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区域: 代表处:

项目编码: 项目名称:
稽查人员:
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分包商EHS管理稽查表
区域: 代表处:
项目编码: 项目名称:
稽查人员:
EHS稽查点
分包商是否给其塔工配备足够的个人安全防护用品(PPE),如:安全帽、安全鞋、全身安全绳、双安全
绳(带双挂钩)、定位安全绳等(塔工名单、PPE发放台账记录)?

分包商塔工是否拥有政府认可的(或华为认可的)第三方认证机构颁发的塔工证?

分包商电工是否有合法的电工证?

分包商是否任命EHS管理组织(EHS经理或EHS负责人),并定义其EHS管理职责?

分包商是否有EHS管理的指导文件(EHS指导手册、EHS管理程序文件、指导书等)?

分包商是否存有站点EHS审核报告以及对EHS不符合的整改报告?

分包商是否每月都有领导上站(有上站记录或照片)?

分包商是否给其作业队伍配备紧急救援的设备(急救箱等)?

分包商内部是否其所有作业人员和现场管理人员进行EHS培训和考试(有培训和考核记录)?

分包商在其公司内部对EHS是否进行宣传(宣传材料)、张贴EHS海报等?
稽查日期:
是/否 备注


Checklist for Subcontractor EHS Management
Region: Central Sumatera Rep.Office:Pekanbaru
Project : Swap Telkomsel Project SUBCON NAME:PT.XERINDO
Checked by QHSE Tri Wahjuhono W Audit Office date:
# EHS Checking Items Y/N Remark

Whether subcontractor provides enough PPE (Personal Protective Equipment) to their riggers - Safety
1 Y
Helmet / Safety Shoes / Full-body harness / Double lanyard / Position lanyard?

Whether riggers working for subcontractors have been certified by 3rd parties (approved by local
2 Y
government or Huawei)?

3 Whether electricians working for subcontractor have been certified (legal certificate)? Y

Whether subcontractor has set up EHS management organization (documented with EHS manager or
4 Y
EHS responsible person), define their EHS management responsibility?

Whether subcontractor has EHS management documents (EHS Manual / EHS management procedure
5 Y
/ EHS working instruction)?

Whether subcontractor has documented with on-site EHS checking reports, corrective action reports for
6 N
noncompliance?

Whether subcontractor has arranged leadership (PM / GM) on-site audit by monthly basis (With audit
7 N
evidence)?

8 Whether subcontractor provides First Aid facilities to their crews? Y

Whether subcontractor has trained their operators and field managers and examined them (with training
9 N
record and examined result)?

10 Whether subcontractor has posted with EHS posters inside of their offices? Y
EHS Indicator Score
Safe/Green 9 - 10
Warning/Yellow 6 - 8.5
Unsafe/Red 0 - 5.5
Uncoplete Checklist Deduction 0,5 point

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