PWA SAFETY QUESTIONNAIRE

Description
YES
NO N/A
MANAGEMENT
Ref. to: (QCS: 11.1.1 + 11.2.1 + 11.2.3 + 11.2.4). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 35).
1:
OH&S plan submitted for approval Within 30 days of the award of the contract?
2:
OH&S organization chart available
3:
OH&S Policy displayed
4:
Regular meetings record
5:
Responsibilities defined
6:
Near Miss & Hazard reporting and follow up
7:
Provision for visitors
8:
Monitoring effectiveness implementation of OH&S program
9:
Generic Risk Assessment & Management
10:
Monitoring & Control Sub-contractor to comply with all existing rules & regulations?
11:
In general, contractor following the government rules & regulation.
Ref. to: (QCS: 11.1.1.8).

YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES

SAFETY STAFF
12:
OH&S Safety Staff CV submitted for approval within 30 days of the award of the contract?
13:
OH&S Officer available during all working hours
14:
OH&S Officer is exclusive for site & for H&S jobs
Ref. to: (QCS: 11.1.1 + 11.2.2 + 11.2.3). (Labor Law: Article 99).

YES
YES
YES

TRAINING
15:
Orientation / Site Induction
16: Tool Box Talk (TBT) daily documented
17: Task specific (Equipment Operators, Scaffolders, Riggers, Fire Watchers, Emergency Drill, etc
18:
Management
19:
Refresher courses
Ref. to: (QCS: 11.1.2 + 11.2.2 + 11.2.3). (Worker Rights Booklet 2009 Page 41 & 45). (CDD / Fire Safety Handbook
Safety / 3 Page 9 & 10).

YES
YES
YES
YES
YES
/ Building Worksite

WORK ENVIRONMENT
20
21
22
23
24
25
26
27
28
29
30
31

:
:
:
:
:
:
:
:
:
:
:
:

Ventilation
Removal of fumes and dust
Dust controls preventive measures
Noise levels (instrument available?)
Vibration
Lighting
General purpose for evening work
For a particular task around construction site
Absence of glare
Work area
Corridors
Exteriors

YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES

PWA SAFETY QUESTIONNAIRE

32 : >Ergonomics - layout of work area
33 : The disposal of surplus water and the accompanying growth of trees and the proliferation of insects and
rodents
34 : Does the site pose danger to the surrounding environment?
35 : Site office furniture
Ref. to: (QCS: 11.1.2) (Labor Law: Article 103,106 & 107).

YES
YES
NO
YES

WELFARE FACILITIES
36 : Clean toilets with exhaust fan
37 : Toilets & Sanitary in good condition
38 : Potable water provided
39 : Eating and resting areas
40 : Messing / Canteen facilities
41 : Washing facilities
42 : Regularly cleaned area
43 : Work clothes lockers and hanging areas
44 : Prevent the breeding of mosquitoes on the site
Ref. to: (QCS: 11.1.2.4 + 11.1.6 + 11.2.2 + 11.2.3). (Labor Law: Article 100,104,105 & 115).

YES
YES
YES
YES
YES
YES
YES
NO
N/A

FIRST AID AND MEDICAL

45 : Paramedics available & Names displayed according to number of workers
46 : Average Manpower Labor
47 : Accident reporting, records available &follow up
48 : Periodic medical examinations for workers and follow up
49 : Medical record book existing
50 : Paramedics Telephone numbers displayed
51 : Adequate first aid kits supplies & expiration dates (as per Hamad Medical Corporation Requirement
52 : Adequate first aid equipment
53 : Availability of stretcher / ambulance / Standby Vehicle
54 : Clean room with potable water supply.
55 : Doctor, Site Nurse & Site Clinic must be approved from Supreme Council of Health.
Ref. to: (Labor law: Article 100). (CDD / Fire Safety Handbook / Fire Safety Provisions For Construction Worksites
/ 2 Page 16).

YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES

EMERGENCY EQUIPMENT
56
57
58
59
60
61
62
63
64

:
:
:
:
:
:
:
:
:

Procedures
Assembly / Muster point
Conducted Emergency Drill Training every 6 month
Availability of Fire / Smoke / Gas detection mobile devices
Emergency contact telephone numbers / Communications
Breathing apparatus and / or respirators (if applicable)
Torches
Loud Hailer
Emergency lighting

YES
YES
YES
YES
YES
YES
YES
YES
YES

PWA SAFETY QUESTIONNAIRE

65 : Adequate and safe Emergency Exit / Doors are provided
66 : Escape routes, access ways to assembly points, extinguishers, hydrants and other firefighting equipment's
and first aid kits kept clear of obstruction at all times
Ref. to: (Labor Ministry Decision No. 20 of 2005). (CDD / Fire Safety Handbook / Fire Safety Provisions For
Construction Worksites / 2 Page 17).

