Near miss/ Incident/ Accident report

‫تقرير حادث‬
Near miss / ‫حادث وشيك‬
Report First aid / ‫إسعافات‬
‫الوقوع‬ Incident /‫حدث بدون اضرار‬ ‫تقرير‬
‫أولية‬
Time 12:46 PM ‫وقت حدوثه‬ Date 29-11-2023 ‫التاريخ‬
Location SEC RPP ‫الموقع‬ Report N° 01 ‫رقم التقرير‬
Detailed Description ‫وصف مفصل‬
. During the commencing of the drilling activity subcon using the water for the purpose of making surface
smoothness. Adil Khan was the co-worker/operator of the activity, has saw the water pipe is sway from the direction,
then he plan to keep hammer tool on it as a support purpose, during it the hammer has slipped from the hand and
hit on the right leg instep and got a moderate injury as attached evidence.

photographs ‫صور لألضرار‬

Possible Causes(s) ‫األسباب المحتملة‬

 Human error and inappropriate tool
 Other factors such as faulty tool, poor maintenance & inadequate safety measure (adequate grip)
 Failure to hold onto or properly secure tool

EH-HDO-HSE01-FOR-019Rev01 1
 Near miss/ Incident/ Accident report
‫تقرير حادث‬
Responses / Corrective Actions ‫ اإلجراءات التصحيحية‬/ ‫اإلستجابة‬
 Immediately informed to the site management
 The injured person has to send to hospital for the treatment

Suggested Preventive Measures ‫التدابير الوقائية المقترحة‬

 Use tool lanyards to prevent tools from falling
 Keep all material at least 3 feet from a leading edge, other than material specifically required for work in process
 Remove items from all loose or unsealed pockets, especially top shirt pockets, such as phones, pens, and tools.

Translator Name Translator signature

‫اسم المترجم‬ ‫توقيع المترجم‬

Incident responsible

Signature

Approved by ‫معتمد من طرف‬

Position ‫الوظيفة‬
Name ‫االسم‬

Date ‫التاريخ‬

Signature ‫التوقيع‬

EH-HDO-HSE01-FOR-019Rev01 2