Form XXXI

(see Rule 23(6)}

SAFETY OFFICER’S REPORT

(Framework on Occupational Health & Safety Program)

1. OHS Policy

 Effective Date

 Revisions

2. Safety Information

 Displays

 Leaflets

 Pamphlets

 Booklets

3. Risk Assessment

 HARA, HAZOP, JSA, Internal Inspections

 Periodicities

4. SOPs

 List of SOPs with effective date

 Revision frequency

5. Training & Education

 Need Analysis

 Target hours

 Induction & Job Specific

 Refresher frequency

 Pep talks

 Effectiveness criteria

6. Contractor Control

 Change management

 Tools & Equipment control

 Procedures control

 Capacity assessment

 PPE monitoring

7. Pre-Startup Safety Review (PSSR)

8. Condition Monitoring

 Statutory & other critical equipment, plants

9. Non-Routine Works Safety Management

 Work Permits

 LOTO

10. Management of Change

 Changes in material, technology, process, equipment, people

11. Incident Reporting & Investigation

 Near Miss

 LTI

 Serious

 Fatal

 Dangerous occurrences

12. Emergency Planning & Response

 Onsite Emergency Plan

 Review frequency

 Mock Drills

 Fire Drills

13. PPE Matrix

 Activity vs PPE identified

14. Compliance Audits

 Internal

 External

 Departmental Inspections

15. Workers Participation

 Safety Committees

 Expert Committees

 Review Committees

16. Safety Culture Building

 Perception Survey

 Targets

 BBSM

 Safety Budgeting

 Outside premises activities

 Collaborations

 Motivation & Inspiration

 Safety Leadership

17. Promotional Activities

 Celebrations

 Competitions

 Cultural activities

Signature of Safety Officer

Factory name