ASHI & BUSHNAG Co.

Ltd
LFC # 6600023244
YC&FMS
BRIEF INCIDENT & ACCIDENT
LOCATION: NGL REPORT

DATE : June 02, 2012 TIME :

PRELIMINARY FINDINGS
INCIDENT DETAILS:
[Nature/type of incident; location details; personnel involved, badge numbers; vehicles, equipment, area affected, etc.]

ABC # 414 Double Cab Pickup is assign to the electrical segment and this car is driven by day shift and as per
the internal investigation when night shift driver Hamed Al Juhani was inspecting the car he found that the car
was dented and immediately he informed to his colleague and night shift Foreman, And in the day shift this car
was driven by Abdul Aziz Sanany.

INCIDENT RESPONSE:
[Emergency responders; corrective action and/or salvage operations, etc.]

None

INJURIES & DAMAGE:

[Personnel injuries; medical treatment/first- aid; extent of damage; repair/demolition required, etc.]

No Injury
Property Damage
ABC #414 – dent on right hand side near rare door

DATE OF INVESTIGATION: July 04 ,2012 TIME OF INVESTIGATION: 2:00 pm (approx.)

 ESTIMATED COST OF DAMAGE:

INVESTIGATED BY: P. Abdul Samad BADGE #: 8997443

SIGNATURE: Abdul Samad DATE:

July 04, 2012

RECOMMENDATION
[Recommended follow-up action to prevent future occurrence]

 Report all the accident/incident & near miss to your supervisor or your Safety
Department either it is on-Job or off-Job.
 Before drive your vehicles check the vehicle properly.
 Be alert all the time while driving.
 Maintain traffic two second gap between your and others car.
 Don’t ignore traffic signal & sign.

Witness:

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