coil Checking
17 Anemometer Function Checking
18 Remarks
Inspected By Name & Signature:
UltraTech Cement Limited
Dhar Cement Works
Tower Crane Weekly Checklist
Sl.No Description Monday Tuesday Wednesday Thursday Friday Saturday Sunday
1 Mast Bolt & Nut Checking
2 Trolley Pulley Greasing
Rope Corrector Shaft cleaning &
3
greasing
4 Swing Body Bolt Checking
5 Hoist Gear Box oil Checking
Swing Gear Box & Trolley Gear Box oil
6
checking
7 Tie Rod Bolt Nut Checking
8 Counter weight Locking Pin Checking
9 Rope U clamp checking
10 Trolley roller greasing
11 Hoist Hook Pulley Block Greasing
12 Remarks
Inspected By Name & Signature:
UltraTech Cement Limited
Dhar Cement Works
Hydra Inspection Checklist
Agency/Vendor: Hydra No.:
Date of T.P. Inspection: S.W.L. (Marked)
Condition/Availability
Sr. No. Check Point Remark
Ok Not Ok NA
1 Valid Registration Certificate / Insurance papers & RTO
Fitness.
2 Is Hydra Operator having Valid Driving License?
(Heavy duty)
Is SWL Marked on Hydra & Anchoring Hooks on
3 boom, Test date & Due date of testing should be clearly
marked.
4 SLI interlocked with hoist Cut-off system.
5 Hydra shall be equipment with adequate run over protection
guard.
6 Is Safety Latch in Hook is provided and Hook is
without damage?
7 Is Wire rope free from tolerable Damage?
(Kinked, Wear, Broken wire more than 10% etc.)
8 Is Load - Wire rope & other parts are well
Lubricated?
9 Any Oil Leakage from Hydraulic parts (Piston
drums)?
10 Is any Damage in Tires (Crack, Cut, air pressure etc.)
11 Are Head Lights & Rear Lights in good condition?
12 Is Front Horn in working Condition?
13 Is Reverse Horn provided and in working
condition?
14 Is Boom structure in good condition while full
expansion? (Free from Damage, Crack or Jam).
15 Are Brakes in good condition?
16 Are Travelling, Steering, Braking, Motions (in
both directions) satisfactory?
17 Is Condition of Battery is good ?
18 Is Load Chart Displayed in Operator Cabin?
Load at the appropriate radius.(Max & Min radii)
19 Side/Rear view mirrors must be present.
20 Are wheel Chokes available ?
21 Flagman available to navigate the Hydra while marching on
road.
22 Is Fire Extinguisher provided in Operator Cabin?
23 Is Stability of Hydra satisfied?
24 Any other points
Checked By:
Signature:
UltraTech Cement Limited
Dhar Cement Works
Mobile Crane Inspection Checklist
Agency/Vendor: Crane No.:
Date of T.P. Inspection: S.W.L. (Marked)
Condition/Availability
Sr. No. Check Point Remark
Ok Not Ok NA
1 Valid Registration Certificate / Insurance papers & RTO
Fitness.
2 Is Crane Operator having Valid Driving License?
(Heavy duty)
Is SWL Marked on Crane & Anchoring Hooks on
3 boom, Test date & Due date of testing should be clearly
marked.
4 SLI interlocked with hoist Cut-off system.
5 Boom-Limit Switch
6 Boom Angle indicator
7 Boom-Limit cut-off switch
8 Is Safety Latch in Hook is provided and Hook is
without damage?
9 Is Wire rope free from tolerable Damage?
(Kinked, Wear, Broken wire more than 10% etc.)
10 Is Load - Wire rope & other parts are well
Lubricated?
11 Any Oil Leakage from Hydraulic parts (Piston
drums)?
12 Is any Damage in Tires/Crawler (Crack, Cut, air pressure
etc.)
13 Are Head Lights & Rear Lights in good condition?
14 Is Front Horn in working Condition?
15 Is Reverse Horn provided and in working
condition?
16 Swing motion horn working Condition.
17 Out riggers fully extendible & its condition.
18 Is Boom structure in good condition while full
expansion? (Free from Damage, Crack or Jam).
