表格 3A | FORM 3A
Author: Novade Solutions
Published on: 4/20/2023表格 3A | FORM 3A
工廠及工業經營（安全主任及安全督導員）規例 FACTORIES AND INDUSTRIAL UNDERTAKINGS (SAFETY OFFICERS AND SAFETY SUPERVISORS) REGULATIONS
受僱在建築地盤工作的安全督導員每週須予填報的報告書 WEEKLY REPORT TO BE PREPARED BY SAFETY SUPERVISOR EMPLOYED ON CONSTRUCTION SITES
本表格乃由勞工處處長就工廠及工業經營(安全主任及安全督導員)規例第17(2)條的需要而認可 Form approved by the Commissioner for Labour for the purposes of regulation 17(2) of the Factories and Industrial Undertakings (Safety Officers and Safety Supervisors) Regulations
一般安全檢查(請填上良好、滿意或欠佳) | General Safety Check (G=Good; S=Satisfactory; P=Poor)
進出口 Access and Egress：
木板路 Gangways
梯 Ladders
通路 Passageways
高空作業 Working at Height:
棚架 Scaffolds
工作平台 Working Platforms
樓面邊緣/孔洞 Floor Edges/Openings
升降機槽/孔洞 Lift Shafts/Openings
泥土工程 Earthwork:
挖掘工程 Excavations
坑槽 Trenches
沉箱 Caissons
隧道 Tunnels
斜坡 Slopes
起重機械及起重裝置 Lifting Appliances and Lifting Gear:
起重機(例如: 塔式起重機、龍門起重機、流動起重機等) Cranes (e.g. Tower Cranes, Gantry Cranes, Mobile Cranes, etc.)
絞車 Winches
滑輪組 Pulley Blocks
載人吊重機 Passenger Hoists
物料或吊斗吊重機, 包括吊重機槽 Material or Skip Hoists, including Hoistway
吊船 Suspended Working Platforms
鏈、纜索、吊、吊索 Chains, Ropes, Hooks, Slings
電力 Electricity:
開關掣 Switches
電線 Wiring
固定裝置 Fixed Installations
手提式照明設備 Portable Lighting
手提工具 Portable Tools
焊機 Welding Machines
防火措施 Fire Prevention:
消防器具 Fire Fighting Appliances
走火通道 Means of Escape
危險品倉庫 Dangerous Goods Stores
氣焊氣樽 Gas Welding Cylinders
健康 Health:
石棉控制 Asbestos Control
塵埃控制 Dust Control
噪音控制 Noise Control
危險物質的防護 Protection from Dangerous Substances
急救設備 First Aid Equipment
清洗設備 Washing Facilities
廁所 Latrine
機器 Machinery:
木工機械 Woodworking Machines
負荷物移動機械 Loadshifting Machines
磨輪 Abrasive Wheels
啤機 Power Presses
一般事項General:
地盤管理 Housekeeping
安全網和斜棚 Safety Nets and Fans
物料堆疊 Stacking of Materials
通路 Passageways
照明設備 Lighting
通風設備 Ventilation
有關僱用安全主任/安全督導員的告示 (有/沒有) Notice of Employment of Safety Officer/Safety Supervisor (YES/NO)
個人防護設備 Personal Protective Equipment:
安全頭盔 Helmets
護眼用具 Eye Protectors
聽覺保護器 Ear Protectors
呼吸器 Respirators
安全帶 Safety Belts
手套 Gloves
安全鞋 Safety Shoes
反光外套 Reflective Jackets
安全督導員簽署 Signature of Safety Supervisor
†*東主/安全主任簽署 †*Signature of Proprietor/Safety Officer
附註Note:
(1) *“東主”包括當其時管理或控制在該工業經營或應呈報工場中進行業務的人，亦包括法人團體、商號，以及任何工業經營或應呈報工場的佔用人及此等佔用人的代理人。
“Proprietor” includes the person for the time being having the management or control of the business carried on in the industrial undertaking or notifiable workplace, includes a body corporate, a firm and also the occupier and the agent of such occupier.
