Professional Documents
Culture Documents
Rev No. 02
Location:
Severity Rating Criteria- Audit Team:
1 = Untidy area minor issues sets pool example
2 = Restricted access, unacceptable trash, disorderly
3 = Rule or procedure violation, potential injury
4 = High potential risk: incident likely to happen that can cause serious injury Audit Time:
Note:
5 = Dangerous practices: stop work and correct immediately; will cause fatality / permanent 1. For severity 4 and 5 violations stop the job immediately and rectify the unsafe practice.
disability / Heavy property losses 2. For average severity is 4 and above work at all the locations shall be stopped and corrective actions shall be
taken.
Number
Respon Leading
Personnel Violations
sible Indicators
Observed
Number of
Unsafe Act
Safe Workmen
Unsafe Condition
Thermax Engineer
Contractor
Violators
Violations
Violations x
Severity
4&5
PPE
Observation
Severity
classification Target
Sl No Description (from 4th sheet -
Area Action to be taken Action by
Date
Status
Summary of MIS)
10
11
12
13
14
15
16
17
18
19
SUB TOTAL 0 0 0 0 0 0 0 0 0 0
Number of Violations 0
Formulas used:
Average Severity = ( Violations x Severity ) / Number of Violations.
Percentage of Person observed working safely = Number of safe workmen / ( Number of safe workmen + Violators )
Percentage of 4 and 5 Violations = ( Number of 4&5 Violations) / Number of Violations
Percentage of workers Observed = Number of workers observed / Number of People on site.
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THERMAX LIMITE
SITE SAFETY SEV
Site Name:
Location:
Severity Rating Criteria-
1 = Untidy area minor issues sets pool example
2 = Restricted access, unacceptable trash, disorderly
3 = Rule or procedure violation, potential injury
4 = High potential risk: incident likely to happen that can cause serious injury
5 = Dangerous practices: stop work and correct immediately; will cause fatality / permanent
disability / Heavy property losses
Observation
classification
Sl No Description (from 4th sheet -
Area
Summary of MIS)
6
7
10
11
12
13
14
15
16
17
18
19
SUB TOTAL
Number of Violations
Formulas used:
Average Severity = ( Violations x Severity ) / Number of Violations.
Percentage of Person observed working safely = Number of safe workmen / ( Number of safe workmen + Violato
Percentage of 4 and 5 Violations = ( Number of 4&5 Violations) / Number of Violations
Percentage of workers Observed = Number of workers observed / Number of People on site.
ERMAX LIMITED ( POWER DIVISION)
ITE SAFETY SEVERITY INDEX REPORT
Audit Team:
Audit Time:
Note:
ty / permanent 1. For severity 4 and 5 violations stop the job immediately and rectify the unsafe practice.
2. For average severity is 4 and above work at all the locations shall be stopped and corre
taken.
Number
Respon Leading
Personnel Violations
sible Indicators
Observed
Number of
Safe Workmen
Unsafe Condition
PPE
Unsafe Act
Thermax Engineer
Contractor
Violators
Violations
Violations x
Severity
4&5
Severity
Action to be taken
0 0 0 0 0 0 0 0 0 0
#DIV/0!
#DIV/0!
#DIV/0!
0
#DIV/0!
n site.
Format No :OHS / FT36
Rev No. 02
Date: 06.07.2018
Target
Action by Status
Date
Total points
Sr. No. Open points closed points Average Severity
observed