SAPL KAFD HSE Team Inspection Record

Reference KAFD-A2-C22-SAP-HSE-SOR-00009 Surveillance Type SOR

Cluster (Area 2) / Work Scope (Sitewide) C22 Parcel/Location C22 Area Area 2

Other representatives
Time: 06:00 - 11:59 Date: 1/1/2023 SAPL Lead: Marloun Manalo SAPL HSE Co-ordinator: Marloun Manalo Abrar Hussain - HSE Supervisor, ABC
(Role and Company)

Level / Response Additional Commentary Photo Close out photo

No. Topic Item Issue Severity Contractor Close out Action taken? Date?
Location Required (only if required) (only if required) (only if required)
1 Floor Openings Floor Opening Unsecured Life Critical Al Bawani Roof Secure Unsecured floor opening cover was observed
/ Gaps / Holes in parcel A02B roof level. High potential risk to
fall from height/ falling object in lower level.

2 Work at Height Ladder Unsecured Life Critical Al Bawani 2 Secure An operative was found working on
/ Scaffolding / unsecured ladder. High potential risk to fall
Ladders from height.

3 Briefings STARRT Card Unsigned Non-Life Al Bawani 1 Instruct STARRT Card briefing record missed to
Critical signed by operatives involved in the task.

4 Work at Height Scaffold Uninspected Non-Life Al Bawani 2 Inspect Scaffolding inspection tag missing. No
/ Scaffolding / Critical evidence of inspection conducted for the
Ladders scaffolding.

5 Plant & Generator Damaged Non-Life Al Bawani GF Repair Temporary generator exhaust was found
Equipment Critical damaged.

Form No: KAFD-RY-RIA2-PGEN-SAP-QMS-FRM-00060 R00 05 Jul 2021 Page 1 of 3 Pages

 SAPL KAFD HSE Team Inspection Record

Level / Response Additional Commentary Photo Close out photo

No. Topic Item Issue Severity Contractor Close out Action taken? Date?
Location Required (only if required) (only if required) (only if required)
6 Work at Height Design Unavailable Non-Life Al Bawani 2 Supply Unsecured floor opening
No copy of approved cover
design was observed
provided for the
/ Scaffolding / Critical in parcel A02B
scaffolding roof level.
structure High
erected atpotential risk to
parcel A02-A
Ladders fall from height/ falling object in lower level.
level-2.

7 Lifting 3rd Party Unavailable Non-Life Al Bawani 2 Supply No evidence of 3rd party inspection provided
Equipment Inspection/Cer Critical for the lifting hoist re-installed at parcel A02
tification level-2.

8 Electrical Distribution Uninspected Non-Life Al Bawani 1 Inspect No evidence of inspection conducted for the
Board Critical temporary DB, inspection tag missing.

9 Housekeeping Waste Inappropriate Non-Life Al Bawani 2 Remove Accumulated waste observed on Site, no
Critical regular disposal of waste materials.

10 Storage Chemicals Undesignated Non-Life Al Bawani GF Relocate Flammable material was left unattended and
Critical left in undesignated storage area.

11 Access/Egress Cable Low Non-Life Al Bawani GF Remove Temporary lighting cables routed at low level.
Critical

Potential Severity Description Potential Failure Consequence example Response

Form No: KAFD-RY-RIA2-PGEN-SAP-QMS-FRM-00060 R00 05 Jul 2021 Page 2 of 3 Pages

 SAPL KAFD HSE Team Inspection Record

Level / Response Additional Commentary Photo Close out photo

No. Topic Item Issue Severity Contractor Close out Action taken? Date?
Location Required (only if required) (only if required) (only if required)
Life Critical Major failure e.g. fatality, LTI, major injury, or Unsecured
dangerous floor opening cover was observed
occurrence
in parcel A02B roof level. High potential risk to
Immediate < 1 Working day (if not temporary suspended)
fall from
Potential Minor injury Incident, Environmental height/ falling
or Welfare object in lower level.
Issue. Fix in < 3 working day
Non-Life Critical
Good Practice N/A None however look to share good practice

Issued By: Marloun Manalo Signature: Date: 1/1/2023

Form No: KAFD-RY-RIA2-PGEN-SAP-QMS-FRM-00060 R00 05 Jul 2021 Page 3 of 3 Pages