ESV-02-000 (Form 5) Rev.

03 - 14 Feb 2022

SITE INCIDENT PREVENTION PLAN (SIPP) S. NO.

PERMIT VALIDITY: 14 DAYS FROM EHS VERIFIED DATE

THIS PERMIT MUST BE DISPLAYED AT THE WORK AREA
LOCATION: B2 – Production CONTRACTOR: TTE Engineering Sdn Bhd

DESCRIPTION OF WORK: Speaker Installation Work

TYPE OF WORK: CONSTRUCTION INSPECTION REPAIR OTHERS:

STAGE 1: FILL & COMPLETED BY IEM PROJECT OWNERS

RISK INVOLVE
 Routine / Cold Work  Hot Work  Working At Height  Confine Space  Hoisting Work
PPE REQUIRED (TICK FOR ITEM REQUIRED)
 Safety helmet  Hot work (shield / apron) Ear muff/plugs  Chemical suit/ Jumpsuit
 Safety glasses / goggle  Gloves (Chemical / Heat)  Harness & life line  Fire extinguisher
 Safety / Chemical shoes Other:

COMPULSARY DOCUMENT
 Construction safety planning  SIPP & Daily Check  Hirarc  Workers List
OTHERS ( IF RELATED)
 SDS  Competence Certificate  B. ownership form  Calibration Certificate Other:

ANY GENERATION OF WASTE (NOTIFY TO SW PIC)

 General Waste  Schedule Waste If Tick (/) SW, Please fill up the SW Code :

COMMENCEMENT DATE: _____/_____/_____ TIME _________ HRS COMPLETION DATE: ______/______ /______ TIME:_________ HRS

I UNDERTAKE TO COMMUNICATE THE HAZARDS TO THE WORKFORCE / VENDOR AND TO STOP THE WORK IMMEDIATELY IN THE
EVENT OF CHANGE OF CONDITION / INCOMPATIBLE WORK.

Name Signature Emp. No. Date & time

NOTE: SOFTCOPY COMPULSARY AND ATTACHMENT MUST SUBMIT TO EHS DEPT. 24H BEFORE START WORK.

STAGE 2: VERIFIED BY EHS DEPARMENT

REMARKS/ADDITIONAL SAFETY REQUIREMENTS:
FIT FOR WORK
NOT FIT FOR WORK ………………………………………………………………………………………………………………………………………..

Name Signature Emp. No. Date & time

STAGE 3: WORK COMPLETED NOTIFICATION

I verify above job already completed housekeeping completed.  Daily Checklist

Name Signature Emp. No. Date & time

STAGE 4: PERMIT CANCELLATION BY EHS DEPT. / MANAGER (IF ANY VIOLATION HAPPEN)
Name Signature Emp. No. Date & time

IMPORTANT: ANY CHANGES IN THE ABOVE & CHECKLIST CONDITIONS WILL IMMEDIATELY INVALIDATE THIS PERMIT
ESV-02-000 (Form 16) Rev. 02 - 03 May 2021 Page 1/2

DAILY CHECK : ROUTINE / COLD WORK Area No.: ________

SIPP NO.: DATE ISSUED: LOCATION:

DESCRIPTION OF WORK:

The following are to be checked and confirmed before commencement of work:

(a) Personnel involved in the operation using approved and suitable personal protective equipment (PPE).
(b) Toolbox Meeting conducted & Worker understand job scope and risk of the activities ( fill page 2).
(c) Check drawing for electrical or water piping system (if necessary).
(d) Kanban board has been display on-site and area has been check clear from any hazard.
(e) Adequate hazard sign or Barriers tape ownership form must be provided at material storage area.
(f) Suitable hand tool or equipment for the job and prepare waste segregation / disposal for the work process.
(g) Barricade work areas and work area must be kept from unauthorized personnel.
(h) Chemical or electrical supply already “shut off” before start work activities.
NOTES: 1) Please tick (/) the column below (checked by Subcontractor & verified by IEM PIC).
2) IEM PIC must close this form and hand over to EHS.
DATE & CHECKED & CONFIRMED WORK START CHECK: DAILY CLOSURE:
REMARK
TIME A B C D E F G H VENDOR PIC IEM PIC IEM PIC
Name: Name: Name:
IC: Emp.No: Emp.No:

Signature: Signature: Signature:

Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:

IMPORTANT : If the requirements stipulated in the Daily Checklist are not met, permit will be automatically INVALIDATED
ESV-02-000 (Form 7) Rev.02 - 03 May 2021 Page 1/1

DAILY CHECK: WORKING AT HEIGHT Area No.:

SIPP NO.: DATE ISSUED: LOCATION:

DESCRIPTION OF WORK:

The following are to be checked and confirmed before commencement of working at height:
(a) Worker understand job scope and working at height SOP (ensure at least 2 person work - buddy system).
(b) Scaffolding/ladder already inspected in good condition.
(c) Lifting equipment ( e.g.: sky lift) has valid certificate of fitness.
(d) Suitable fall prevention already applied (harness/safety belt/guarding).
(e) Surrounding and weather in good condition (Wind speed is below 25km/h).
(f) Suitable fall prevention already applied (life line,harness/safety belt/guarding).

