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ASSISTANT TO CHIEF EXECUTIVE OFFICER RESPONSIBLE FOR OCCUPATIONAL HEALTH

AND SAFETY IN TERMS OF SECTION 16 (2) OF THE OCCUPATIONAL HEALTH AND SAFETY
ACT, NUMBER 85 OF 1993 AS AMENDED

NAME OF COMPANY : Manzo Engineering

IN TERMS OF THE ABOVE-MENTIONED ACT :

I / WE Mandy Nkwanyana (FOR EMPLOYER) APPOINT YOU Senzo Nkwanyana of ID

7309125433084,

AS ASSISTANT TO THE CHIEF EXECUTIVE OFFICER RESPONSIBLE FOR OCCUPATIONAL

HEALTH AND SAFETY for the installation of the Concrete sleepers from CS 1 – CS16 and Sleeper
TP1 at Medupi Power Station Construction project under GPWG.

YOUR RESPONSIBILITIES ARE AS FOLLOWS :

1. Responsible and accountable for Occupational Health and Safety at this plant / depot / factory
/ premises / company.
2. Familiarise yourself with the various aspects of the Occupational Health and Safety Act,
relevant Regulations
3. Comply with all statutory requirements at all times.
4. Ensure that, in the event of any accident or incident, appropriate steps are taken according to
the Act
5. Attend appropriate training to ensure satisfactory execution of duties and responsibilities.

SIGNATURE : ……………………………. SIGNATURE : ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION : …………………………. DESIGNATION : …………………………

DATE : …………………………………….. DATE : ……………………………………

ACCEPTANCE

I, ………………………………….. ACCEPT THIS APPOINTMENT. I AM FAMILIER WITH THE ACT

AND REGULATIONS AND THE ASSOCIATED DUTIES AND RESPONSIBILITIES.

SIGNED : ……………………………….. DATE : ……………………………….

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APPOINTMENT AS INCIDENT INVESTIGATOR IN TERMS OF GAR 9 (2) OF THE

OCCUPATIONAL HEALTH AND SAFETY ACT, NUMBER 85 OF 1993 AS AMENDED

NAME OF COMPANY : Manzo Engineering

IN TERMS OF THE ABOVE-MENTIONED ACT :

I / WE Mandy Nkwanyana (FOR EMPLOYER) APPOINT YOU Senzo Nkwanyana of ID Number

7309125433084and Incident Investigator for the installation of the Concrete sleepers from CS 1 –
CS16 and Sleeper TP1 at Medupi Power Station Construction project under GPWG.

AS INCIDENT INVESTIGATOR YOUR RESPONSIBILITIES ARE AS FOLLOWS :

1. Investigate all incident or Occupational Diseases which result in an injury to a person, or any
incident which has the potential to injure a person.
2. Record the findings of those investigation, in the Annexure 2.
3. Bring the findings of those investigations to the attention of the Assignee and Occupational
Health and Safety Committee.
4. Ensure that the record of each is endorsed by the Assignee and by the chairman of the
Occupational Health and Safety Committee.

SIGNATURE : ……………………………. SIGNATURE : ……………………………

(ASSIGNEE) (WITNESS)

DESIGNATION : …………………………. DESIGNATION : …………………………

DATE : …………………………………….. DATE : ……………………………………

ACCEPTANCE

I, ………………………………….. ACCEPT THIS APPOINTMENT. I HAVE STUDIED THE

RELEVANT SECTIONS OF THE ACT AND REGULATIONS AND UNDERSTAND WHAT IS
REQUIRED OF ME.

SIGNED : ……………………………….. DATE : ……………………………….

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APPOINTMENT 17 : FIRST AIDER

NAME OF COMPANY : Manzo Engineering

IN TERMS OF THE ABOVE-MENTIONED ACT :

I / WE Senzo Nkwanyana (FOR EMPLOYER) APPOINT YOU ...........................................

AS FIRST AIDER for the installation of the Concrete sleepers from CS 1 – CS16 and Sleeper TP1 at
Medupi Power Station Construction project under GPWG.