YES
YES

HOUSEKEEPING AND TIDINESS

67 : Segregation of waste and scrap
68 :
Sufficient bins
69 : Waste and scrap regularly collected & removed from site
70 :
No buildup of flammable materials
71 :
Removal of combustibles
Ref. to: (Worker Rights Booklet 2009 Page 45). (CDD / Fire Safety Handbook / Fire Safety Provisions For
Construction Worksites / 2 Page 10). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 12).

YES
YES
YES
YES
YES

STORAGE-RACKS BINS SHELVES

72 : Aisles and walkways kept clear
73 :
Neat and orderly
74 : Not too high
75 :
Heavy items kept low
76 :
Sufficient space to access items
77 : Are chemicals, paints, flammable liquids and gas cylinders stored only in designated areas?
Ref. to: (QCS: 11.1.1.12).

YES
YES
YES
YES
YES
YES

SITE SECURITY AND ACCESS

78 : Adequate transportation between working site & accommodations
79 :
Security check correctly performed
80 : Guardhouse continuously manned
81 :
Round check register updated
82 :
Perimeter fence intact
83 :
Inspection of materials gate passes
84 :
Need for the existence of surveillance cameras inside the site
85 :
Need for security personnel within the site
Ref. to: (QCS: 11.1.2 + 11.2.3). (Labor Law: Article 101).

YES
YES
YES
YES
YES
YES
N/A
YES

PERSONAL PROTECTIVE EQUIPMENT

86
87
88
89
90
91
92
93
94

:
:
:
:
:
:
:
:
:

Coveralls
Eye protection
Head protection
Hand protection
Foot protection
Hearing Protection
Safety reflecting vests
Dust mask
Any other protection

YES
YES
YES
YES
YES
YES
YES
YES
YES

PWA SAFETY QUESTIONNAIRE

Ref. to: (Worker Rights Booklet 2009 Page 45).

SAFE WORK PRACTICES

95 : Avoid manual handling (Use mechanical handling equipment)
96 :
Not working alone
97 :
Cap (cover) for rebar / reinforcement steel
Ref. to: (QCS: 11.1.5.4 + 11.2.2 + 11.2.3). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 19).

YES
YES
YES

EXCAVATIONS
YES
98 :
Location of existing utilities confirmed
YES
99 :
Signs posted
YES
100 : Adequate hard barrier installed
YES
101 : Adequate warning tape & lighting
N/A
102 :
Bracing & Shoring provided (if applicable)
YES
103 :
1m spoil clearance from the excavated pit
N/A
104 :
Sloping maintained (if applicable)
YES
105 :
Correctly made ladders provided for access into excavation
YES
106 : Appropriate access provided (temporary bridges & footpaths)
Ref. to: (QCS: 11.1.1.4). (Worker Rights Booklet 2009 Page 46). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 10).

MECHANICAL
107 : Adequate guarding on machines
108 :
Inspected regularly with color code sticker & maintenance records
109 :
Grounding installed to equipment/machine
110 :
Unused machines electrically isolated
111 :
Emergency isolation switches
112 :
Safety devices
113 :
Heating equipment
Ref. to: (QCS: 11.1.5.3 + 11.2.2). (Worker Rights Booklet 2009 Page 46). (CDD / Fire Safety Handbook / Building
Worksite Safety / 3 Page 10).

YES
YES
YES
YES
YES
YES
YES

ELECTRICAL
114 :
115 :
116 :
117 :
118 :
119 :
120 :
121 :
Ref. to:

Insulation, cables, industrial plugs in good condition

Cables suspended using S hooks and lead stands
Inspected regularly with color code sticker
ELCB provided to site power boards
Qualified electrician hired to install (Name & Qualification)
Protection of fittings against external damage
Trailing leads used?
Ovens and furnaces in good condition?
(QCS: 11.1.3 + 11.2.3). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 19).