19 Are all Brakes & Lock (Swing,Propel ,Hoist & Boom) in good
condition?
20 Are Travelling, Steering, Braking, Motions (in
both directions) satisfactory?
21 Is Condition of Battery is good ?
22 Is Load Chart Displayed in Operator Cabin?
Load at the appropriate radius.(Max & Min radii)
23 Side/Rear view mirrors must be present.
24 Are wheel Chokes available ?
25 Flagman available to navigate the Crane while marching on
road.
26 Is Fire Extinguisher provided in Operator Cabin?
27 Is Stability of Crane satisfied?
28 Any other points
Checked By:
Signature:
UltraTech Cement Limited
Dhar Cement Works
FULL BODY HARNESS CHECKLIST
Name of the Agency/Dept: Inspection Date:
Full body is Snap hook are in a good
Lanyard do Harness
in a good Shock condition such as
Clip lock at the not damage self life not
Serial/ Batch No MFG. Year of condition, chest and leg are D-RING does not or tear & absorber is in bending, twisting, expired or Harness safe
S No. No of Full body ID No do not have have rust or a good increased throat opening, Remark/ Status
/Model Product in a good Visibility of manufactur for use
Harness cut, tear, condition bend. Indicative condition crack, nick, Locking ing date
swollen or and covered. arrangement and
Thread within 3yrs.
crack inoperative latches.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Inspected By Name: Signature :
UltraTech Cement Limited
Dhar Cement Works
Welding M/C Checklist
Condition/Availability
Sr. No. Check Point Remark
Ok Not Ok NA
Machine outer body cover condition. (There should
1 not be any opening so as to avoid direct ingress of
water, any foreign particle etc.)
2
All nut-bolts of machine should be properly
tightened.
Power supply terminal box should be equipped
3 with required cover. (It should not be directly
exposed)
4 Machine Output terminal condition.
5
Mains Supply ON - OFF Switch Should be in proper
working condition.
6 Condition of earth terminal for double earthing
7 Condition of current regulator & its knob
8 Power cable connection through ELCB or RCCB
9
Check the welding M/C lead connection (lug and its
tightness)
10
Condition of welding holder, job clamp and its
insulation
11 Proper routing of power cable
12 Condition of ON-OFF Switch
13 Healthiness of cooling fans
14
Condition of cables (Insulated & exposed bare
conductors)
15
Welding machine inspection tag from electrical
dept.
16
Welding cable current rating not more than
machine current rating
17 Is all Job specific PPEs available
Checked By:
Signature:
UltraTech Cement Limited
Dhar Cement Works
Gas Cutting Set Checklist
Condition/Availability
Sr. No. Check Point Remark
Ok Not Ok NA
1 Condition of Cutting hose & Torch
2 Gas cylinders vertically kept (trolley) then tighten with chain
3 Flash back arrester installed buth in Gas cylinders & Cutting Torch
4 Hose clamp of standard type on cutting hose
5 LPG Cylinder test date with expiry date
Cutting set Regulator condition ( Two no. of pressure gauge i.e. One
6 gauge for inlet pressure and other for outlet pressure )
7 Any Leakage from cutting set, Cylinders
8 Gas cylinder valve cap available
9 Appropriate Face shield use during grinding, cutting
10 Availability of fire extinguishers near gas cylinders.
11 Are Flammable materials has been removed/covered?
12 Is Sun/Rain Protection shed available
13 Is all Job specific PPEs available
Checked By:
Signature:
UltraTech Cement Limited
Dhar Cement Works
Grinding Machine Checklist
Condition/Availability
Sr. No. Check Point Remark
Ok Not Ok NA
1 Is the work rest used and kept adjusted to within 1/8
inch of the wheel?
2 Is the adjustable tongue on the top side of the grinder
used and kept adjusted to within 1/4 inch of the wheel?
3 Do side guards cover the spindle, nut, and flange and
75 percent of the wheel diameter?
4 Is the maximum RPM rating of each abrasive wheel
compatible with the RPM rating of the grinder motor?