YOUR RESPONSIBILITIES ARE AS FOLLOWS :

1. To maintain the necessary legal minimum content of all first aid boxes as per GSR 3.
2. To make yourself available for training in first aid as required.
3. To be ready to react to all emergencies.
4. maintain a general readiness and accept responsibility for the effective functioning of first aid
teams.

SIGNATURE : ……………………………. SIGNATURE : ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION : …………………………. DESIGNATION : …………………………

DATE : …………………………………….. DATE : ……………………………………

ACCEPTANCE

I, ............................................... ACCEPT THIS APPOINTMENT. I HAVE STUDIED THE

RELEVANT SECTIONS OF THE ACT AND REGULATIONS AND UNDERSTAND WHAT IS
REQUIRED OF ME.

SIGNED : ……………………………….. DATE : ……………………………….

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APPOINTED PERSON TO CONDUCT RISK ASSESSMENT ON SITE: CONSTRUCTION

REGULATION 9 (1)

NAME OF COMPANY: Manzo Engineering

IN TERMS OF THE ABOVE-MENTIONED REGULATION

I / WE Mandy Nkwanyana (FOR EMPLOYER) APPOINT YOU …Senzo Nkwanayna… to

conduct RISK ASSESSMENT on Site for the installation of the Concrete sleepers from CS 1 – CS16
and Sleeper TP1 at Medupi Power Station Construction project under GPWG.

YOUR RESPONSIBILITIES ARE AS FOLLOWS :

1. The identification of the Risk and hazards to which persons may be exposed to
2. The analysis and evaluation of the risks and hazards identified
3. A document plan of safe work procedures to mitigate, reduce or control the risks and
hazards that have been identified
4. A monitoring plan; and
5. A review plan
6. Give training to employees on risk assessments .

SIGNATURE : ……………………………. SIGNATURE : ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION : ………………………….. DESIGNATION : …………………………

DATE : …………………………………….. DATE : ……………………………………

ACCEPTANCE

I, ………………………………... ACCEPT THIS APPOINTMENT. I AM FAMILIAR WITH THE

REGULATIONS AND THE ASSOCIATED DUTIES AND RESPONSIBILITIES OF THIS
APPOINTMENT.

SIGNED : ……………………………….. DATE : ……………………………….

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APPOINTED PERSON FOR THE PREPARATION OF A FALL PROTECTION PLAN:

CONSTRUCTION REGULATION 10 (1) (a)

NAME OF COMPANY : ……………………………..……

IN TERMS OF THE ABOVE-MENTIONED REGULATION

I / WE ……………………….… (FOR EMPLOYER) APPOINT YOU ……………………..…….

AS RESPONSIBLE PERSON FOR THE PREPARATION OF A FALL PROTECTION PLAN

YOUR RESPONSIBILITIES ARE AS FOLLOWS:

1. The designation of a competent person, responsible for the preparation of a fall protection
plan
2. The fall protection plan contemplated in paragraph (a) to be implemented, amended where
and when necessary and maintained as required
3. Steps to be taken in order to ensure the continued adherence to the fall protection plan
4. The procedure addressing the inspection, testing and maintenance of all fall protection
equipment

SIGNATURE : ……………………………. SIGNATURE : ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION : ……………………….…. DESIGNATION : …………………………

DATE : …………………………………….. DATE : ……………………………………

ACCEPTANCE

I, ………………………..….. ACCEPT THIS APPOINTMENT. I AM FAMILIAR WITH THE

REGULATIONS AND THE ASSOCIATED DUTIES AND RESPONSIBILITIES OF THIS
APPOINTMENT.

SIGNED : ……………………………….. DATE : ……………………………….

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PERSON RESPONSIBLE FOR STACKING AND STORAGE IN TERMS OF CONSTRUCTION

REGULATION 28 (A) OF THE OCCUPATIONAL HEALTH AND SAFETY ACT, NUMBER 85 OF
1993 AS AMENDED

NAME OF COMPANY : ……………………………

IN TERMS OF THE ABOVE-MENTIONED REGULATION:

I / WE ………………………….… (FOR EMPLOYER) APPOINT YOU ………………………….….

As the person responsible for STACKING for the installation of the Concrete sleepers from CS 1 –
CS16 and Sleeper TP1 at Medupi Power Station Construction project under GPWG.

