Galfar Engineering & Contracting SAOG HSESP-005-F/10; Rev.

FIXED POWERTOOLS INSPECTION RECORD (Typical)

Job # & Name: Month:

Monthly Inspection Details (Yes / No / NA)

Identification #
Bit, Wheel, Blade,
Type / Description of the Tool Good
Tool firmly On / Off / isolation
Moving / etc., in good
Cooling Three pronged
Users of
Sl # (Fixed drill, grinder, lathe, saw, grooving /
housekeeping
positioned and switch, Operating
rotating condition and
system (self plug used; Cable routed
the tool
Remarks / Actions, if any
cutting machine, etc.) provision for job lever in good feed) without power source safely and in
in the parts suitable to the job identified /
piece to be condition within exposing the connected to good condition
surrounding guarded & rated capacity controlled
secured. safe access operator ELCB
of the machine

Inspection carried out by: ___________________________________________________________ Signature with Date: ___________________________

Forward report to Line Manager / Supervisor responsible for actions to be taken, considering the criticality of actions / level of intervention required.

Report Forwarded To:___________________________________________________________ Agreed date for action completion: ____________________

(To be signed by the Line Manager / Supervisor concerned on completion of action and returned to the function who carried out the inspection for close-out)

Actions identifed above have been completed

Name of the responsible Line Mgr./ Supr.: ________________________________________ Signature: ___________________________ Date: ___________

Signature of the function who carried out the inspection (upon verification of action completion): ______________________________________ Date: ___________

Copies to be sent to / retained by: 1. Line Mgr./ Supr. responsible for that area / activity; 2. Function who carried out the inspection / HSE Advisory Staff in the Project / Unit.