Rev 01

CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2796
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

Barrication not available near excavation Barrication provided for the excavation

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023

 Rev 01
CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2797
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

Improper stacking of materials Proper stacking of materials done

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023

 Rev 01
CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2798
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

Dust accumulated in the corridors and rooms Dust removal and suprresion done

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023

 Rev 01
CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2799
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

unwanted materials kept on the access Unwanted materials removed

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023

 Rev 01
CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2800
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

Refregerent stored inside the temporary Refregerent stored in the designated storage
chemical storage without protection area.

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023

 Rev 01
CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2801
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

Unwanted materials kept outside the fence Unwanted materials removed

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023

 Rev 01
CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2802
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

Scaffolding tag found expired Scaffoldings inspected and tag updated.

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023

 Rev 01
CORRECTIVE ACTION REPORT (CAR) Date 10-Jun-23

FORM
Please utilize this template while submitting closeout reports for any observations raised on the job site.

Design, Build, Operate & Maintain of Field Operations Base for Block 10/
Project/Site Location: Walkthrough(Permanent Facility - Admin, laundry, kitchen, CFM, FM,
Gym&recreation, SS-3,SS-6 )

Date action was

Date Observed: 03.07.2024 6/7/2024
taken:

Observation Action
2803
Tracking Registry No.
Shall match on ATR record

PHOTOS

BEFORE AFTER
DETAILS
What was observed? Corrective action(s) taken

Earth pit covered with safety cone Hard barrication provided for the earth pit

CLOSEOUT CONFIRMATION
Was the corrective action(s) taken reduced the hazard to as low as reasonably practicable (ALARP) condition?
Please thick the box based on your assessment on the corrective actions taken.

Checked By: Confirmed By:

Yes No Yes No

Name & Signature Name & Signature

Galfar Site Supervisor / Engineer Galfar HSE Manager / Field HSE Advisor

Verified By:
Yes No

Prasad Thayyil

Galfar Project/Construction Manager

Approved By:
Approved Rejected

Name & Signature

Shell Oman Construction Site Manager or his delegate

Note: Only after approval shall the observation be closed in the HSE Action Tracking Register (ATR).

Corrective Action Report form_Rev.01_6-June-2023