1a: a PROJECT / DEPARTMENT: Al-Shirawi Project @ Business Bay Dubai [Date And Time 05-08-2020 @ 03:47 PM [Name Of The Person injured / Nationality - N/A ‘staff / Card No / Sub-Contractor HVAC Werkmen Name OfTheConsutant ar consutrants [Accident Rating / Delay In Program N/A Lost working Hours surance Claim wR Name OF The immediate Supervisor Lal Babu (HVAC Piping Charehand) |Location / Damage Ete First Floor ‘type Of injury / Nature And Severity N/A Incident Location First Floor | {Today @ 03:47 PM During DeShuttering Process At 7th Floor Edge Area One ‘Description Of Incident And Task Being Carried Out 'Wooden Suppot Fell Down To The First Floor Material Area Where Our HVAC |Workmen Was Working Near To That Place.Thanks God No Body Got Injured. Witness Name And Statement Lal Babu (HVAC Piping Charghand) ‘Treatment Rendered Including Hospital Report N/A It Was Totally A Mistake Of DeShuttering Tear They Didn't Took Any Safety Precaution For Falling Objects ‘During Investigation We Find That The Team Doing Deshuttering Process Is 'UnProfessional And Falling Objects Protection Was Not Done. Immediately We Informed The Civil And Arranged The Protection And Also Arranged Meeting (TOOL BOX TALK) With All Chill Water Workers. [ab Arabia safety Team immigiatlly informed The Civil And Arranged The Immediate Causes “onclusions / Findings [Detail OF Action Taken ‘Barrication To That Area And Also Fixed The Falling Objects Board For Information. _| [Remedial Measures To Be Implemented Near Miss To Be Communicated With All Workmen In Next Tool Box Talk [Date Injured Person Returned To Work: [Date Of Rectification In Case Of Environmental Incident: n/a Signature: Y VA bate: wav Name: Anwar Ul Hague(Sr.Project Manager) Name: Samee Ullah (Safety Officer) P.13/F01 Revo