PETROKEMYA ENVIRONMENT, HEALTH, SAFETY & SECURITY (EHSS)

MANAGEMENT SYSTEM

Description No. Date

Revision 06 November 2015
PK SHEMS-05.00 Third Party EHSS Management Amendment 1 March 2016
Next Review - November 2020
Page 1 of 2
Attachment VII

Tools Inspection Checklist

Form 9
PO/PR/WO No._______________ Contractor Name:__________________

[ ] Group 1 [ ] Group 2 [ ] Group 3 [ ] Group 4

[ ] Slings (Wire Rope /
[ ] Wrenches [ ] Grinder [ ] Scaffolding
Nylon)
[ ] Shackles [ ] Jacks [ ] Drilling Machines [ ] Ladders
[ ] Chain Blocks [ ] Pumps [ ] Transformers [ ] Tricycles
[ ] Heating Treatment
[ ] Clamps [ ] Nuts Splitter [ ] Trolleys
Machine
[ ] Spreader Beams [ ] Torque Device [ ] Extension Cables [ ] Hand Tools
[ ] Air Blower / Exhaust Fan
[ ] Eyebolt [ ] Hand Lamps
“Pneumatic”
[ ] Lifting Cage (Man [ ] Air Blower / Exhaust
[ ] Manifold
Basket) Fan “Electrical”
[ ] Cable drum stand

Passed(P) /
Group SN Checks N/A Remarks
Failed(F)
Lifting tools should be free of broken wire strands / kinks /
1
core damaged / cracks / spreading / wear and deformation
*Lifting tools / accessories has to be certified by third party
Group 1

2
and valid.
3 Safety latch should be in good condition for all hooks.
4 Cable drum stand have third party load test certificate
5 Load Capacity is marked on cable drum stand
Group 2

6 *Third party certificate available

7 Hoses and fittings should be in good condition.
8 Hoses safety locks should be available.
9 Cable condition / size / rating.
10 Ground wire is available in the cable.
11 Condition of the plug / rating.
12 On/off switch condition of the tool.
Group 3

13 Condition of the light fixture / glass.

14 Condition of the transformer if it is greater than 12 Volts light.
15 Grinder safety catch should be in good condition.
Grinder safety switch should be in good condition and
16
available.
17 Grinder wheel guard and condition to be added
Group 4

Scaffold tubes / Ladders should be free from cracks, corrosion

18
and bending.
19 Caster wheels (if mobile) has locking system & lubricators
 PETROKEMYA ENVIRONMENT, HEALTH, SAFETY & SECURITY (EHSS)
MANAGEMENT SYSTEM

Description No. Date

Revision 06 November 2015
PK SHEMS-05.00 Third Party EHSS Management Amendment 1 March 2016
Next Review - November 2020
Page 2 of 2
Attachment VII

20 Scaffold planks / Ladders steps should be in good condition

21 Ladder steps are knurled or with anti-skid coating
22 Scaffolding fittings and fixtures should not be corroded.
23 Scaffolding tubes has to be painted / galvanized.
24 Ladders should have rubber pads at both ends.
25 Tricycles Tires are properly inflated.
Tricycles both fenders and chain guard are in place and
26
secure.
27 Tricycles Reflectors are mounted on the front and rear.
28 Tricycles Brakes are in good working condition.
29 Tricycles and trolleys should be in good condition.
30 Hand Tools should be in good condition & not modified

INSPECTION RESULTS
[ ] Accepted [ ] Rejected
Reason for Rejection:
1.
2.
3.

Date
Inspected by: 1.
2.
3.

Sticker No./ Valid Until

Color code:
Signature: Date

*Note: Third party inspection certificate shall be valid during inspection.

ID: ____________________ Signature: ____________________

NOTE:
Any other tools not specified in this form; End user & contractor subject matter
experts need to agree on a checklist requirement and attach it to this form.