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Name of Reporting Incident Time

Sl No. Person Gate Pass no. Name of Contractor Incident Date ( Hrs and Min)

M/s DTH Infra Engineers


1 Mr. Hemant Sharma 10082275 22.11.2021 11:40 AM
P Ltd.

M/s DTH Infra Engineers


2 Mr. Hemant Sharma 10082275 22.11.2021 09:42 AM
P Ltd.
M/s DTH Infra Engineers
3 Mr. Hemant Sharma 10082275 22.11.2021 10:40 AM
P Ltd.

4 Mr. Hemant Sharma 10082275 M/s DTH Infra Engineers 23.11.2021 12:35 PM
P Ltd.

M/s DTH Infra Engineers


5 Mr. Hemant Sharma 10082275 23.11.2021 2:30 PM
P Ltd.
Exact location of the
Name of the Project Site Incident

Indresidh Project Compressor area

Indresidh Project OSBL- Substation

Indresidh Project Compressor area

Indresidh Project Near Technical


Structure

Indresidh Project Pipe rack -01


Is It Near Miss? *
Unsafe Act
Incident Description / Details (Select from drop ( Select from dropdown)
down)

Two worker worked without safety hand gloves Not Not

Baby roller (compactor) rotation part found open condition Not Not

Two people (Subash & Bablu ) going to height wihtout safety belt
Not Yes
during column ring fixing work

Ramjuwari (Civil Sup ) found wihtout boiler suit (Dangri) Not Yes

Hot work (Uses Electric hilty machine for column breaking)


without wearing PPE'S like IFR Suit,face shield,hand gloves,goggles Not Not
etc.
Unsafe Condition
(Select from drop down) Recommendations for Remedial Status

Yes Provided hand gloves immidiately Closed

Remove from site and inform to Mr. Parveen maurya & Mr.
Yes Open
Azad Singh

Not work stopped immediately Closed

Not Explained about our safety rules Open

Yes Inform to Mr. Parveen Maury & Mohan Singh Open


Unsafe Act
Failure to warn/secure
Improper material handling
Lack of knowledge
Non adherence to SOP
Non use/Improper PPE
Slip/Trip/Fall
Unauthorised activity
Use of defective equipment
Violations of Safety Norms
Others

Unsafe Condition
Congestion/restrictive area
Defective equipment
Defective PPEs
Fall of objects
Inadequate illuminations
Ladder/work platform/scaffolding
Leakage /spillage
Poor housekeeping
Slippery floors
Others

Name of the Project Site


2G Project
3G Project
DEF Project
Fabrication Yard
TAME Project
DCU Project Area
CR11 Project Area
PX Project Area
PTA Project Area

Is It Near Miss? *
Yes
No

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