Site Safety UAE

Heat Stress Daily Check — Supervisor Software Form

UAE Midday Break Law · MOHRE Decree 401 · ADOSH-SF · Dubai Municipality

Form: SSU-HS-DC-01

Rev: 1.0

Retain: Daily site record

DateProject / SiteContractorSupervisor (name)EmirateShift startShift endWeather forecast (°C hi/lo)

1. Midday Break Compliance (15 Jun – 15 Sep · 12:30 – 15:00)

Is today between 15 Jun and 15 Sep?Outdoor work stopped 12:30 – 15:00?Exempted works (list task & reason)

2. WBGT Readings & Work / Rest Cycle

Acclimatised: ≤ 28 continuous · 28–30 45/15 · 30–32 30/30 · > 32 stop

Time	Location / area	WBGT (°C)	Work load (L/M/H)	Work / rest cycle applied	Action taken
07:00
09:00
11:00
13:00
15:00
17:00

3. Water, Shade & Cooling Provision

Cool drinking water stations within 60 m of every work areaMinimum 1.5 L per worker per 2 hours stockedElectrolyte / rehydration sachets availableShaded rest area with seating & fans set upInsulated water coolers refilled & sanitisedNo caffeinated or sugary drinks distributed

No. of water stations on siteLitres of water on site (start of shift)Rest shelter locations

4. Pre-Shift Worker Checks (record any concerns)

All workers acclimatised (14 days on site or gradual re-entry after leave)No worker reports dizziness, cramps, headache or nauseaPPE appropriate: light cotton coveralls, wide-brim hard hat, sunglassesFitness-for-duty check completed — no fever, illness or medication concerns

Workers on modified duty / removed from heat exposure

5. Heat-Related Incidents & Stop-Work

Heat exhaustion / stroke cases todayStop-work events triggered (WBGT / condition)First aid / medical referralsImmediate corrective actions

Site Supervisor

Name & signatureDate / time

HSE Officer

Name & signatureDate / time

Project Manager

Name & signatureDate / time

Tip: choose A4 paper and portrait orientation in the print dialog.