Please do not merge cells, please do not change cells' format

Contractor/ Work No. of

Kind of Description/Comments/Immediate action Work Status of Addition Information
Obsv Date of event Event Observer Subcontr Area/Location Task Hazard Priority Reccomended Corrective Actions stoppage Target Date Corrective Actions (description) Corrective Closure Date
observation taken stoppage Obs. (if any)
Involvement period Actions

Working with electrical devices while there

was water spill in the area that may cause Removing the water level using hand tools,
1 2/1/2022 Company HSE Joint Co/Cntr ABG co. ZMDEI-Electrical Other (see comments) Electrical hazard UC H electrical shock furthermore electrical socket Y < 1h 4/1/2022 replacing the electric line with a safer one 1 closed 5/1/2022
Superv/inspection Substation was without cover that increase the possibility with tight locks
of electrical hazards.

Company HSE ZMDEI-Electrical Rebar was observed showing up after rain that Carefully remove and cleaning the area and
2 2/1/2022 Joint Co/Cntr ABG co. Other (see comments) Fall,Trip,Slip UC H N 4/1/2022 1 Closed 5/1/2022
Superv/inspection Substation means it was hided by the soil Send it to the metal dirt area

Worker was using the drilling device and was

3 2/1/2022 Company HSE Joint Co/Cntr ABG co. ZMDEI-Electrical Tools/Equipment Fall,Trip,Slip UC H standing on unsafe ladder and putting the N 4/1/2022 Changing the ladder and using a safer one, 1 Closed 5/1/2022
Superv/inspection Substation giving TBT about the dangers of falling
electrical socket on the top of it as well.

Company HSE ZMDEI-Electrical Electrical Panel was inspected and cover for A warning sign has been placed, identified
4 7/1/2022 Joint Co/Cntr ABG co. Tools/Equipment Electrical hazard PO H protection from rain and other weather N 6/1/2022 2 Closed 8/1/2022
Superv/inspection Substation and wrapped with a rainproof material
conditions
Continuous cleaning and removal of all
Company HSE ZMDEI-Electrical
5 7/1/2022 Superv/inspection Joint Co/Cntr ABG co. Substation Housekeeping Fire hazard PO M Positive housekeeping was observed around N 6/1/2022 work equipment to its designated place 1 Closed 8/1/2022
worksite after completion of its use

Chemical substance that reported previously was

Company HSE ZMDEI-Electrical Other (see used without MSDS furthermore same issue with
6 14/1/2022 Superv/inspection Joint Co/Cntr ABG co. Substation Chemical products comments) UC H new substance and workers were not wearing Y < 1h 15/1/2022 1 Open
(safety gloves, proper mask and disposable
coverall).

Company HSE ZMDEI-Electrical Pipes and other materials were observed The equipment has been removed to the
7 14/01/2022 Superv/inspection Joint Co/Cntr ABG co. Substation Tools/Equipment Fall,Trip,Slip UC H obstructing the walkway that may cause trip N 15/1/2022 storage area 1 Closed 15/1/2022
and fall hazards

8 14/01/2022 Company HSE Joint Co/Cntr ABG co. ZMDEI-Electrical Chemical products Other (see UC H Till now the insolation chemical material is N 15/1/2022 Completeness of personal protavrive 1 Closed 16/1/2022
Superv/inspection Substation comments) without MDSD and stored improperly that equipment(PPE) and presence (MSDS)
may cause cancer to workers who work inside
the building all day due to its tiny fibers
9
10
11
12
13
14
15
16
17
18
19
20
Please do not merge cells, please do not change cells' format Windows User:
If any, describe kind of
No. Date of event Event Notes Report details
report
1 16/1/2022 Company Management visit Lifting Operations HSE Site visit report
2 Windows User:
3 Free text, describe
event
4
5
Please do not merge cells, please do not change cells' format
Contractor/ Dpt
Incident Date of Area/
Subcontr Involvem Task Type of Incident Priority
No. event Location
Involvement ent
Description/Comments Immediate Action taken
 Work
Work
Reccomended corrective actions stoppage Target Date
stoppage
period
 No. of
Status of
Corrective action (description) Correctiv Closure Date Notes
Obs.
e Actions
Please, custom your lists filling and completing lists below. Contact EIBV HSE coord
Contractor/Subcontr Dpt accountability Area/Location
Accountability (accountable) (deptaccountable) (area)

