EEI CORPORATION

THE BEACON TOWER PROJECT

Chino Roces Ave., cor. Arnaiz Ave. MAkati City
Job # 7040 R

Date : February 7,2009

To : F.T. Dacquel, Jr.
From : SAFETY DEPARTMENT
Subject : ACCIDENT REPORT

PERSONAL CICUMSTANCES:

PERSON INVOLVED : Alberto B. Siblas (LH-Rough Carpenter)

DATE/TIME OF ACCIDENT : February 5, 2009 / 4:00 P.M.
PLACE OF ACCIDENT : Level 7, area 1
EXENT OF DAMAGE : Contusion at left thigh

DESCRIPTION OF ACCIDENT:

On February 5, 2009 at around 4:00 P.M., Alberto B. Siblas accidentally got hit by a 2”
Ǿ , 1M, G.I. Pipe on his left thigh.

RELATED FACTS:

1.) At the given date and time, Alberto Siblas was engaged in the stripping job at
level 7 of area 1.
2.) While loose fitting a tie rod to unlink a double pipe overhead, it slipped from his
grip then dropped, directly hitting his left thigh.
3.) Mr. Siblas sustained contusion on his left thigh.

ACTIONS TAKEN:

1) Employee was given first aid treatment at the site clinic.

RECOMMENDATIONS:

1) Re-orientation to all workers involve in the stripping works

2) To be referred to St. Patrick Clinic for further treatment.
2) To be discussed on the next toolbox meeting

For your information and final disposition

J.S. Jocson
Safety Engineer