JVC VIDEO MALAYSIA SDN. BHD.

CONTRACTOR WORK INFORMATION FORM

DEPARTMENT / SECTION

TO: SAFETY AND HEALTH SECTION Date of Information: ____/____/____

MANAGER

PERSON IN-CHARGE

SECTION A) DETAILS OF PERSON IN-CHARGE (JVM EMPLOYEE) Name : Position: Section: Tel. no.: SECTION B) DETAILS OF SITE SUPERVISOR (JVM EMPLOYEE) Name : Position: Section: Tel no.: SECTION C) CONTRACTORS DETAIL Company Name : Person In-Charge : Tel. no.: SECTION D) WORK DETAILS Work Title: Location of Work: Description:

Site In-charge Name: Tel. no.:

Duration of work: Start :___/___/___ time ___:___ am/pm to End :___/___/___ time ___:___ am/pm

FLOW OF DOCUMENT: JVM PERSON IN-CHARGE SECTION MANAGER SAFETY SECTION

JVC VIDEO MALAYSIA SDN. BHD.

STOP-WORK REPORT TO CONTRACTOR
TO: (Company Name) CC : (Safety and Health Section / JVM Person In-Charge / JVM Site Supervisor) SECTION A) DETAILS OF PERSON ISSUING (JVM EMPLOYEE) Name : Position: Section: Tel. no.: Issued Date: Time Stop-Work: SECTION B) DETAILS OF SITE SUPERVISOR (JVM EMPLOYEE) Name : Position: Section: Tel no.: SECTION C) CONTRACTORS DETAIL Company Name : Person In-Charge : Tel. no.: SECTION D) REASON FOR STOP-WORK WORK TITLE:
DEPARTMENT / SECTION MANAGER PERSON IN-CHARGE

Site In-charge Name: Tel. no.:

FLOW OF DOCUMENT: JVM PERSON IN-CHARGE OR SAFETY SECTION

SECTION MANAGER

CONTRACTOR

JVC VIDEO MALAYSIA SDN. BHD.

PERMIT TO WORK (TO CONTRACTOR)
TO: (Contractor Company Name) CC: ENGINEERING (Safety and Health Section / JVM Person In-Charge / JVM Site Supervisor) SECTION A) DETAILS OF PERSON ISSUING (JVM EMPLOYEE) Name : Position: Section: Tel. no.: Issued Date: Duration of work: Start : / / time: : End : / / time: : SECTION B) DETAILS OF SITE SUPERVISOR (JVM EMPLOYEE) Name : Position: Section: Tel no.: SECTION C) CONTRACTORS DETAIL Company Name : Person In-Charge : Tel. no.:
DEPARTMENT / SECTION MANAGER PERSON IN-CHARGE

am/pm to am/pm

Site In-charge Name: Tel. no.:

SECTION D) SPECIAL SAFETY PRECAUTIONS TO BE TAKEN:

FLOW OF DOCUMENT:
JVM PERSON IN-CHARGE OR SAFETY SECTION

SECTION MANAGER

CONTRACTOR

JVC VIDEO MALAYSIA SDN. BHD.

CONTRACTOR WORK SAFETY ANALYSIS
CONTRACTOR NAME: TO: SAFETY AND HEALTH SECTION CC: (JVM Person In-Charge / JVM Site Supervisor) DATE: ___/___/___. SECTION A) DETAILS PIC:
(CONTRACTOR) SAFETY SECTION MANAGER PERSON IN-CHARGE

TEL. NO.:

Page ____of____

SECTION B) WORK SAFETY ANALYSIS WORK DESCRIPTION POTENTIAL HAZARDS

(EXAMPLE) Welding for 8 hours Start a Fire Electrical Shock Eye injury by spark or by welding burn Heat burn Welding fumes

SAFETY PRECAUTIONS
Weld away from combustible material. Prepare fire extinguisher nearby. Wear insulated foot ware and gloves while welding. Ware safety goggles or use welding shield. Handle newly welded work piece with tongs. Weld at well ventilated areas or use exhaust system

DOCUMENT FLOW: To submit 1 working days before work start. CONTRACTOR JVM PERSON INCHARGE CONTRACTOR

JVC VIDEO MALAYSIA SDN. BHD.

CONTRACTOR WORK SAFETY ANALYSIS
SECTION B) SAFETY ANALYSIS Page ____of____ WORK DESCRIPTION POTENTIAL HAZARDS SAFETY PRECAUTIONS

JVC VIDEO MALAYSIA SDN. BHD.

Safety Briefing Note
JVM PERSON IN-CHARGE TO BRIEF CONTRACTOR ON FOLLOWING ITEMS

Contractor to observe JVM company rule at all times. No Smoking inside factory. Smoking at designated place only. No eating or drinking at work area. To wear shoe cover while walking in the company area. Shoe cover is slippery thus need not wear shoes cover at work site; To observe 5 S practices in the company. To maintain proper housekeeping all the times. Arrange material neatly. Do not block emergency corridors. Ensure cleanliness at work site and do not dirty the area out of work site. To prepare first aid kit. To use good condition tools. Consult JVM Chargeman for electrical power requirements. Dispose waste or sludge accordingly.

Safety check Guidelines

The use of PPE: Safety Helmet: Safety helmet shall be used where injury to head due to falling object or bump to hard object is present. Goggles and Safety Glasses: Goggles for eye protection shall be used where injury to eye due to projectile or dust from work is present. Special dark glasses shall be worn during welding works. Precaution shall be taken to protect others during such welding works. Mask: Masks shall be used where dust is generated during work. If necessary install exhaust ventilation system to draw out excessive dust generated. Ear Protection: Suitable ear-plugs or ear muffs shall be worn when the working environment generate excessive noise exceeding safe level. Respirator with filters: Respirator shall be used where hazardous fume or gas is generated or used during work. Special care shall be taken in selection of suitable filters depending on airborne concentration of such fume or gas. Since special equipment and expertise is required in monitoring and deciding it is prohibited to perform such hazardous work in production floor. Gloves: Suitable glove shall be worn while handling chemicals, sharp objects or very hot materials. Apron or Protective Clothing: Apron as a PPE it is used to protect body from heat, chemical splashes or to avoid clothing from entangling to moving parts. Apron shall be prohibited when working with ladder. Safety Shoes: Shall wear Safety shoes where heavy tool used or heavy material is handled. Other safety PPE: Use other suitable safety devises such as full body harness, reflective jackets, Traffic cones, Hazard lamps, safety signages, breathing apparatus and Etc. Isolate working area: Other than workers and persons related to the job shall not be allowed at the work area. Cordon of the working area. Use appropriate hazard tape. If necessary use ceiling height barrier.