YES
YES
YES
YES
YES
YES
N/A
N/A

SCAFFOLDS AND LADDER

122 :
123 :
124 :

Certified scaffold supervisor and scaffolders

Scaffolds correctly erected
Scaffolds properly secured

YES
YES
YES

PWA SAFETY QUESTIONNAIRE

125 :
126 :
127 :
128 :
Ref. to:

Toe boards, guardrails (top & mid rail), handrails & access checked
Fully boarded platforms
Scaffolds correctly tagged
Materials in good condition
(QCS: 11.1.3 + 11.2.3). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 11, 12 & 19).

YES
YES
YES
YES

WORKING AT HEIGHT
129 :
Personnel working above 1.2 m using fall protection devices
130 :
Fall protection devices condition / Certificate
131 : Adequate safe access in place to working height elevations
132 :
Personnel properly trained in the selection and use of fall protection devices
133 : All loose material & tools at heights secured or removed
Ref. to: (QCS: 11.1.4 + 11.2.2 + 11.2.3).

YES
YES
YES
YES
YES

PLANT AND EQUIPMENT

YES
134 :
Qualifications of operators available
YES
135 : Available Qatar license for drivers / operators
YES
136 :
Banks man available
YES
137 :
Used as per its design (for intended purpose
YES
138 :
Vehicle and equipment condition
YES
139 :
Reverse alarm installed
YES
140 :
Flashing light installed
YES
141 :
Generators and welding machine in good condition?
YES
142 :
Compressors and water pumps in good condition?
NO
143 :
Oil / fuel leak causing environmentally pollution
Ref. to: (QCS: 11.1.4 + 11.2.3). (Worker Rights Booklet 2009 Page 45). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page
19).

LIFTING OPERATIONS
144 : Available Qatar license/third party certificate for operators and certificate of training for banks men and YES
riggers
YES
145 :
Load capacity displayed
YES
146 :
Certification updated
YES
147 :
Condition of access and ground
YES
148 :
Lifting locations barrier off
YES
149 :
Outriggers/supports fully extended
YES
150 :
Hoist limiting device and SWL indicator working
Ref. to: (QCS: 11.1.4 + 11.2.3). (Worker Rights Booklet 2009 Page 45). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page
19).

LIFTING GEAR
151
152
153
154

:
:
:
:

Ropes, Chains, Shackles etc. in good condition

Identity number and SWL displayed
Color-code system in place
Available 3rd party certificate for every lifting gear

YES
YES
YES
YES

PWA SAFETY QUESTIONNAIRE

155 :
Damaged lifting devices removed from the workplace
Ref. to: (QCS: 11.1.2.14).

YES

COMPRESSED GAS CYLINDERS

156 :
157 :
158 :
159 :
160 :
161 :
162 :
163 :
Ref. to:

Stored upright, valves protected

Regulators Gauges working; hoses inspected
Flashback arrestor fitted
Cylinders are securely tied or with trolley
Type of gas clearly marked on cylinders
Segregation of incompatible gases
Transported on appropriate trolley
Correct signage
(QCS: 11.1.1.10).

YES
YES
YES
YES
YES
YES
YES
YES

SAFETY OF THE PUBLIC (For Road Works)

164 : Approval from PWA, then from Traffic Dep. & Environmental ministry
165 :
International Warning signs
166 :
Warning yellow lights
167 : Adequate Barricades (to comply with Traffic law no. 19)
168 :
Railing
169 :
Pedestrians pathway signs & not interacted with work zone
170 : Adequate safe access to all properties
171 :
Night watchman available
172 : To provide road hump to reduce & control speed with approval from Traffic Department
Ref. to: (QCS: 11.1.8.2). (Labor Ministry Decision No. 20 of 2005).

YES
YES
YES
YES
YES
YES
YES
YES
YES

SAFETY SIGNAGE AND NOTICE BOARD

173 :
Clearly displayed
174 :
Shall be in Arabic, English & other languages
175 :
Clean and legible
176 :
Enough traffic diversion signboard?
177 : Adequate warning signs and guides are provided
178 :
Shall be fully illustrated and provide details of key safety procedures to be followed
Ref. to: (QCS: 11.2.2 + 11.2.3).

YES
YES
YES
YES
YES
YES

WORK PERMITS
179 :
Confined Space
180 :
Hot Work
181 :
Excavation
182 :
Scaffolding
183 :
Electrical Work
184 :
Work permit correctly issued and signed
185 : Ashghal s work permit enforced
Ref. to: (QCS: 11.1.7 + 11.2.2 + 11.2.3). (Fire Safety Handbook / Fire Safety Provisions For Construction Worksites

FIRE PROTECTION PREVENTION

YES
YES
YES
YES
YES
YES
YES
/ 2 Page 8).

