HSEC Significant Incident / Free Lesson Report

VOLCAMIENTO CAMIONETA RUTA B - 475

NOTIFICATION - REQUIRED WITHIN 24 HOURS OF THE INCIDENT
PART 1 (To be submitted by the asset/site manager)
Incident Date: (eg 1 January 2006) 23 junio 2006 Incident Time:(eg 0915 or 2115): 17:45
CSG: Base Metals Asset/Site: Escondida Country: Chile

Description of HSEC Incident: (Who, what, how, when)

Bajando desde Escondida a Antofagasta el conductor de camioneta patente ZB-6824 de la empresa
DRIVER, al llegar aproximadamente al Kilómetro 84, pierde el control del vehículo al quedarse dormido
volcandose en el camino. Viajaba con 1 acompañante

Details of Injury/Damage/Impact: (Nature and extent of injuries/damage/impact)

Chofer : Policontuso, herida colgajo pabellón auricular derecho, contusión pulmonar en observación
hemotórax Acompañante 1: Policontuso con herida contuso cortante cuero cabelludo. Perdida total de
camioneta

Immediate Actions Taken by Line Management following Incident:

Los lesionados son llevados para atención médica a policlínico Mina y luego a Mutual Antofagasta
La camioneta es retirada del sector
Inicio de investigación ICAM.

Employee, Contractor and/or Third Party Incident? Contractor

Work category of person injured or involved Specialist/Engineer/Scientist
Is the activity Controlled, Monitored or Uncontrolled? Monitored
Was a risk assessment conducted for this task? Yes/No Yes
Does a site standard or procedure exist to control this risk? Yes/No Yes
ACTUAL : POTENTIAL :
Incident type and consequence (some incidents Incident type and consequence (corresponding
may have multiple outcomes) : with the actual outcome discipline ) :
H S E C Level 2 H S E C Level 5
The most causal Fatal Risk Control Protocol or 1. Light Vehicles     
Major Incident Type :

Was this incident a Property damage greater Yes No

Yes No
Refining/Process failure ? than USD 10,000 ? Amount $     
Status of Investigation? Preliminary Date investigation completed Junio 2006

PART 2 RESULTS FOLLOWING THE ICAM INVESTIGATION

Absent or Failed Defences: Description

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Individual/Team Actions: Description
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Subject to legal professional privilege. This alert is forwarded under common interest privilege due to your common
interest with BHP Billiton in ensuring that similar accidents do not occur in the future.
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HSEC Significant Incident / Free Lesson Report
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Task/Environmental Conditions (Workplace) : Description
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Task/Environmental Conditions (Human) : Description
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Organisational Factors: Description
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Underlying (Root) Causes and Key Contributing Factors:
     
Description of Incident FOLLOWING the ICAM investigation (complete if changed from Part 1) :
     
Permanent Corrective Actions to be Taken: (Actions should relate back to ICAM investigation findings)
Action Due date Responsible person job title
                 
                 
                 
                 
                 
                 
                 
Key Learnings: (Summary of learnings from incident)
     
Asset risk register reviewed and updated following the investigation Yes No
Responsible Line Manager: José Salazar F. Telephone: 09-541 4816
Gerente Servicio a   jose.h.salazar
Title : Email:
Procesos @bhpbilliton.com
Photographs: (Insert photographs below)

Subject to legal professional privilege. This alert is forwarded under common interest privilege due to your common
interest with BHP Billiton in ensuring that similar accidents do not occur in the future.
499525843.doc / P10aSignificantIncidentReportFromV2 Page 2 of 3
 HSEC Significant Incident / Free Lesson Report

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Subject to legal professional privilege. This alert is forwarded under common interest privilege due to your common
interest with BHP Billiton in ensuring that similar accidents do not occur in the future.
499525843.doc / P10aSignificantIncidentReportFromV2 Page 3 of 3