HSE/FOR/9011

Issue Date: 05/09/2019

Version: 1.1

Ad Dhakhiliyah Water Transmission System Phase II

NEAR MISS REPORTING CARD
Date: 10/01/2023 Time: 10:30 AM
Location: MPS Reported By: Balasubramaniam K
Department: Section 1A Near Miss Report No: L&T/ NMR/ JAN/ 01

Tick boxes applicable to the incident & describe below.

Behaviour Road traffic accident

PPE Walked into item

Slips, Trips & Falls Fall from height

Poor supervision Confined space

Heat, Sparks, Flame Lifting

Environmental issues (Noise, Dust, COSHH Spillages, Leaks of material

Lightning & Material Storage) or liquid
Risk of person falling Service strike

Access & egress Falling object

Electrical hazard Risk of Excavation Collapse

Plant & equipment Signing and guarding

Head Injury Man-Machine strike

Brief description of Incident:
Chlorination building roof slab parabout openings found to be left unattended on the work location leads to risk of
person fall from height hazards
Action taken:
 Immediately advised the supervisor to ensure proper hard barricades with caution tapes
 Collective protection properly provided

Note:
 Near Misses is an unplanned event that did not result in injury, illness, or damage – but had the potential to do
so, these events can be resulted by Unsafe Acts form people/Unsafe Conditions of workplace
 All Near Misses shall be investigated with evidence.

Attached to: HSE/PRO/9007 This document is the property of Public Authority for Water (Diam) 1/2
The controlled version of the document is available online in Diam- QMS Library. Printed copies are ‘Uncontrolled’
 HSE/FOR/9011
Issue Date: 05/09/2019
Version: 1.1

Ad Dhakhiliyah Water Transmission System Phase II

NEAR MISS REPORTING CARD

NEAR MISS PHOTOGRAPH

CORRECTIVE ACTION PHOTOGRAPH

Attached to: HSE/PRO/9007 This document is the property of Public Authority for Water (Diam) 2/2
The controlled version of the document is available online in Diam- QMS Library. Printed copies are ‘Uncontrolled’