NOTES: 1) Please tick (/) the column below (checked by Subcontractor & verified by IEM PIC).
2) IEM PIC must close this form and hand over to EHS.

CHECKED & CONFIRMED WORK START CHECK: DAILY CLOSURE:

DATE & TIME REMARK
A B C D E F VENDOR PIC IEM PIC IEM PIC
Name: Name: Name:
IC: Emp.No: Emp.No:

Signature: Signature: Signature:

Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:
Name: Name: Name:
IC: Emp.No: Emp.No:
Signature: Signature: Signature:

IMPORTANT : If the requirements stipulated in the Daily Checklist are not met, permit will be automatically INVALIDATED
ESV-02-000 (Form 16) Rev. 02 - 03 May 2021 Page 2/2

TOOLBOX TALK RECORD FORM

TBM TOPIC DATE & TIME

INSTRUCTOR COMPANY

NO NAME POSITION SIGNATURE

10

11

12

13

14

15

16

17

18

19

20
 TTE (M) ENGINEERING (M) SDN.BHD.
Work Location Process / Work Activities Date Prepared By Initial Review By
B2 - Production Speaker Installation Work 15/10/2022 AMIR IZAN FIDA'IY
HAZARD DEFINITION CURRENT & PLANNING CONTROL RISK ANALYSIS RISK CONTROL AND STATUS
(1) Elimination
(2) Substitution
JOB STEP A/N/E (3) Isolation / Engineering
HAZARD CONSEQUENCES L S R ADDITIONAL ACTION STATUS RESPONSIBILITY
(4) Administration
(5) PPE
Note: Minimum Administration Control is required
1) Only allow trained person with IEM Module B and
Register to conduct work inside Workers list to
enter for IEM Premises.
Workmen not
Pre-construction health 1) Identify/prepare related layout drawing and identify
aware of the
& safety meeting On-Site any risky area. Supervisor/
1 N hazards or workers First aid injury 1 1 1 Nil
where work will be 4) Follow procedures stated in the work HSE Team
do not receive
performed. permit/checklist (if any)
suitable training
4) TBM and identify potential hazards before start.
4) Set-up Traffic Control Equipment (if needed).
5) Check PPE suitable for the job task

1. Proper monitor and good arrangement

site supervisor
3.Practice toolbox and identify potential hazards if -To carry material to
N Trips/falls due to any
- To mobilize & uneven/slippery work area comply with Supervisor
unloading material to First aid injury 4.Set-up Traffic Control Equipment (if needed). 2 1 2 buddy system L
surfaces 5.Wear proper PPE: Safety Helmet, Safety Shoes, and
work area.
-To barricade working Cotton Hand Glove.
Area & unloading area
with cone and barricade 4. Apply buddy system during carry heavy materials.
tape N 4.Practice correct body posture during handling 2 2 4 L
Ergonomic hazard Back pain muscular material. Supervisor
-To put signage at work
2 area 4. Use trolley to mobilize material.
-To carry material with
manpower or trolley 1. Barricade working area. Make sure no other
(Materials & Tools: people except workers and supervisor.
-Awareness of the work
Tools: Battery drill, 2. Deploy sufficient and skillful manpower to assist
on going & work area
Wrench, Screwdriver, Jig in carrying the material.
2. Full time monitoring & supervisor or safety at surrounding.
saw, Vacuum cleaner & Supervisor
N Materials dropped Minor injury site. 2 2 4 -Practice toolbox and L
Cutter)
during manual identify potential
3. Practice correct lifting posture and job rotation if
unloading hazards if any.
necessary
5. Wear proper PPE: Safety Helmet, Safety Shoes, and
Cotton Hand Glove, Safety hardness.

VERIFIED BY: CONTRACTOR PIC REVIEWS BY: IEM PROJECT PIC (PROJECT OWNERS) REVIEWS BY: IEM EHS

Signature Signature Signature

Name Name Name
Date Date Date
 TTE (M) ENGINEERING (M) SDN.BHD.

Work Location Process / Work Activities Date Prepared By Initial Review By

B2 - Production Speaker Installation Work 15/10/2022 AMIR IZAN FIDA'IY
HAZARD DEFINITION CURRENT & PLANNING CONTROL RISK ANALYSIS RISK CONTROL AND STATUS
(1) Elimination
(2) Substitution
JOB STEP A/N/E (3) Isolation / Engineering
HAZARD CONSEQUENCES L S R ADDITIONAL ACTION STATUS RESPONSIBILITY
(4) Administration
(5) PPE
Note: Minimum Administration Control is required
-Brief to workers about
1.To inform PIC of work before leave work area and
situation and do not
inform TTE PIC the situation
panic until situation
2.Any accident/incident refer to the escalation chart SUPERVISOR /
3 In case of emergency N Physical injury 1 1 1 under control. L
1.Trip & fall 3.Do not run or panic, just walk fast to assembly point safety
-To ensure everything is
area for headcount.
safe condition before
4.Wait until situation secured and resume work back.
allowing to start work