ABG co. A ZMDEI-Electrical Substation

Subcontractor 1 B C
Subcontractor 2 C D
Subcontractor 3 A E
Subcontractor 4 B T
Subcontractor 5 C Y
Subcontractor 6 A U
Subcontractor 7 B I
C O
A P
B
C
A
B
ct EIBV HSE coordinators if other blocked lists need any modification
THIS SHEET IS PROTECTED BY PASSWORD
Type of Work Work
Incident Priority stoppage stoppage observation Report
Observer Event Task Hazards Kind of observation status
(inciden (pr) status period (status) status
t) (stop) (stopper)

Company Contractor HSE Superv/inspection Access/Egress Biological hazard PO Near Mis H Y < 30 min Open N/A
Contractor Company HSE Superv/inspection Awareness/Behaviours Chemical hazard UA Damage to M N < 1h Closed Closed
Joint Co/Cntr Joint HSE Walk down Chemical products Cought by collapse UC Damage tL N/A < 5h N/A Draft
Other (see comments) Company Management visit Confined Space Covid19 Damage to N/A < 12h
Contractor Management visit Covid19 management Electrical hazard Fatality < 24h
Audit/Assesment Driving Fall from height First Aid Case > 24h
Drill/Exercises Energized System Fall,Trip,Slip Lost Time Injury
Health & Hygiene Insp. Excavation/Trenching Fire hazard Lost Workday Case
Firefighting Health Medical Treatment Case
Health-Hygiene Hearing hazard Restr Workday Case
Heat/cold environment Heat stroke/dehydration
Housekeeping Infection hazard
HSE MS Injury (generic)
Illumination Musculoskeletal Disease
Lifting Noise hazard
Lone working Pressure hazard
Manual Handling Struck by/Hit by
PPE Vibration hazard
PTW N/A
Re-Fuelling Other (see comments)
Safety signals/Barricades
Scaffolds/Ladders
SIMOPS
Tools/Equipment
Vehicle/Machinery Movement
Welding/Cutting
Working at Height
Other (see comments)

Confined space entry

Chemical cleaning
Excavation
Painting / sand blasting
Machinery
Kind of observation UC

Count of Obsv Status of Obs.

Event Open Closed Total Result
Company HSE Superv/inspection 1 5 6
Total Result 1 5 6
6 Count of osafety observations vs. events
years 2020-2021
5

4 Status of Obs. Open

Closed
3

0
Company HSE Superv/inspection Total Result
ons vs. events
1

Status of Obs. Open

Closed
Years - all -
Quarters - all -
Months - multiple - ‫اإلجمالي‬
Days - all - 12

Count of No. 10

0
‫اإل‬
Count - Data (All)
(All)
Months (All) ‫اإلجمالي‬
Days (All) 12

10

0
‫اإلجمالي‬

‫‪Column B‬‬
TABLE FOR WEEKLY REPORT, FILL THEM FROM GREEN LABELLED SHEETS

UNSAFE ACTS/CONDITIONS (No. of)

Event Total Closed Total Open Total
Company HSE Superv/inspection 8 1 8
Contractor HSE Superv/inspection 0 0
Company Management visit 1 1

SPECIAL EVENTS (No. of)

Event Total Last week
Drill/Exercises 0 0
Company Management visit 1 0

INCIDENTS (No. of)

Event Total Last week
Lost Time Injury
Lost Workday Case
Restr Workday Case
Medical Treatment Case
First Aid Case
Damage to asset
Damage to environment
Damage to reputation
Near Miss
BELLED SHEETS

NS (No. of)
Last week
0
0
Date of event - all -

Count of Obsv Kind of observation

Event UC Total Result
Company HSE Superv/inspection 6 6
Total Result 6 6
 Safety Observations vs events 2020
7

0
Company HSE Superv/inspection Total Result
ervations vs events 2020-2021

Kind of observation UC

Total Result
Date of event - all -

Kind of observati Status of Obs. Count of Obsv

PO
Closed 2
UC
Open 1
Closed 5
Total Result 8
 ‫اإلجمالي‬
12

10

8
Status of Obs.
6

0
PO UC Total
Result
 ‫اإلجمالي‬

Date of event - all -

Observer Count of Obsv

(empty) 12
Total Result 12

Total Result
50%
‫اإلجمالي‬

‫)‪(empty‬‬
‫‪50%‬‬
Kind of observation UC
Priority - multiple -
Date of event - all -

Task Count of Obsv

Chemical products 2
Other (see comments) 2
Tools/Equipment 2
Total Result 6

Total Result
50%
 Safety observations vs. Tasks
Priority: all
June-July 2021

Chemical products
17%

otal Result Other (see comments)

50% 17%

Tools/Equipment
17%
asks