Health & Safety : One page incident report

Tata Steel Ltd

Location : TSJ/TSK/TSM/RM
Incident title: First Aid Case of Contractor Employee
Incident category: (LTI / FAC/Property damage etc.)

Division : Steel Manufacturing Department: New Bar Mill Section: Operations

Date of iincident :17/05/2023 Time: 16:30 pm

Place of incident: Near Water Box B2 line
(In case of injury give further information as below, otherwise omit this)
Name : Mr. Ganesh Mahato P.No./Gate Pass No: TSP/479/425/0203
Age : 54 Y Designation : Rigger
Vendor Name : M/s C S Bedi Injury details: CLW over left cheek

Consequence detail:

Category of Consequence Actual Consequence Potential Consequence

(People/Asset/Community/Environment) (C1/C2/C3/C4/C5) (C1/C2/C3/C4/C5)

People C2 C3

• EHS risk assessment for this job is available : (Yes / No)

• Incident scenarios was identified in EHS risk assessment : (Yes /No/ NA)

What happened: (Brief of incident): On 17/05/2023 in B shift, Mill was stopped for RCPC. At around 4:30 pm while working at
water box nozzle cleaning, IP was opening the ball valve of water line at water box the valve opened from the threaded portion
and hit on IPs left cheek.

He immediately reported to West Plant First Aid and furthered referred to TMH.

Document Number: SAFETY/FORMS/GEN/ONEPAGEREPORT : Rev 2.0 : Effective date:13/05/22 Page 1

Preliminary findings:

1. SOP was available at site and work was being done under control stop.

2. IP has work experience of 9 years.

Immediate actions/Recommendations:

1. Communication done to all employees.

2. PIR logged for the incident.

Document Number: SAFETY/FORMS/GEN/ONEPAGEREPORT : Rev 2.0 : Effective date:13/05/22 Page 2