Obs Ref: ELRASS / 11
HSE Observation Record
Date Raised: 2025/03/13
Cluster: NWC Directorate/CBU: منطقة القص م
جنوب وع تنف ذ ش ات ال ف الص م
Project Name: Project no. 161240138
محافظة الرس
Supervising Consultant: كه كة ع دﷲ السع د و Contractor: للمقاوﻻت كة الع
Location visited: التعل م Observer: م الرو م ع دال
1. OBSERVATION: A non-fulfilment of specified requirements (details shall include the requirement, the failure, the objective evidence
and the implication for the project or process if the risk remains un-managed):
الرحاب محافظة الرس وتم رصد المﻼحظات ف الص وع أن شاء ش ات ال لنظام السﻼمة والصحة المهن ة لم خﻼل عمل ة المراجعة والتدقيق الداخ
: التال ة
. عدم وجود لوحات ارشاد ة وتحذي ة -1
. عدم نظافة منطقة العمل عد اﻻنتهاء من العمل -2
Name: م الرو م ع دال Signature: Date: 2025/03/13
2. IDENTIFY ROOT CAUSE: The action plan should be prescribed by the Contractor.
3. CORRECTIVE ACTION: The action plan should be prescribed by the Contractor.
4. PREVENTIVE ACTION (action taken to prevent recurrence): This section should only be completed where a root cause of the
observation has been identified that requires further action, in order the observation does not recur.
Proposed Action Date
Name: Signature: Date:
Consultant Approval: Approved ☐ Approved with comments ☐ Rejected ☐
Comments:
Name: Signature: Date:
5. FOLLOW UP AND CLOSE-OUT: The following evidence has been examined and confirms that corrective action has been taken.
Consultant Approval: Approved ☐ Approved with comments ☐ Rejected ☐
Comments:
Consultant 1 of 2
Consultant 2 of 2
