Emergency Action / Reporting Accident Hospital:

Diagram (package_____) Cell:

Witness (worker)
1. Location: xx, Fire Service: 999
2. Time: xx or 02- 9555555
3. What Happen: xx
(Information via Telephone) Contractor Management

Contractor Safety In-Charge

This Emergency Action Plan Must be
Submitted to the Engineer where any
change arrived.
PM:
Site Engr. / Safety Officer (Day) Co- PM :
Name:
site Engr. / Safety Officer (Night)
Name: (Instruct For Rescue/ Hospitalization,
Restoration)
(Information via Telephone) (Information via Telephone)
1. Location 2. Time 3. What Happens Note: Initial Incident/ Accident/Near miss
4. Injury Information must be reach consultant Core
Team within 2 Hours

Consultant Safety In-Charge Consultant package Managers Contractor Safety Manager Contractor Admin. Manager

Name: Name: Name:

RE :
ARE : Rescue/Hospitalization/ Rescue/Hospitalization
Client DRE : Restoration Follow up Follow up

(Initial accident report)

- Prepare initial accident report incl. update the status
Via E-mail of victim by Contractor Safety Manager and submit
Via Phone Call
& Phone to Contractor Mgmt (SPM / PM)
PD : - Contractor Mgmt (SPM / PM) will submit to
APD : Consultant Core Team consultant package Managers the initial accident
PM : report & updated status of victim within 24 hours

ATL: (Hospital FFD= Fit For Duty)

OM : - After discharge from hospital FFD submit to
Contractor PM by Contractor Safety / Admin
- Contractor Mgmt submit FFD to consultant package
Managers