Form HSE/FOR/9011

Issue Date: 05/09/2019

NEAR MISS REPORTING CARD Version: 1.1

Date: 18-1-2024 Time: 10:40

Location Al Sanaiya TFS, Quriyat TFS, Al Nahda Reservoir Quriyat Main Reservoir, Quriyat TFS
Reported by: Said Alrubkhi
Department: O&M of OWWSC Assets (Distribution) in Muttrah, Amerat & Quriyat (GALFAR)

Tick boxes applicable to the incident & describe below.

Behaviour Road traffic accident

PPE Walked into item

Slips, Trips & Handling Fall from height

Poor supervision Confined space

Heat, Sparks, Flame Lifting

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

& Material Storage) liquid

Risk of person failing Service strike

Access & egress Falling object

Electrical hazard Risk of Excavation Collapse

Plant & equipment Signing and guarding

Head Injury Other: ………….

Brief description of Incident: no observation report it the AC condition is good

Action taken:
The action has taking from the team to clean the AC

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) 1/1
The controlled version of the document is available online in Diam- QMS Library. Printed copies are ‘Uncontrolled’