YOUR RESPONSIBILITIES ARE AS FOLLOWS:

1. Ensure that the stacking in the area designated to you comply with the requirements of CR 28
(C&D).

SIGNATURE: ……………………………. SIGNATURE: ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION: ……………………….…. DESIGNATION: …………………………

DATE: …………………………………….. DATE: ……………………………………

ACCEPTANCE

I, ………………………….. ACCEPT THIS APPOINTMENT. I HAVE STUDIED THE RELEVANT

SECTIONS OF THE ACT AND REGULATIONS AND UNDERSTAND WHAT IS REQUIRED OF ME.

SIGNED : ……………………………….. DATE: ……………………………

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SUPERVISION OF CONSTRUCTION WORK IN TERMS OF CONSTRUCTION REGULATION 8 (7)

OF THE OCCUPATIONAL HEALTH AND SAFETY ACT, NUMBER 85 OF 1993 AS AMENDED

NAME OF COMPANY: Manzo Engineering

IN TERMS OF THE ABOVE-MENTIONED REGULATION:

I / WE Senzo Nkwanyana. (FOR EMPLOYER) APPOINT YOU ……………………..…….

As SUPREVISOR of CONSTRUCTION WORK for the installation of the Concrete sleepers from CS
1 – CS16 and Sleeper TP1 at Medupi Power Station Construction project under GPWG.

YOUR RESPONSIBILITIES ARE AS FOLLOWS:

1. Supervise all construction work on the premises in accordance with Construction Regulations
8 (7).
2. Ensure compliance with all the requirements of the National Building Regulations.
3. Always ensure that your employees that are working under you are working safely.
4. Ensure that all Hazards and risk are communicated to your employees prior to work.
5. Report all incidents immediately to the safety department.

SIGNATURE : ……………………………. SIGNATURE : ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION : …………………………. DESIGNATION : …………………………

DATE : …………………………………….. DATE : ……………………………………

ACCEPTANCE

I, …………………………………………... ACCEPT THIS APPOINTMENT. I HAVE STUDIED THE

RELEVANT SECTIONS OF THE ACT AND REGULATIONS AND UNDERSTAND WHAT IS
REQUIRED OF ME.

SIGNED : ……………………………….. DATE : ……………………………….

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OCCUPATIONAL HEALTH AND SAFETY ACT, 85 OF 1993 CONSTRUCTION

REGULATIONS 12(2)
Temporary Works Supervisor

I, Senzo Nkwanyana, the 16(2) Appointee of Manzo Engineering, appoint you, Sibusiso Nkwanayna , of ID
Number, 7910265583081, as the Temporary Works Supervisor for the Medupi Fire and Portable Water Ring Main
P10A at Medupi Power Station Construction project under WBHO.

You are required to supervise all activities relating to the erection and disassembling of temporary works structures
on site. The following applies to you:

1. Only allow the use of erected temporary works on site once inspected and approved by the temporary works
designer.

2. Supervise all temporary works operations.

3. Ensure that all temporary works structures are adequately erected, supported, braced and maintained by a
competent person so that they are capable of supporting all anticipated vertical and lateral loads that may be applied
to them, and that no loads are imposed onto the structure that the structure is not designed to withstand.

4. Ensure that all temporary works structures are done with close reference to the structural design drawings, and
where any uncertainty exists the structural designer should be consulted.

5. Ensure that detailed activity specific drawings pertaining to the design of temporary works structures are kept on
the site and are available on request to an inspector, other contractors, the client, the client's agent or any
employee.

6. Ensure that all persons required to erect, move or dismantle temporary works structures are provided with
adequate training and instruction to perform those operations safely.

7. Ensure that all equipment used in temporary works structure are carefully examined and checked for suitability by
a competent person, before being used.

8. Ensure that all temporary works structures are inspected by a competent person immediately before, during and
after the placement of concrete, after inclement weather or any other imposed load and

at least on a daily basis until the temporary works structure has been removed and the results have been recorded
in a register and made available on site.

9. Prevent the casting of concrete, until authorization in writing has been given by the competent person.

10. Ensure that if, after erection, any temporary works structure is found to be damaged or weakened to such a
degree that its integrity is affected, it is safely removed or reinforced immediately.