Are fixed or permanently mounted grinders connected to
5 their electrical supply system with metallic conduit or
other permanent wiring method?
6 Does each grinder have an individual on and off control
switch of Dead man type
7 Is each electrically operated grinder effectively
grounded? Check plug
8 Before new abrasive wheels are mounted, are they
visually inspected and ring tested?
9 Is the cable free from defect Joint
10 Is all Job specific PPEs available
Checked By:
Signature:
UltraTech Cement Limited
Dhar Cement Works
SAFETY INSPECTION CHECKLIST FOR DUMPER,LOADER,POCLAIN & EXCAVATOR
Vehicle Number:
Agency:
Inspection Date/Time:
Driver Name & Licence No:
DETAILS OF INSPECTION
S. N. Check List Ok Not Ok NA Remarks
1 Overall condition & build structure of
the equipment is safe
2 Availability of safety belt & condition
3 Engine control and switchs are in
good operating condition
4 Fuel tank has no leakage & proper cover
5 Hydrulic systems are in good condition,
no leakage from the hoses & cylinder.
6 Bucket hinge & rear flap hinge are in
good condition
7 Hydrulic cylinder hinge is in
good condition
8 Breaking systems & parking break is in
operation condition
9 Battery system & housing
10 Condition of tires
11 All light points
12 Condition of the rear view mirrors.
13 Horn & reversing horns in working
condition
14 Driving license & operational
competency of the driver
15 Registration,Fitness,Insurance & PUC
certificate
16 Wheel Chokes
17 Driver having and using Safety Helmet /Safety
Shoes/Reflective Jacket
18 Any other/ site specific requirements.
INSPECTED BY
Contract Agency Representative- Sign:
UTCL Representative - Sign:
UltraTech Cement Limited
Dhar Cement Works
Ladder Inspection checklist
Plant/Location:
Type of Ladder: Date of Inspection:
Due Date Of Inspection:
Ladder Tag No.: Ladder Tag No.: Ladder Tag No.: Ladder Tag No.: Ladder Tag No.: Ladder Tag No.: Ladder Tag No.:
Remarks
Sr. No. Checks
Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No
Rail Damaged (Bend,Cracks,
1 deformation, Loose,Cut Or Any visual
Damage)
2 Rung broken
3 Rung missing
4 Rungs clean
5 Rung distance uneven
6 Bottom non-skid pad
damaged/missing
7 Top and bottom rung tie rod provided
8 Rungs loose
9 Non-slip bases
10 Any other (specify).
Inspected By:-
Name:____________________________________Designation:_____________________Sign:________________Date:________________
Reviewed By:
Name:____________________________________Designation:_____________________Sign:________________Date:________________
UltraTech Cement Limited
Dhar Cement Works
Vehicle Inspection Checklist
Date of inspection : Date : Date : Date : Date :
Location: Location: Location: Location:
Vehicle Registration Number: Vehicle Reg. No: Vehicle Reg. No: Vehicle Reg. No: Vehicle Reg. No:
Insurance Validity:
Vehicle Type:
DL Number: DL No:
Mobile No:
Agency/Transport:
Norms S.N. Description of Check Point YES/NO/NA Comments YES/NO/NA Comments YES/NO/NA Comments YES/NO/NA Comments
1 Driver having Valid License
2
Driver passed the Alcohal Test (Based
on Breath Analyser result)
Driver
3
Driver having and using Safety
Helmet /Safety Shoes/Reflective Jacket
4
RC Book/Fitness Certificate/Insurance
and PUC available and valid
5
Head Light / Rear Light Working /Horn &
Reverse Horn working and Audible
VEHICLE
CONDITION/ 6
Brakes and Hand brakes in working
ROAD order
WORTHINESS
7
Rear view mirror available /Windscreen
wipers in working condition
8
No hazardous good kept inside cabin
(Stove, kerosene, Chemicals etc)
9 Is Driver well aware of Road Safety
10
Is hygenic condition inside vehicle is up
Hygiene
Condition to mark
11
Is Cleanliness of vehicle inside/out side
is up to the mark
OTHER
DEVIATION
COMMENTS
CHECKED BY &
SIGNATURE