(2) † 請刪去不適用者。Delete if inapplicable.
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表格 3A | FORM 3A
工廠及工業經營（安全主任及安全督導員）規例 FACTORIES AND INDUSTRIAL UNDERTAKINGS (SAFETY OFFICERS AND SAFETY SUPERVISORS) REGULATIONS
受僱在建築地盤工作的安全督導員每週須予填報的報告書 WEEKLY REPORT TO BE PREPARED BY SAFETY SUPERVISOR EMPLOYED ON CONSTRUCTION SITES
本表格乃由勞工處處長就工廠及工業經營(安全主任及安全督導員)規例第17(2)條的需要而認可 Form approved by the Commissioner for Labour for the purposes of regulation 17(2) of the Factories and Industrial Undertakings (Safety Officers and Safety Supervisors) Regulations
一般安全檢查(請填上良好、滿意或欠佳) | General Safety Check (G=Good; S=Satisfactory; P=Poor)
進出口 Access and Egress：
木板路 Gangways
梯 Ladders
通路 Passageways
高空作業 Working at Height:
棚架 Scaffolds
工作平台 Working Platforms
樓面邊緣/孔洞 Floor Edges/Openings
升降機槽/孔洞 Lift Shafts/Openings
泥土工程 Earthwork:
挖掘工程 Excavations
坑槽 Trenches
沉箱 Caissons
隧道 Tunnels
斜坡 Slopes
起重機械及起重裝置 Lifting Appliances and Lifting Gear:
起重機(例如: 塔式起重機、龍門起重機、流動起重機等) Cranes (e.g. Tower Cranes, Gantry Cranes, Mobile Cranes, etc.)
絞車 Winches
滑輪組 Pulley Blocks
載人吊重機 Passenger Hoists
物料或吊斗吊重機, 包括吊重機槽 Material or Skip Hoists, including Hoistway
吊船 Suspended Working Platforms
鏈、纜索、吊、吊索 Chains, Ropes, Hooks, Slings
電力 Electricity:
開關掣 Switches
電線 Wiring
固定裝置 Fixed Installations
手提式照明設備 Portable Lighting
手提工具 Portable Tools
焊機 Welding Machines
防火措施 Fire Prevention:
消防器具 Fire Fighting Appliances
走火通道 Means of Escape
危險品倉庫 Dangerous Goods Stores
氣焊氣樽 Gas Welding Cylinders
健康 Health:
石棉控制 Asbestos Control
塵埃控制 Dust Control
噪音控制 Noise Control
危險物質的防護 Protection from Dangerous Substances
急救設備 First Aid Equipment
清洗設備 Washing Facilities
廁所 Latrine
機器 Machinery:
木工機械 Woodworking Machines
負荷物移動機械 Loadshifting Machines
磨輪 Abrasive Wheels
啤機 Power Presses
一般事項General:
地盤管理 Housekeeping
安全網和斜棚 Safety Nets and Fans
物料堆疊 Stacking of Materials
通路 Passageways
照明設備 Lighting
通風設備 Ventilation
有關僱用安全主任/安全督導員的告示 (有/沒有) Notice of Employment of Safety Officer/Safety Supervisor (YES/NO)
個人防護設備 Personal Protective Equipment:
安全頭盔 Helmets
護眼用具 Eye Protectors
聽覺保護器 Ear Protectors
呼吸器 Respirators
安全帶 Safety Belts
手套 Gloves
安全鞋 Safety Shoes
反光外套 Reflective Jackets
安全督導員簽署 Signature of Safety Supervisor
†*東主/安全主任簽署 †*Signature of Proprietor/Safety Officer
附註Note:
(1) *“東主”包括當其時管理或控制在該工業經營或應呈報工場中進行業務的人，亦包括法人團體、商號，以及任何工業經營或應呈報工場的佔用人及此等佔用人的代理人。
“Proprietor” includes the person for the time being having the management or control of the business carried on in the industrial undertaking or notifiable workplace, includes a body corporate, a firm and also the occupier and the agent of such occupier.
(2) † 請刪去不適用者。Delete if inapplicable.