General Petroleum Installations

LETTER OF STATUS
APPOINTMENT Risk Assessor & H&S Plan Developer Release
Department Originator Approved By: Approved Date:
RESPONSIBILITY Quality Cheree Lombard Oscar Mouton 01.07.2016

Occupational Health and Safety(Act 85 of 1993

Construction Regulation 9

Every contractor performing construction work shall before the commencement of any construction work and
during construction work, cause a risk assessment to be performed by a competent person appointed in writing and
the Risk Assessment shall form [art of the Health and Safety plan to be applied on the site and shall include at
least:

 the identification of the risk and hazards to which persons may be exposed to;
 the analysis and evaluation of the risks and hazards identified;
 a documented plan of safe work procedures to mitigate, reduce or control the risks and hazards that have
been identified;
 monitoring and review plan.

I, Oscar Mouton, on behalf of the principle contractor of(Company Name) General Petroleum Installations,

hereby appoint Chemoné Louw as the Risk Assessor and Health and Safety

Plan Developer’s responsible for (Name of Site) Mabena Associates Nelson Mandela soccer stadium in terms of
Regulation 9(1) of the Contraction Regulations to assess Risks and develop ofa Health and Safety plan and ensure
its implementation.

You shall ensure that you meet all the requirements in terms of the Construction Regulations.

__________________________ ________15.05.2022____________
On behalf of GPI Date

Acceptance of Designation

I, Chemoné Louw Risk Assessor and Health and Safety Plan Developer

understand the implications of this appointment as detailed above and confirm my acceptance.

________CL__________________ ________15.05.2022____________
Signature Date
ELECTRONIC VERSION CURRENT. UNCONTROLLED IF PRINTED

Document Nº: Approved By: Approve Date: Last Revision Date: Revision Nº: Pages
APP.014 Oscar Mouton 02.10.2012 26/01/2022 01 1 of 1
 ELECTRONIC VERSION CURRENT. UNCONTROLLED IF PRINTED

Document Nº: Approved By: Approve Date: Last Revision Date: Revision Nº: Pages
APP.014 Oscar Mouton 02.10.2012 26/01/2022 01 1 of 1