Doc.

Driving Violation and

RPSG-IMS-F-44
No. Investigation Form 5D

Driving Violation and Investigation Form 5D.

Incident Details:

Location: MJN – DS1

Time of
Date of Incident:27-02-2020 11:30:00
Incident:
Department: Drivers

Driver Name: Karim Hilal Contract No: MFD-IFMS-001 Site: Majnoon

Departmental Hisham Mendil

Managers Name:

To Be Completed by the Journey Planning Manager:

Description of The Incident:

- At approx. 11:30am on the 27th Feb 2020 the Mercedes Benz flatbed plate # 149519 (bottled
water delivery truck) hit the Jersey barrier at DS1 while leaving the site after delivering water
at Karama Camp.

To be completed by the Project Manager:

Actions Taken:

- The driver was stopped by the road safety officials (at DS1) and he complied.
- A written statement was obtained from the driver (see attached).
- Arrangements were made the following day to restore the Jersey barrier to its original position.
- The driver was advised accordingly and a TBT conducted for the drivers to observe caution
while driving, turning and passing through gates and barriers (see the TBT record and
supporting photos attached).

Uncontrolled when printed.

This cannot be copied in whole or part without the written consent of Quality
Assurance Manager
 Doc. Driving Violation and
RPSG-IMS-F-44
No. Investigation Form 5D

Project Manager:

Investigation Outcome:

- The driver miscalculated the actual position of the Jersey barrier while turning the truck and hit
the Jersey barrier. The Jersey barrier tilted from the impact.

Has the Driver received a disciplinary: ( X) Yes ( ) No

- A verbal warning has been given to the driver.

Has the Driver violated the Road Safety Transport Plan before?: NO

If yes – how many violations?: None

Journey Planner : Hisham Mendil

Date: 01-03-2020

Additional Comments/ Notes/ Witness Statement: NA

Uncontrolled when printed.

This cannot be copied in whole or part without the written consent of Quality
Assurance Manager