Below Ceiling
1. To climb on
Platform / A frame
4 ladder and make
hole on the ceiling
surface by cordless
drill machine.
2. To install 5 nos of
bracket and new
N 2.Backpain muscular
speaker using hand
tools. (bolt and nut
installation)
Height : 2.3 Mtr
Above Ceiling
4. To do cable pulling
from existing speaker to
new speaker location in
range 30 mtr max.
4. Ensure ladder in good condition
5. To wear harness and hook to solid structure.
3. Apply buddy system
4. Ensure that the ladder is placed on a level, stable
surface.
4. Avoid climbing a ladder in wet shoes as this
increases the risk of slipping Continues monitoring by
3. Never work from the top three rungs of the supervisor team
1.Minor/major injury ladder.
1.Falling from height -Close monitoring by M
3. Maintain three point contact on the ladder - SUPERVISOR /HSE
2.Ergonomic hazard 2 4 8 supervisor
3.Electrical hazard 3.Electrical shock two feet and one hand, or two hands and one foot. Sufficient lighting while
-
4.Edge sharp object 4. Inhalation 3. Never place ladders near power lines, on ice,
work above ceiling.
5.Dust or against unstable surfaces or structures -Do not drop any tools
5. Wearing PPE such safety helmet, safety shoes, from above ceiling
glove, N95 mask and safety harness.
3. Ensure power supply switched off (LOTO)
prior start by IEM PIC.
4. To install plastic cover for drill point to
prevent dust.

VERIFIED BY: CONTRACTOR PIC REVIEWS BY: IEM PROJECT PIC (PROJECT OWNERS) REVIEWS BY: IEM EHS

Signature Signature Signature

Name Name Name
Date Date Date
 TTE (M) ENGINEERING (M) SDN.BHD.

Work Location Process / Work Activities Date Prepared By Initial Review By

B2 - Production 15/10/2022 AMIR IZAN FIDA'IY
Speaker Installation Work
HAZARD DEFINITION CURRENT & PLANNING CONTROL RISK ANALYSIS RISK CONTROL AND STATUS
(1) Elimination
(2) Substitution
JOB STEP A/N/E (3) Isolation / Engineering
HAZARD CONSEQUENCES L S R ADDITIONAL ACTION STATUS RESPONSIBILITY
(4) Administration
(5) PPE
Note: Minimum Administration Control is required

4. Ensure there are no trailing cables that can cause

To switch on back - Workers falling Minor /major
from work at height injury people to trip or fall Close monitoring by
power supply for
speaker at PA Room N 5. Continue using safety hardness and Hook solid 2 4 8 supervisor / Area should M SUPERVISOR /
5 be barricade before start
structure during working at height. Safety
- Trip & fall 5 Wear proper PPE: Safety Helmet, Safety Shoes, and work
Physical injury
Cotton/Rubber Hand Glove, Safety hardness.

4) To clear all debris immediately after works

Tidy work area and
6 N
remove material/site
barricade
(Housekeeping)
completed and place barricade ownership signage at
Obstruction (Trip Continues monitoring by
First aid injury the construction (if need to left material before 1 2 2 L
and fall hazards) supervisor team
resume work)
4) Wear proper PPE: Safety Helmet, Safety Shoes, and
Cotton Hand Glove and Wearing high visibility safety
vest at all times to make them visible

VERIFIED BY: CONTRACTOR PIC REVIEWS BY: IEM PROJECT PIC (PROJECT OWNERS) REVIEWS BY: IEM EHS

Signature Signature Signature

Name Name Name
Date Date Date
 TTE (M) ENGINEERING (M) SDN.BHD.

RISK ANALYSIS GUIDE:

Likelyhood indicate “PROBABILITY” for any Incident / Accident to happen as below table (if work conducted strictly follow HIRARC control):
Rating 1 2 3 4 5
Inconceivable Remote Conceivable Possible Most Likely
Likelyhood to happen Maybe Happen in the Normally to happen Normally to happen
Impossible to happen Never Happen inside IEM
future (Yearly Basis) (Monthly Basis) (week Basis)

Severity indicate how “SEVERE” the injury /damage can accur if any Incident / Accident happen (take the highest severity if accident/incident happen):
Severity Rating Category
Catastrophic 5 More than one (1) fatality, property / equipment damage which can’t be repair (total damage)
Fatal 4 One (1) fatality, property / equipment damage which can be repair
Serious 3 Permanent injury to any employees body part
Minor 2 Lost Time Injury but employees can recover back
Negligible 1 First aid injury to employees

Risk Rating Calculation ( Risk = Likelyhood X Severity )

Likelyhood
1 2 3 4 5
Severity
5 5 10 15 20 25
4 4 8 12 16 20
3 3 6 9 12 15
2 2 4 6 8 10
1 1 2 3 4 5

High Risk (H) (15-25) Work can’t proceed, immediate action need to be taken and been monitored closely
Medium Risk (M) (5-12) Work can be proceed and further risk control improvement can be reviewed
Low Risk (L) (1-4) Work can be proceed follow existng risk control
 B2 PRODUCTION

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