Instrument, Installation & Maintenance Co.
Job Safety Observation Report No: IMCO_JSO_32
P. O. Box 22803, Doha, Qatar
Tel no. 0974-466-79-10/23/24 REPORT Project Title: EPIC FOR POWER
SUPPLY TO DSSA & NWDH
Describe in detail the Job Safety Observation: (including scenarios and recommendations)
_________________________________________________________________________________________________
Date of Job Safety Observation: 22 Oct.’ 07 Time of JSO: 08:00 am
Person Involved: Gutham Bahadur Company Name: Qatar Al Atiyah
Nationality: Nepali Badge Number: Sub Contractor
Location of Incident: 33kV s/s control bulding IMCO Worksite Supervisor: Abdul Rahman
Brief Description of incident:
At around 8:00 am, during backfilling activities of excavation using mini bulldozer (BOBCAT). Mr.Guatam
Bahadur, Civil Supervisor of QAIG subcon of IMCO pursue his workers at 11kV s/s-907 to work with shovel
manually under the excavation even the mini bulldozer dumping the backfilling materials above the area.
Attach separate sheets if insufficient space; NOTE IMCO_FO_JSO_019a
Action Taken:
Immediately stop the unsafe acts of the bulldozer operator and give a verbal warning to Gutham Bahadur for
his unsafe attitude due to advising the workers which is possible cause of accident due to ignorance while
doing unsafe acts.
State actions taken to correct and prevent such occurrence: If closed what evidence have you to verify:
If still OPEN state measures for closure:
Recommendation;
1) Engineers and Worksite Supervisor should correct the unsafe acts or unsafe condition noticed by an individual or
take measure to reduce risk and not them are the one who tolerating the unsafe acts of their people.
2) Ensure that the safety rules and regulation for contractors are adhered to and those relevant safety precautions
are taken.
3) Breach of established safety rules, regulation or procedure resulting in an unsafe acts or unsafe condition shall be
regarded by IMCO and or Client as serious misconduct and appropriate disciplinary action shall be taken against
the individuals responsible, in accordance with the personnel policies and procedures manual.
Confirm if Job Safety Observation is Open or Closed
OPEN CLOSED
If closed sign: Safety Officer: I hereby confirm that the Job Safety Observation has been closed and corrective preventive
methods applied
Signature: Roger P. Drilon Date open: Date closed:
Reported By: Reviewed and Checked by HSE In-Charge ONLY:
Name: Roger P. Drilon Name: Francis E. Tan
Signature: Date: Signature: Date:
Designation: Safety Officer Confirm closure if applicable
Are their attachments
YES NO Closed: YES NO
Note: Form must be completed in all sections where possible; clear precise legible reporting must be made, ensure that any
attachments are correctly filled out and stabled or adequately clipped
Form Created: 16_January_07 IMCO_FO_JSO_019
Form revision # : 0