DOC NO:
REV:
WEEKLY HSE REPORT DATE:
Project
Name/No: Month: Date:
S.NO General Unit WTD YTD PTD
1 Total Manpower No.
2 Total man-hours worked Hrs.
3 Total safe man-hours worked ( without LTI) Hrs.
Leading Indicators Unit WTD YTD PTD
1 Total Hazards/HSE card reported/Unsafe only
2 No of near miss incidents
3 No of Findings (Inspections, Audit, Walk About etc.)
4 No of Findings (Inspections, Audit, Walk About etc.)closed out
5 No of incident recommendation Actions
6 No of incident recommendation Actions closed
7 HSE Induction Hrs.
8 Other HSE trainings/In addition to induction
9 HSE committee meeting
Lagging Indicators Unit WTD YTD PTD
1 Fatality No.
2 No of Lost Time Injury No.
3 No of Restricted Work Cases No.
4 No of Medical Treatment Cases No.
5 No of First Aid Cases No.
6 No of Assets damage (equipment, vehicle damage or loss) No.
7 Commuting incidents ( Non work related) No.
8 No of environmental incident No.
9 No of Fire Incident No.
10 No of security related incident No.