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MEMBER COMPANY NAME:
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Your Company Only
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Your
Sub-contractors
(if any)
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1.
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Total number of hours worked (inclusive of overtime)
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2.
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Total number of First Aid Cases (FAC)
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3.
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Total number of Medical Treatment Cases (MTC)
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4.
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Total number of Restricted Work Cases (RWC)
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5.
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Total reported number of Lost Workday Injuries (LTI)
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6.
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Total number of Workdays Lost (LWD)
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7.
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Split of LWI:
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- Transportation / vehicle-equipment accident / traffic
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- Lifting operations
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- Work at height / scaffolding
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- Hand tools
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- Involving slips, trips and falls
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- Excavation / earth collapse
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- Confined spaces
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- Impact with construction equipment
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- Welding operations
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- Hazardous substances
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- Other
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Please briefly describe the "Other" incident(s)
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8.
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Total number of fatalities included in LWI (questions 5 and 7)
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Split of fatalities:
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- Transportation / vehicle-equipment accident / traffic
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- Lifting operations
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- Work at height / scaffolding
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- Hand tools
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- Involving slips, trips and falls
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- Excavation / earth collapse
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- Confined spaces
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- Impact with construction equipment
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- Welding operations
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- Hazardous substances
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- Other
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Please provide an investigation report as detailed as possible, for each incident involving a fatality as to the root cause(s) to hse@iploca.com
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Do you authorise IPLOCA to publish the report(s) on the IPLOCA Health, Safety and Environment Shared Experiences platform?
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YES
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NO
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9.
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Total number of Road Traffic Accidents (On and off-public road)
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Total number of kilometres driven
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10.
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Total number of near misses
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Do you identify High Potential near misses (HIPO)?
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YES
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NO
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If yes, total number of HIPOs
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11.
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Do you identify occupational illnesses?
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YES
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NO
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If yes, total number of occupational illnesses
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12.
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Your Company Only
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Your
Sub-contractors
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13.
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Total Fuel consumption (in thousand litres)
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14.
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Time spent training staff (in person-hours)
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Health & Safety Training |
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Environmental Training |
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15.
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a) Does your company have a carbon emission / energy reduction policy?
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YES
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NO
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b) Does your company calculate its greenhouse gas emissions?
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YES
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NO
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c) Does your company have a water management policy? |
YES
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NO
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d) Does your company have a waste reduction policy? |
YES
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NO
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| 16. |
Does your company produce an annual Corporate Social Responsibility (CSR) report? |
YES
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NO
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If yes, is it in line with a recognised standard? |
YES
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NO
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If yes, which one? |
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17.
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Do you have a certificated Management System?
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YES
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NO
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a) If no, is it planned to certificate the following systems in the future?
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YES
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NO
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b) If yes, which of the following certificates do you have?
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