Form# ESH-001

Royal Commission & SABCO

Rev # 1
Jubail Project - ES&H Department
Date: 1.03.16

POTENTIA L INC ID ENT R EPOR T (PIR )

Date Observed: 28 Oct, 2018 Report # 002 Project # 09J-C06

Location: AHC LAYDOWN AREA Observer Name: Iqbal Mohammad

Risk Rating (Probability X Potential Severity) – Please refer to Risk Assessment Matrix

High (10 to 25)  Medium (5 to 9)  Low (1 to 4) 

Risk Assessment Matrix
Potential Probability (P)
Severity (S) 1. Improbable 2. Remote 3. Occasional 4. Probable 5. Frequent
1. Negligible 1 2 3 4 5
2. Marginal 2 4 6 8 10
3. Critical 3 6 9 12 15
4. Severe 4 8 12 16 20
5. Catastrophic 5 10 15 20 25

HAZARD DESCRIPTION Category

Please write what you saw and where it took place Please Tick () in the appropriate box

O n 2 7 t h O cto be r 2 01 8, t he win d spe e d wa s ve ry Working at height  Tools & Equipment. 

h ea vy; all sig na g e f e ll do wn on th e ro ad . Environment √ Manual Handling 
Win d sp e ed to o k of f a ll g ree n me sh (ne t ) f ro m Scaffolding and or
t he fe n ce (n o in ju ry)
MEPI  Falsework

Lifting Operations  Permit 
Confined Space
work
 Welfare 
Housekeeping  Training 
Any Other:

Were you able to correct the problem? Yes √ No 

What action was; Taken √ Suggested 
 Re mo ved a ll fe ll d o wn ro ad sign a ge
 Re co ve re d all g ree n Me sh (n et )

Is Detailed Investigation Required? Yes  No √

If Detailed Investigation Required Name of Team
Members (Assigned by Site in-charge):

SL Recommendation(s) Action by Target Date


1. In fo rme d lab o rs f ix f irmly ro a d sig na g e, n ot
clo se r t o t he ro ad

2. Aske d Tie p rop e rly g ree n Me sh (ne t ) o n t he 28/10/2017 28/10/2107
fe n ce


Reviewed By: Name Designation Date Signature

Site In-charge Ali Al Dali CM 28/10/2018

HSE In-charge Iqbal Mohammad Safety Manager 28/10/2018

 Form# ESH-001
Royal Commission & SABCO
Rev # 1
Jubail Project - ES&H Department
Date: 1.03.16

POTENTIA L INC ID ENT R EPOR T (PIR )