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Format to record the facts during on-field survey / In-plant Training / Industrial Visit / Internship etc..

Name of the student :

Year and branch of study :

Register Number of the student :

Name and address of the Institution :

Staff Advisors Name and Designation:

Photograph of the

student

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S.No. Topics Data

1. Name and address of the organization /

work site / event / Person

2. Day(s) & Date(s) of visit

3. Time in:

4. Time out:

5. Name and Designation of the person(s)

with whom the student interacted:

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6. Products / Processes/ Services /

Activities

7 7. Output from /throughput of theorganization

Per shift

Per Day

Per Week

Per Month

Per Annum

Inputs for the organization

Per shift

Per Day

Per Week

Per Month

Per Annum

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8 8. Man power details

(for larger organization section wisebreakup)

Total Number of persons working

Men

Women

Categories

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(This page maybe Multiple copied to record about individual machineries /processes)

9. Machinery / process description

Number of machines

Input

Output

Machinery manufacturers name & address.

Cost of purchase

Date / Year of purchase

Manpower required to operate the machine /

process with the details of specific skills

required to perform

Noise (decibels)

Vibration

Heat (Temperature / Humidity)

Maintenance procedure

Safety precautions adopted

Whether the student has studied about the

machine / process during his study?

Or Whether is it? included in the forthcoming

study period.

How many machines are idle? How long?

& Why? (Enclose in a separate sheet)

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Energy consumption details

Types of fuel

Quantity consumed per unit time

Cost of fuel

Source of fuel

Any alternative fuel possible?

Non conventional energy sources utilized

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10. Financial details

Investments,

Loans,

Paid up capital,

Shares etc.

Operational Expenditure

Manpower Cost

Profit / Loss

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12. Work flow diagram

(To be enclosed as appendix II)

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13. Details regarding Safety and security

Emergency exits

Number and place of fire extinguishers

alarm bells

smoke and fire alarms

Sand buckets

First aid boxes

Access to medical care

Any other matter

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14.a

Facts about Pollution Control & EcologyConservation

Number of trees

Greenery

Landscaping

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14

b.

Amenities

Drinking water

Canteen Facilities

Rest and recreation facilities

Sanitation

Transportation

Residences / Quarters

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15. Standard certifications:

ISO 9000

ISO 14000

SA 8000

OHSA 18000

ISO-27000

Any other

16. Awards / Prizes Won (to be enclosed in a

separate sheet)

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17. Physical location of the site in a Hand drawnmap

(To be enclosed as appendix III)

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18. Photographs of the students visit to the

industry

(To be enclosed as appendix IV)

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19. Information leaflets from the organization

(To be enclosed as appendix V)

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20. During the period of stay of the student in the

organization, Is there any specific, noteworthyevent happened?

21. What she/he likes most in the organization?

22. What she/he likes least in the organization?

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23. What she/he wants to change immediately?

24. What she/he feels to change gradually?

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25. What are his/her ideas to improve theatmosphere prevailing in that organization?

26. What facilities he/she feels to be done?

27. In which area, he/she feels to take up some

improvement / development activity utilizing

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his / her institutes knowledge, skills and

expertise? (with specific time frame and man

power commitment)

28. The opinion about the student by the

organizations contact person(s) with whom

the student interacted during his/her stay inthe organization.

(If possible get it in the form of atestimonial, so that a copy of the samemay be enclosed)

29. Any other details.

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