Suite 126 LRI Business Plaza, 210 N. Garcia St.

, Bel-Air II, Makati City 1209 Philippines

Tel. +632 535-1101, +632 535-1102. +632 535-3332

Incident Report

Project 3298-SOLAIRE NORTH CASINO & HOTEL Date 28-May-24

FIT-OUT Area LEVEL 7

CORRIDOR
Location Bagong Pag-asa North Ave., Quezon City
DETAILS OF INCIDENT REPORT

1. MEDICAL / SAFETY INCIDENTS

Medical Treatment Serious Injury Fatalities
(minor cuts, bruises or strains) (temp. or permanent disability) (Death)
Near-Miss Illness Other
Failure to follow safety rules
2. NON-MEDICAL INCIDENTS
Theft Bomb Joke Damage to Property Threatening
Threats Complaint Nearmiss Information report
Other ___________________

3. WEATHER DISTURBANCE / NATURAL CALAMITY

Typhoon Earthquake InformationReport
Flood Other

Details of Incident Report Incident Date and Time

May 9, 2024 (PM) Upon random checking with SPI Inspector we noticed
a small scratch after we removed the masking tape covering the portion of the Vanity 5/9/2024

mirror (MICE Male Toilet), after taking photos for documentation all the remaining mirrors Date

with masking tape is been removed and another Vanity mirror (MICE Female Toilet) has
damaged. (2 Vanity Mirror has damaged) 3:00 PM

Time

Prepared by

MICHAEL TUGAWEN
SOLN RGSP SAFETY OFFICER

Investigated by
Cause of the Incident:
1 Damaged on hauling
2 Damaged/struct by tools RUEL TERO/JULIAN LESTER
Immediate Action Taken: SOLN RGSP SAFETY OFFICER

1 Check All Permit to work by ODC who worked on the area Checked by

MARICEL BAYUBAY
SOLN RGSP-SAFETY HEAD
Recommendations
1 Mirror Replacement
Noted by

MARK LOUIE PASTRANA

SOLN PROJECT MANAGER

(PLEASE SEE ATTACHED PHOTOS, & STATEMENT

RGSP/SO-03
RGSP/SO-03
 Suite 126 LRI Business Plaza, 210 N. Garcia St., Bel-Air II, Makati City 1209 Philippines
Tel. +632 535-1101, +632 535-1102. +632 535-3332

Incident Report

RGSP/SO-03