“COMPANY NAME”

HSE PLAN

Project Title:    “PROJECT NAME –LOCATION”

Contract Number:        “0120….”

Contract Mode:            1

HSSE Risk:                     Medium

 Version:                         1.0

 Version Date:               February 2017

 APPROVALS

Role Name Signature Date
CONTRACT HOLDER
COMPANY SITE SUPERVISOR
HSE ADVISER
CONTRACTOR SUPERVISOR

 PAGE 2

 

Table of Content                                                                                                      Page

  • Introduction …………………………………………………………………………….
  • Scope of Work …………………………………………………………………………
  • Organization and Responsibilities …………………………………………………..
  • Key personnel …………………………………………………………………………
  • Hazard Identification, Risk Assessment and Control ……………………………
  • Key Site Activities ………………………………………………………………………
  • Equipment Required …………………………………………………………………
  • Permit Required ………………………………………………………………………
  • PPE Required …………………………………………………………………………
  • Emergency Response Plan …………………………………………………………
  • Welfare …………………………………………………………………………………
  • General Site HSE Requirements ……………………………………………………
  • HSE Performance and Review ………………………………………………………

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