36Th National Safety Day Celebration 4Th March 2007

GENERAL GUIDELINES

FOR PARTICIPATION IN KARNAKATKA STATE SAFETY INSTITUTE

SAFETY AWARDS - 2007

INTRODUCTION:

To recognize industries performance and to encourage the commitment of management and employees in the fields of Safety, Health and Environment, Karnataka State Safety Institute, Bangalore, is inviting application / proforma from various industries located in Karnataka state registered under Factories Act – 1948.

CATEGORY OF AWARDS:

One each award for all category of industries.

- Best Industries

- Best Boiler

- Best Worker

Category of industries

Small : Less than 100 workers

Medium : 100 – 500 workers

Large : more than 500 workers

BASIS OF AWARDS:

The applications / proforma received would be evaluated on ‘Total SHE Performance’

PERIOD:

The award will be given based on the SHE performance during calendar year 2006.

EVALUATION COMMITEE

Dy. Director of Factories - Chairman

Asst. Director of Factories - Member

AWARDS’ COMMITTEE

The awards committee constitutes various professionals drawn from different fields and is responsible for assessment and declaration of the winners. The decision of the awards committee will be final and no correspondence in this connection will be entertained.

SUBMISSION OF PROFORMAS FOR SAFETY AWARDS:

The duly filled proforma in all respects should be submitted through the concerned area officer to the Evaluation Committee, on or before 15th Feb 2007. For any clarification required, the concerned area officer or the Evaluation Committee may be approached.

36th National Safety Day Celebration – 4th March 2007.

PROFORMA FOR SAFETY AWARD – INDUSTRY

Introduction:

1. Enclosed supporting documents wherever required.

2. Separate sheets may be used to furnish the additional information.

3. Information shall be furnished for the calendar year 2006.

Licence No.: MY

1. / Name and address of the Factory:
2. / Name of the Occupier / Manger:
3. / Workers:
· / No. of actual workers employed
· / No. of workers ordinarily employed
· / Total (including contract workers)
4. / Nature of industry / Brief manufacturing activity
Category (Por X)
· / Large > 500 workers / Large
· / Medium > 100 < 500 workers / Medium
· / Small < 100 workers / Small
5. / Details of Safety Health & Environment (SHE) Policy:
· / Organization:
· / Budget:
· / Policy:
· / Auditing:
6. / Statistics for the year 2006
a. / No. of Fatal Accidents:
b. / No. of serious accidents:
c. / No. of Reportable Accidents;
d. / Total no. of Accidents (a+b+c):
e. / No. of man days worked:
f. / No. of man-hours worked (e X 8 + OT Hr):
g. / No. of man days lost due to accidents:
h. / Accident Frequency Rate = / d X1000000
f
j. / Severity Rate = / g X 1000000
f
k. / Longest accident free period:
l. / Control measures to prevent accident:
m. / System for Reporting / Investigating / Analyzing of accidents and dangerous occurrences
7. / No. of safety suggestions received / accepted / implemented.
8. / Amount spent on purchase of personal protective equipment in the year 2006 and percentage of budget allotted towards safety in current budget.
Amount spent on safety issues during 2006
9. / Medical Examination:
· / No. of Medical Examinations conducted:
· / No. of Occupational health hazards identified:
· / Follow-up action
· / No. of persons trained in First Aid
· / Ambulance room, OHC facility
· / Ambulance van
10. / Machine Guarding
· / Status Report
· / Amount spent during the year 2006
11. / Hazard identification and control of emergency
· / SOP (Standard Operating Procedures) viz. Start-up, Shut-down, Work permit etc.
· / Safety Audits
· / Risk Assessment (HAZOP / HAZAN)
· / On Site Emergency Plan
· / No. of mock drills
· / Safety inspection check list
12. / Fire Prevention:
· / Control measures
· / No. of personnel trained
13. / Safety Awareness Programme:
· / In-house training conducted
· / No. of persons attended outdoor training
· / Amount spent on training SHE
· / Level of awareness on SHE policy / training
14. / House Keeping:
· / Status Report
· / Measures adopted
15. / SHE Promotion Activities:
· / Safety Committee
· / Workers Participation
· / Authority delegated to decision making
· / Safety Propaganda Activities like Safety day celebration, fire day celebration, world environment day etc.
· / On going SHE activities like new letter, suggestion scheme, film, Video, training, exhibition etc.
· / Establishment of safety department.
16. / Has your company participated in local, district, state or national level SHE activities - Achievement viz. Competition (i.e. poster, slogan, quiz, essay dram etc.), Awards, Certifications etc.
17. / Further action plan / commitment to promote SHE Policy during the coming year/s
18. / Corporate social responsibility action plan, implementation status and feed back.
19. / Related additional information, if any,

Signature and seal of the Occupier / Manager

(Name in block letters)

Date:

Place:

36th National Safety Day Celebration – 4th March 2007.

PROFORMA FOR SAFETY AWARDS – WORKERS

Introduction:

· Enclose supporting documents wherever required.

· Separate sheets may be used to furnish any additional information required.

· Information shall be furnished for the calendar year 2006.

1. Name of the worker:

2. Name and address of the factory in which he / she is working:

Category (Por X)
Large > 500 workers / Large
Medium > 100 < 500 workers / Medium
Small < 100 workers / Small

3. Designation:

4. Nature of Manufacturing process:

5. No. of years of services:

6. Age:

7. Qualification:

· General / · Safety / · Fire Fighting
· Technical / · Environment / · Occupational Health

8. Training acquired in the field of safety, if any:

Any suggestions given to improve Safety or to avoid accidents:

9. Outstanding performance in the field of safety, if any:

· Whether averted any accident

· Any suggestion, which has improved safety standard at work.

· Any suggestion which has saved cost / resources.

10. Any specific Skill:

· First-Aid / · Good trainer / speaker / demonstrator
· Rescue / · Safety awareness
· Fire Fighting

11. Recognition / Awards / Citation if any –

12. Reasons for recommendation by the employer:

Signature and seal of the Occupier / Manager Signature of the Worker

(Name in block letters) (Name in block letters)

Date:

Place:

36th National Safety Day Celebration – 4th March 2007.

PROFORMA FOR SAFETY AWARDS – BOILER

Introduction:

· Enclose supporting documents wherever required along with the Questionnaire.

· Separate sheets may be used to furnish the additional information.

· Information shall be furnished for the calendar year 2006.

1. Name and address of the factory:

2. No. of Boiler Operators Appointed:

a. I – Class:

b. II – Class:

3. No. of Boiler Operation Engineers Appointed:

4. Make of Boiler:

5. Boiler efficiency - Steam to fuel ratio:

6. Stack emission:

7. Accident History of the Boiler / Boilers for the last 10 years:

8. Specify the strong reasons for participation in the Competition:

(Not exceeding 100 words)

Signature and seal of the Occupier / Manager

(Name in block letters)

Date:

Place: