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 # 001 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

Th e re wa s Hea vy ra in o n 2 7 t h O cto be r 2 01 8, Working at height  Tools & Equipment. 

Ne xt da y 28 t h O cto be r 2 01 8 g ro un d wa s Environment √ Manual Handling 
slip p e ry, o ne of ou r e mp lo yee wh ile wa lking Scaffolding and or
slip p ed , bu t h o ld b y a no th e r e mp lo ye e so no
MEPI  Falsework

in ju ry 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 
 I mme d iat e ly h old h im by a no th e r e mp lo yee
 Th e we t a re a sp re ad by so me so f t san d
 Un t il d ra y a sked a ll lab o r do n ’t wa lk o n t ha t a re a (we t a re a ba rrica d ed )

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 a ll e mp lo yee s b e ca ref u l wh ile
wa lking o n th e we t g ro u nd du rin g ra in y

se a son 28/10/2017 28/10/2107

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 )