>)? ‘Galea Engioeing Woks LID. C0. (LLC) Dace CGEW.ISE-O6 00 YS Incident Investigation Report DETAILS OF DAMAGES! NJURIES wus PROPERTY OAMAGE cearecort | escrow DETALS NAME No.-)0F | (BRIEF DESCRENON OF MaEoAMAGE TO "SESGRIPHON OF Te MOINES peor Imeivert | fan incer orem” | harmed sabia emp 16537) OTHERS DETAILS OF PERSONS HOSPITALIZED Tguaned_ Slag Eraneerna Fabctr ‘evened Cre Hosp ‘DETAILS OF WACHINERY/ VEHICLES INVOLVED IN THE INCIDENT NEAR MISS! MACHINERY! VEHICLE Paget ofoS reas oxen eee eee —! eharanas Shahid was doing the measreent fie his helper Kyarudsn Ansar trom Zak Bshr Was pertoring the futtng operation ising 2 cui se ad suadenly te etn de brake a Hit Matured Saison than nce ‘ge aig nar etry as en imate tad ond avn oi he doe oe fr tet neeson ad ‘resin ofthe wand Tiainiet cud tve been svete Lif Ryanuan Anat woulshave done testing parton crt, ‘ROOT CAUSES OF THE IDENT ‘CORRECTIVE MEASURES 1+ vara waning vent jamin Asa ori eaigenes 1 Fatealon Supers alos nats sow ayn helpers cry out cut aig anal rer. MASE — sae: soasiirninn —sonarune §, S\N Zrtoure samme oe * coo aceon cu er + Abe wer a sy ey rr mated sel cry cn ten ATTACHMENTS (PLexse Nox: [aloe lortens LEASE SPECI (CC to: HSE Manager , HI department, General Page? ofroy (ala Enginesig Works LTD. C0. (L1.C) Dec Ne <— vestigation Report GEWAISE 06 00 I Page soGM, | or avantevcineerine works 110.c0 1.0) |ooeno.crwaise-ri4 Sa TESTA REFORT LocationsGEW Worksop Report no. GEWSE-FAOT bate: a] paldooa Name oftheiniwedperson= 7 V-y way oy Cicert) Peseratons Fy Yas lage: Soe Male [Time and place: Gey 4 Fabacdien he pectrey Qukt Wal + ; Brief detail oF injury: v a Doak ery om ooh Ud ke Jy. fw Raper = Re dag venga Oe LS pg wets wats tee hat was the root cause? 4 iN C. o © ce a" sent to hospital? YS) No = za Name and sign Name and sign[ADVANCED CARE MEDICAL CENTER.ADVANCED CARE MEDICAL CENTER aa TTTw emerye ssuheg 1989 w Fert matey et ove woo aay mk BATT ort wna sy © panacea pot ee ee sousra cos wo oem NCU WA OD, Faaad A vn yh oN BHO Gpvzavnenmion eens cosa ete SH 210K enn 0 Apevia 3aNvO OZONE MSNADVANCED CARE MEDICAL CENTER BR- DIC MEDICAL CERTIFICATE Reference Ne®| Date 03-09-2025, Facity Information Feaclty Nome ‘Advanced Care Medial Canter Bx Die iy: Daboi Emeate: Unies Arab Emirates Physician's Name: Fonaz Abdul Fathah Physlcan’s Specaty General Practice Desarment atin infor Patents Name: Mohammed Zahid Mohammad Mzamudain os. 01-00-1977, ‘Gender: Male Natonaty India Mecca Fle No ictes76 IDA 104-1977-02582183 Heath insurance Card No Yoos-o02-117003160-08 Work Nature Place of Wor Employer Name CGALADARI ENGINEERING WORKS LTD CO LLC Diagnosis: {861.2108 -Lacsraton WiO Fo OFF lds age WiO Damage To Na it; M79,648 Pain In Right Treatment Type: OutPatient toatmont Management Dato of Treatment: 3-00-2020, Physician Remarks: For Oficial Use Only ——— Pysiclan'e Name: Fenaz Abdu Fathan | BE GE FENA CE UN | Tonle ie cn Fenaz aco FATA “General Prectitone i ret: HB [_Potortett tee} acoruoassh nos causal Paco orb Eat sanayra con Page of