Lumut Balai Unit 2 Geothermal

FCRS and Power Plant Project

C 2023.3.25 Revised as per PGE and ELC SGH THS FA ZLT

comment

B 2023.2.24 Revised as per PGE and ELC SGH THS FA ZLT

comment

A 2022.12 First Issue SGT CQ CQ ZLT

Rev. Date Modification Content Prepare Check Review Approval

OWNER:

CONSULTANT:

EPC CONTRACTOR:

Construction Schedule
Control
Lumut Balai Unit 2 Geothermal FCRS and Power Plant Project

Approval Zhu Lin Tao Check Teguh Incident and Investigation Procedure
Review F. Amir Design Sigih

LMB2-S-GN-HSE-
Date 2022.12 Scale N/A Doc. No. OPR-AA0-0174 Rev. C
 Lumut Balai2 Project

Incident Investigation and Reporting Procedure

Page 2
 Table of Contents

1 SCOPE .................................................................................................................... - 4 -

2 LEGISLATION AND REFERENCE..................................................................... - 4 -

3 RESPONSIBILITY ................................................................................................. - 4 -
4 REQUIREMENTS .................................................................................................. - 4 -
5 LESSON LEARNT ................................................................................................. - 4 -

Page 3
1 SCOPE

This procedure defines and specifies the incident reporting and investigation relating to Health,
Safety, Security and Environment. It is applicable to HSSE incident management in all project
activities in Lumut Balai2 Project.

2 LEGISLATION AND REFERENCE

 PGE Health Safety Security and Environment Guidelines.

 Consortium HSSE Plan.

3 RESPONSIBILITY

Consortium and subcontractor shall report and investigation the HSSE incident occurs in the project.

4 REQUIREMENTS

If an incident occurs in site, consortium shall report to Client PGE immediately by phone, Whatsapp
or other apps within 1 hour. And an initial report shall be submitted to PGE within (6) hours of the
occurrence of the incident. See the Appendix 1 for the initial report form.

Detailed full investigation shall be conducted by Consortium within 7 days after the incident if
required. The relevant incident investigation report with root cause analysis shall be submitted to
PGE if required. See the Appendix 2 for the Full investigation report form. See the Appendix 3 for
the Root cause Analysis and Appendix 4 for Sample of Incident Timeline.

Incident shall be reported to local authority such as labor department or police station as required
by local law. However, the reporting to local authority shall be approved by PGE.

5 LESSON LEARNT

Consortium shall provide lessons learned to encourage continuous improvement of HSSE. Master
lesson learnt or safety stand down shall be conducted after incident investigation.

Appendix 1 Initial Report Form

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Appendix 2 Full Investigation Report Form

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Page 6
Appendix 3 Sample of Root Cause Analysis

Appendix 4 Sample of Incident Timeline

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Appendix 5 Emergency Contact Number

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Appendix 6 : Accident reporting flowchart