11. Ensure that adequate precautionary measures are taken in order to secure any deck panels against
displacement; and prevent any person from slipping on temporary works due to the application of release agents.
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12. Ensure that the health of any person is not affected through the use of solvents or oils or any other similar
substances.

13. Ensure that upon casting concrete, the temporary works structure is left in place until the concrete has acquired
sufficient strength to safely support its own weight and any imposed load, and is not removed until authorization in
writing has been given by the competent person.

14. Ensure that the foundation conditions are suitable to withstand the loads caused by the temporary works
structure and any imposed load in accordance with the temporary works design.

15. Ensure that provision is made for safe access by means of secured ladders or staircases for all work to be
carried out above the foundation bearing level.

16. Ensure that a temporary works drawing or any other relevant document includes construction sequences and
methods statements.

17. Ensure that the temporary works designer has been issued with the latest revision of any relevant structural
design drawing.

18. Ensure that a temporary works design and drawing is used only for its intended purpose and for a specific
portion of a construction site.

19. Ensure that the temporary works drawings are approved by the temporary works designer before the erection of
any temporary works.

20. Only use a temporary works design and drawing for its intended purpose.

21. Assist me with related incident investigations.

22. Assist me in identifying corrective and preventive actions to address the current problems and prevent similar
situations.

SIGNATURE : ……………………………. SIGNATURE : ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION : …………………………. DESIGNATION : …………………………

DATE : …………………………………….. DATE : ……………………………………

ACCEPTANCE

I, …………………………………………... ACCEPT THIS APPOINTMENT. I HAVE STUDIED THE RELEVANT

SECTIONS OF THE ACT AND REGULATIONS AND UNDERSTAND WHAT IS REQUIRED OF ME.

SIGNED : ……………………………….. DATE : ……………………………….

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OCCUPATIONAL HEALTH AND SAFETY ACT, 85 OF 1993 CONSTRUCTION REGULATIONS

13(1)(a)
EXCAVATION WORK SUPERVISOR / INSPECTOR

I, Senzo Nkwanyana., in my position of assistant to the CEO appoint Sibusiso Nkwanayna of ID Number
7910265583081as the Excavation Supervisor / Inspector for Manzo Engineering at the as the Temporary Works
Supervisor for the Medupi Fire and Portable Water Ring Main P10A under WBHO.

In terms of this appointment, you are required to ensure that all excavation work is performed in accordance
with the requirements of the Occupational Health and Safety Act and in particular with the Construction
Regulations in terms of which you must ensure, amongst others, the following:
1. Evaluate the stability of the ground before excavation work begins;
2. Ascertain the location of electricity, water, gas and similar services and/or structures and ensure that
those are not affected by the excavation process;
3. That such work is performed by suitably trained/competent persons – fully aware of the operational
dangers involved and conversant with the precautionary measures to be taken or observed;
4. That suitable and sufficient steps are taken to prevent persons being buried or trapped by a fall or
dislodgement of material in an excavation and to that end, ensure that excavations are adequately
shored or braced, where required, before allowing persons to enter an excavation;
5. That excavations are inspected, and the results recorded, as required by Construction Regulation
11(3)(h); and
6. That all excavations be adequately protected by means of a barrier or fence.
7. You are required to report any deviation from legislative requirements or the established health and
safety plan to the Site Manager, Senzo Nkwanyana
.
A copy of the OHS Act (No. 85 of 1993) and the regulations is available for your perusal. You are to familiarise
yourself with the requirements of the Act and relevant Regulations.

SIGNATURE: ……………………………. SIGNATURE: ……………………………

(FOR EMPLOYER) (WITNESS)

DESIGNATION: …………………………. DESIGNATION: …………………………

DATE: …………………………………….. DATE: ……………………………………

ACCEPTANCE

I…………………………………………….. ACCEPT THIS APPOINTMENT. I HAVE STUDIED THE RELEVANT

SECTIONS OF THE ACT AND REGULATIONS AND UNDERSTAND WHAT IS REQUIRED OF ME.

SIGNED: ……………………………….. DATE: ……………………………….

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