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目 录
1.安全目标管理··············································································································· 1
1.1 安全管理目标表（ZTCJAQ/1.1）···············································································2
1.2 专职安全生产管理人员统计表（ZTCJAQ/1.2） ···························································3
1.3 分包单位进场情况登记表（ZTCJAQ/1.3）·································································· 4
1.3.1 安全生产协议统计表（项目经理部与分包单位）（ZTCJAQ/1.3.1）···························· 5
1.3.1.1 分包单位安全生产协议书（ZTCJAQ/1.3.1）····················································· 6
1.3.2 安全生产协议统计表（分包单位与班组）（ZTCJAQ/1.3.2）····································· 7
1.3.2.1 班组安全生产协议书（ZTCJAQ/1.3.2.1）························································· 8
1.3.3 安全生产协议统计表（班组与作业人员）（ZTCJAQ/1.3.3）····································· 9
1.3.3.1 作业人员安全生产协议书（ZTCJAQ/1.3.3.1）··················································10
2.安全教育培训管理········································································································11
2.1 项目管理人员安全教育培训计划表（ZTCJAQ/2.1）·····················································12
2.2 项目管理人员安全教育培训情况统计表（ZTCJAQ/2.2）···············································13
2.2.1 项目管理人员安全教育培训记录表（ZTCJAQ/2.2.1）············································· 14
2.2.2 项目管理人员安全考核情况统计表（ZTCJAQ/2.2.2）············································· 16
2.3 作业人员安全教育培训计划表（ZTCJAQ/2.3）···························································17
2.4 作业人员安全教育培训情况统计表（ZTCJAQ/2.4）·····················································18
2.4.1 作业人员安全教育培训记录表（ZTCJAQ/2.4.1）··················································· 19
2.4.2 作业人员安全考核情况统计表（ZTCJAQ/2.4.2）··················································· 21
2.5 分包单位作业人员信息统计表（ZTCJAQ/2.5）···························································23
2.5.1 作业人员三级安全教育卡（ZTCJAQ/2.5.1）························································· 23
2.5.2 作业人员健康状况调查表（ZTCJAQ/2.5.2）························································· 24
2.6 工前教育记录管理台账（ZTCJAQ/2.6）····································································25
2.6.1 工前教育记录表（ZTCJAQ/2.6.1）····································································· 26
2.7 安全技术交底书管理台账（ZTCJAQ/2.7）·································································27
2.7.1 安全技术交底书（ZTCJAQ/2.7.1）····································································· 28
3.安全生产费用管理········································································································30
3.1 安全生产费用年度使用计划表（ZTCJAQ/3.1）···························································31
3.2 安全生产费用提取和使用情况季度统计表（ZTCJAQ/3.2）··········································· 32
3.3 安全生产费用月度使用情况明细表（ZTCJAQ/3.3）·····················································33
4.消防防火管理··············································································································34
4.1 消防设施器材登记表（ZTCJAQ/4.1）······································································· 35
4.1.1 消防设施器材现场平面布置图（ZTCJAQ/4.1.1）··················································· 36
4.2 动火作业证管理台账（ZTCJAQ/4.2）······································································· 37
4.2.1 施工现场动火作业证（ZTCJAQ/4.2.1）······························································· 38
5.重大危险源管理···········································································································39
5.1 项目重大危险源清单（ZTCJAQ/5.1）······································································· 40
5.2 项目专家论证审查重大危险源监管清单（ZTCJAQ/5.2）···············································41
6.安全会议管理··············································································································42
6.1 安全生产分析会记录管理台账（ZTCJAQ/6.1）···························································43
6.2 安全生产分析会记录（ZTCJAQ/6.2）······································································· 44
7 应急救援管理··············································································································46
7.1 应急预案管理台账（ZTCJAQ/7.1）·········································································· 47
7.2 应急救援物资设备及器材管理台账（ZTCJAQ/7.2）·····················································48
7.3 专（兼）职应急救援队伍人员名册（ZTCJAQ/7.3）·····················································49
7.4 应急救援物资设备及器材定期检查维修管理台账（ZTCJAQ/7.4）·································· 50
7.5 应急知识培训管理台账（ZTCJAQ/7.5）····································································51
