INCIDENT REPORT

Report No.: 2021/06/004

1-Customer/ Contractor: DPOC

2. Location of event 3. Time/Date Occurred 4. Time/Date Reported

WENGI- 2 14h June 2021 10:10 AM

10:00 AM

5- Incident Type:

Eqipment Stolen

6- Details of the injured:

Name :
Age (years) :
Nationality :
Position :
Part of body injured :
Lost Time injury Per working hours:
Root cause of the accident
(describe the unsafe acts and unsafe conditions):
The concerned department Immediate
proposed Corrective action taken to
control the situation:
The concerned department proposed
Preventive action required preventing
similar occurrence and proposed
implementation Date:

7- Details of Property Damage or Stolen:

Property: NOVMET SKID

Nature of Damage Pad lock broken & 2 AC stolen
Estimated Cost of Damage (in USD): $2000

8- Brief description of event (s) leading to the incident:

Revision No. Revision Date Page No. Document No.
01 1st June 2017 Page 1 of 3 F.02.17
 INCIDENT REPORT

On 14th Monday ,June 2021 our daily monitoring team with their usual work of monitoring to
WENGGI- 2 , they have found 2 Air conditioners were missing from NOVOMET skid,
immediately they informed to the AC department for Replace the AC’s This is the 17th case
reported in 2021 & this is the 4th event in 2021 June.

9 - Immediate cause of the incident (describe the unsafe acts and unsafe conditions):

No Proper Supervision at Well site ! we have already informed DPOC engineering team and email
communication done for past 50 incidents but up to now no action from DPOC side

10- Basic or root cause of the accident:

Lack of supervision from DPOC security , No proper follow up from Eng. Dept

11- Immediate Corrective action taken to control the situation:

We replaced the AC

12- The Concerned Department Proposed Preventive Action required preventing similar occurrence
and Proposed Implementation Date:

Revision No. Revision Date Page No. Document No.

01 1st June 2017 Page 2 of 3 F.02.17
 INCIDENT REPORT

Cover to be fixed over pad lock and welding to be done all open area

Reported by: - CEW Field monitoring Team.

Name: Thomas Lakudu Signature:

Position: Operation Manager Date: 15-06-2021

Acknowledged by Customer/ Contractor representative:

Name: Position: Prod. Engineer

Signature: Date:

Name: Position: Prod. Superintendent

Signature: Date:

Position : Security Head

Name :
Date
Signature

1. Safety Department
Are the identification of root cause, proposed corrective & preventive action(s) and proposed completion
date satisfactory?
Can concerned department process the proposed Corrective and Preventive Actions to close this case?
□ yes □ no
Comments (if any): DPOC security should more alert and need
their proper support on this matter

Safety Dep. Date: 15-06-2021

Aby S Fernandez
Q HSE Manager

Manager sign:

Revision No. Revision Date Page No. Document No.

01 1st June 2017 Page 3 of 3 F.02.17