PWA SAFETY QUESTIONNAIRE

186 :
Is the firefighting equipment which approved by Civil Defense available at working area?
YES
187 :
Welding and grinding at working area properly secured
YES
188 :
Firefighting equipment not obstructed
YES
189 :
Expiration date of firefighting equipment checked
YES
190 :
Monthly firefighting equipment visual inspected & recorded
YES
191 : Availability of Fire / Smoke / Gas detection system
YES
192 :
Alarm and Emergency Evacuation system
YES
193 : Are Alarms audible in all areas
YES
194 :
Minimum quantities of flammable material shall kept on site with full precautions required
YES
195 : Access for Fire Brigade cleared
Ref. to: (QCS: 11.1.2.3 + 11.2.2 + 11.2.3). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 15, 16, 17 & 18).

N/A

HAZARDOUS SUBSTANCES
196 : Toxic/ hazardous substance correctly tagged/ labeled and secured
197 : Adequate and Proper Storage provided
198 : Appropriate spill containment provided
199 :
Disposal Spill kit (location, appropriate, easy access)
200 :
Material Safety Data Sheet (MSDS) present & required training delivered to concerned employees
201 :
Class B fire extinguisher near by
202 :
Correct signage
203 :
Register of chemicals
204 :
Correct labeling
Ref. to: (QCS: 11.1.5.5). (CDD / Fire Safety Handbook / Building Worksite Safety / 3 Page 13 & 14).

YES
YES
YES
YES
YES
YES
YES
YES
YES

CONFINED SPACES
205
206
207
208
209
210
211

:
:
:
:
:
:
:

Gas detectors/monitors with rechargeable batteries and battery charger (2 No.)

Full body safety harnesses with lifelines and shackles (6 No.)
Lifting frame with fall arrest device (1 No.)
Constant flow escape breathing apparatus complete with storage cases (2 No.)
Automatic positive pressure self-contained breathing apparatus with storage case (1 No.)
To train employee for confined space activity & supervision monitoring
All equipment maintained & calibrated up to date with 3rd party certificate (record is available)
OTHER RELATED SAFETY ITEMS (COMMENTS/REMARKS)

YES
YES
YES
YES
YES
YES
YES

KEY PERFORANCE INDICATOR

212
213
214
215

:
:
:
:

No. of
No. of
No. of
No. of

Medical Treatment Cases

First Aid Cases
Near-Miss
Fatal Cases

Current
Month
0
13
2
0

Accumulating
Up to Date
02
197
18
0

PWA SAFETY QUESTIONNAIRE

216 : No. of RTA (Road Traffic Accidents)

217 : No. of Manpower (Average)

218 : No. of Direct Man-hours

596
14482
8
0
14482
8
0
1
0
1
10231
4

567
2847731

219 : No. of Hours Lost

220 : No. of Man-hours from Last Lost Time Accident
221
222
223
224
225

:
:
:
:
:

No. of Lost Time Accidents

No. of Safety Meeting
No. of Emergency Drill
No. of Audit
Kilometers Driven

297
1826712
1
26
13
16
2329766

**Note: *Number of accident in a year should be include

* No of Fatal Cases * No of Lost Time Accidents

Accumulative Accident Rate = (Accumulative) No. of Medical Treatment Cases + No. of Fatal Cases+ No. of RTA (Road Traffic
Accidents) + No. of Lost Time Accidents X 100,000 / No. of Manpower (Average):
Monthly Accident Rate = No. of Medical Treatment Cases + No. of Fatal Cases+ No. of RTA (Road Traffic Accidents) + No. of Lost
Time Accidents X 100,000 / No. of Manpower (Average):
Accumulative Frequency Rate Accident = (Accumulative) No. of Medical Treatment Cases + No. of Fatal Cases+ No. of RTA (Road
Traffic Accidents) + No. of Lost Time Accidents X 1000,000 / No. of Direct Man-hours:
Monthly Frequency Rate Accident = No. of Medical Treatment Cases + No. of Fatal Cases+ No. of RTA (Road Traffic Accidents) +
No. of Lost Time Accidents X 1000,000 / No. of Direct Man-hours: