Afaq Al Musana Trading L.L.

Emergency Evacuation Drill Form

Job Number: Mock Drill -1 Emergency Lead Name: HSE OFFICER

Location: Duqm T49/2019 T49/2019 Date:27-01-2021
Type of Emergency (Fire Breakout)
Fire Emergency

Emergency Scenario: Fire All Emergency Situations

Sequence of Events (List the events from

the occurrence of emergency situation,
till it is brought under control)

Page 1 of 4
 Afaq Al Musana Trading L.L.C

Emergency Evacuation Drill Form

Event Description Time Inadequacies /

Shortcomings
Declare Emergency
First person came at assembly point.
Last person came at assembly point.
Foreman count all head & check TBT form.
Rescue team check site area.
If there is no emergency so you can go back
to the site and start work.
Recommendation of Observer (HSE In charge/Focal Point) for actions to be taken

1.

Emergency Mock Drill Pictures

Description:
Picture 3:

Page 2 of 4
 Afaq Al Musana Trading L.L.C

Emergency Evacuation Drill Form

Page 3 of 4
 Afaq Al Musana Trading L.L.C

Emergency Evacuation Drill Form

(Forward to Line Manager for action to be taken) (To be signed after

completion of action)

Area/ Construction Manager

Signature with Name & Date

HSE Officer

Signature with Name & Date

Page 4 of 4