Incident Report

Incident Report No:01/2019 Date & Time: 23-01-2019

Incident Related to:

 Health and Safety Location: Tower 1 , Level# 47

 Environment The Address Residence – Sky View Dubai.

Affected Person: Incident Classification:

Company Employee  Visitor  Fatality  Lost Time Injury  Near Miss
 Contractor  Other:___________  Property Damage  Environmental Incident
Notified By: ACC HSE MR.Joseph Department: HSE
Brief Description in Incident with details of injuries / damages:
On 23-01-2019 around 08:00 Am, at Tower 1 Level 47 Mr. Rizwan Ahmed (ID: 4268/ Charge
hand Cloisall) and his crew Mr. Malik Mehran Zahid (ID: 31/UMR/Al Hilal), Mr. Amit (ID:
767/UMR) carpenters were engaged in wall partition with gypsum board. While carrying out
his activity one MDF piece (2mtr length and 50 mm width) slipped and fell down through an
opening from level #47 to level 4. (Approximately 154mtr height). No injury or damages
reported.

Immediate Action Taken:

1. Temporarily suspended the activity.
2. Conducted TBT regarding Near Miss and Importance of Near Miss Reporting.
3. Conducted Training regarding safe handling of materials and how to work safely
near Exclusion zone.
4. Issue warning letter to the violators.

Investigation Required:

Yes, Investigation Report No. 01/2019 (to be filled latter)

 No, Please specify the reason:

Report Prepared By: Anshad Asharaf Signature & Date: ______________

CONTROLLED COPY
Page 1 of 1 FR-88 Rev. 6, 30.04.2015