SNAMPROGETTI SAUDI ARABIA CO. LTD. Health, Safety & Environment (HSE) Rev.

MIP PKG-10 Gas Treatment & Sulfur Recovery Issued For General Use
FORM Reference No. BI-10-09003-HSE-F33 0.0
Serial No.
WORK STOPAGE NOTICE Page 1 of 1

Work Stoppage By:

Client (SAPMT) Contractor (EPC) Construction Team

Contractor (EPC) HSE Team Sub-contractor

Reason for Stoppage:

Construction / Design Natural (Wind Velocity/Rain/Cold/Other)

HSE Non-compliance Other

If HSE reason, then it was: Imminent Danger High Risk

Brief reason for stoppage:

Description:
Date Stoppage: Time Stoppage: Duration (hrs):
Activity(s): Location:
Name of Supervisor:
Name of Responsible Manager:
Name of Area HSE Person:
Did Responsible Foreman / Supervisor Notified: Yes No
Joint agreement was discussed for corrective action: Yes No

Work Resume:
Date Resume: Time:
The corrective action has been taken and satisfied: Yes No

Work Stoppage by Agreed / Reviewed by Distribution List

Job Position Job Position Job Position Name
Name Name Surname PM
Surname
Signature Signature CM

Date Date HSED