7.5.1 应急知识培训记录（ZTCJAQ/7.5.1）·································································· 52
7.6 应急演练计划表（ZTCJAQ/7.6.）············································································ 54
7.7 应急演练组织管理台账（ZTCJAQ/7.7）····································································55
7.7.1 应急演练记录（ZTCJAQ/7.7.1）·········································································56
8.安全考评（验收）管理··································································································57
8.1 分包单位月度安全检查考评情况统计表（ZTCJAQ/8.1）···············································58
8.2 安全验收情况统计表（ZTCJAQ/8.2）······································································· 59
8.3 项目安全管理自评情况统计表（ZTCJAQ/8.3）···························································60
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8.3.1 建筑施工安全检查（验收）评分汇总表（ZTCJAQ/8.3.1）······································· 61
8.3.2 安全管理检查（验收）评分表（ZTCJAQ/8.3.2）··················································· 62
8.3.3 文明施工检查（验收）评分表（ZTCJAQ/8.3.3）··················································· 64
8.3.4 扣件式钢管脚手架检查（验收）评分表（ZTCJAQ/8.3.4）······································· 66
8.3.5 门式钢管脚手架检查（验收）评分表（ZTCJAQ/8.3.5）·········································· 68
8.3.6 碗扣式钢管脚手架检查（验收）评分表（ZTCJAQ/8.3.6）······································· 70
8.3.7 承插型盘扣式钢管脚手架检查（验收）评分表（ZTCJAQ/8.3.7）······························72
8.3.8 满堂式脚手架检查（验收）评分表（ZTCJAQ/8.3.8）············································· 74
8.3.9 悬挑式钢管脚手架检查（验收）评分表（ZTCJAQ/8.3.9）······································· 76
8.3.10 附着式升降脚手架检查（验收）评分表（ZTCJAQ/8.3.10）····································78
8.3.11 高处作业吊篮检查（验收）评分表（ZTCJAQ/8.3.11）·········································· 80
8.3.12 基坑工程检查（验收）评分表（ZTCJAQ/8.3.12）················································ 82
8.3.13 模板支架检查（验收）评分表（ZTCJAQ/8.3.13）················································ 84
8.3.14 高处作业检查（验收）评分表（ZTCJAQ/8.3.14）················································ 86
8.3.15 施工用电检查（验收）评分表（ZTCJAQ/8.3.15）················································ 88
8.3.16 物料提升机检查（验收）评分表（ZTCJAQ/8.3.16）············································· 90
8.3.17 施工升降机检查（验收）评分表（ZTCJAQ/8.3.17）············································· 92
8.3.18 塔式起重机检查（验收）评分表（ZTCJAQ/8.3.18）············································· 94
8.3.19 起重吊装检查（验收）评分表（ZTCJAQ/8.3.19）················································ 96
8.3.20 施工机具检查（验收）评分表（ZTCJAQ/8.3.20）················································ 98
9.隐患排查治理管理······································································································ 100
9.1 安全检查管理台账（ZTCJAQ/9.1）········································································ 101
9.2 项目经理带队检查管理台账（ZTCJAQ/9.2）···························································· 102
9.2.1 安全检查记录表（ZTCJAQ/9.2.1）···································································· 103
9.3 安全隐患整改通知书管理台账（ZTCJAQ/9.3）························································· 104
9.3.1 安全隐患整改通知书（ZTCJAQ/9.3.1）······························································105
9.3.2 安全隐患问题整改前后对比照片及说明（ZTCJAQ/9.3.2）····································· 106
9.4 安全生产处罚情况统计表（ZTCJAQ/9.4）······························································· 107
9.4.1 安全生产处罚通知单（ZTCJAQ/9.4.1）······························································108
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9.5 安全生产奖励情况统计表（ZTCJAQ/9.5）······························································· 109
9.5.1 安全生产奖励通知单（ZTCJAQ/9.5.1）······························································110
10.安全日志管理···········································································································111
10.1 安全日志（ZTCJAQ/10.1）··················································································112
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01 安全目标管理
项目经理部：
1
2
安全管理目标表
工程名称： ZTCJAQ/1.1
类别 具体目标 项目经理部具体措施
1．落实包保责任。坚持党政同责、一岗双责、
齐抓共管、失职追责，实行全员安全生产责任制；
逐级签订安全包保责任书，直至作业队和一线作
业人员；一线作业人员收入与安全生产挂钩，并
依据包保责任书按月考核兑现。
2．主动消除事故隐患。建立风险分级管控和
隐患排查治理双重预防工作机制。以安全隐患排
查治理平台为依托，深入开展隐患排查与治理工
作，做到提前想到、提前发现、提前消除隐患，
实现隐患排查治理的超前性、全面性、真实性和
有效性，确保安全不出问题。
3．遏制险性事件。全年无较大生产安全险性
事件。
4．杜绝伤亡事故。全年无各类人员伤亡事故
（包括与生产有关的生活、交通、消防等）。
5．实现安全创优目标。完成集团公司（工程
公司）下达的创优目标。
6．严格落实安全生产重点工作。抓好工前教
育、机构与人员配备，管好危险源（隐患）和安
全重点，做好应急救援（应急救命）和安全分级
管理，抓实内部安全许可与安全生产评价工作等。
确保各项工作落到实处、成效明显。
7．其他目标： 。
（项目