LAND TRANSPORT AUTHORITY

T A-
SAFETY, HEALTH AND 1b
ENVIRONMENTAL MANAGEMENT
MANUAL
INCIDENT OCCURRENCE REPORT FORM LTA REF NO :

Incident Title

Name of Main Contractor: TCSJV Report Ref. No : TCSJV/ IOR/2024/0022

PART A (Type of Incident)

Dangerous Occurrence Near miss Near Miss (Cat A) Damage to property

(MOM Reportable)

Dangerous incident Security violation Damage to utilities Fire

Road incident Other occurrence Crime

PART B (Details of Incident)

PROJECT : P103 CONTRACT :

EXACT LOCATION : Utility Corridor - CS

OCCURRENCE DATE : 24 October 2024 OCCURRENCE TIME : 1540 hrs

REPORTED DATE : 24 October 2024 REPORTED TIME : 1545 hrs

COMPANY RESPONSIBLE FOR INCIDENT : Raito Kogyo

PART C (Persons involved in the Incident)

A B C
NAME : B Thirumurugan Marimuthu Selvam Subramaniyam Sankar

DESIGNATION : RES Excavator Operator Banksman

COMPANY : Raito Kogyo Raito Kogyo Raito Kogyo

Status (you may tick more than one) :

Incident
Witness LTA Main Subcontractor’s Visitor Public Self Others :
Reporter Contractor’s
Personnel Personnel Personnel Employed

PART D (Details of Damage to Property)

NOT APPLICABLE
Main Contractor’s property LTA property
Subcontractor’s property
Public property Others :
PART E (Details of Damage to Utilities)

Electrical Gas Sewer

Water Traffic NOT APPLICABLE
Multiple Utilities Telecom
Damages s Others :
 ATTACHMENT A-1b
LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM
PART F (Description of Incident)

WHAT HAPPENED ? HOW DID IT HAPPEN ? WHAT WERE THE CONSEQUENCES ? PLEASE ATTACH PHOTOGRAPHS
AND SKETCHES.

On 24 Oct 2024 at approximately 2:50PM, Raito Site Supervisor Thiru, was directed by
other subcon RES to widen a 1m deep excavation for the installation of steel plate
protection
adjacent to a live 6-way Singtel/NLT cable. REO Marimuthu Selvam and Banksman
Shankar was then activated to shift the existing steel plate, which originally positioned
beneath the
excavator, to facilitate the trench widening. While attempting to shift the steel plate, Thiru
observed a 30mm black bare cable (SPPG LT Cable without slab). He immediately
instructed the excavator operator to stop, but sparks were still generated as the steel plate
grazed the
cable's insulation. They immediately stops works and inform their superior.Cable jointer
from SPPG, activated by Raito, arrived at approximately 5:30 PM to rectify the affected
cable and was rectified by 545pm.SPPG were informed of the occurrence by JV UE, and
was told that this cable is not in their plan. The incident also did not trigger anything
from their system.
Upon investigating, this LT cables serves to the substation in Mindef Camp to power up
their light. No stakeholders were affected and there was no feedback from Pasir Ris Camp.

Location of Cable damaged LT Cable repaired

LT cable was from OG Box 099 7C 4091

 ATTACHMENT A-1b
LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM
PART G (Causes of Incident)

(1) Direct Causes

(i) Unsafe Conditions

Absence of safety means Inadequate warning system

Congestion / restricted action Inadequate / improper PPE

Dressing / apparel hazard Inclement weather conditions

Environmental hazard (gas / dust / smoke) Noise hazard

Floor surface hazards (slips / trips / falls) Poor housekeeping

Hazardous arrangement Presence of fire / explosion hazard

High temperature hazard Radiation hazard

Improper / faulty equipment Unknown ground conditions

Inadequate guarding / protection / Unsound structure

precaution

Inadequate illumination No unsafe condition

Inadequate ventilation

Remarks :
NA

(ii) Unsafe Practice

Disregard instructions Not paying attention

Driving / operating error Operating / working at unsafe speed

Failure to secure / warn Operating / working without authority

Horseplay Taking improper / unsafe position or posture

Improper use of fail to use PPE Taking shortcuts

Improper / unsafe lifting/carrying Tampering with equipment in motion

Improper /unsafe use of Under influence of alcohol/drugs

equipment/materials

Improper / wrong use of bodypart Unsafe loading / mixing / placing

Intentional motive Wrong working methods

Making safety devices inoperative No unsafe practice

Remarks :

NA

(2) Root Causes

(i) Work Factors

 Inadequate equipment being used Lack of co-ordination / communication

Inadequate / lack of engineering Poor selection / placement

Inadequate / lack of maintenance Pressure from external influence

Inadequate / lack of supervision Wear and tear

Inadequate / lack or work procedures No work factors

Remarks :

NA
 LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM

(ii) Human Factors

Fatigue Lack of skill

Foul play Lack of training

Illness Needs conflicting with safety

Improper assignment of personnel Not qualified

Improper or lack of motivation / interest Unsafe attitude

Inadequate capability No human factors

Lack of knowledge

Remarks:

NA

(3) Weakness of Safety Management System

Safety policy Safe work practices

Safety training Group meetings

Incident investigation and analysis In-house safety rules and regulations

Safety promotion Evaluation, selection and control of SC

Safety inspections Maintenance regime for all machinery

Hazard analysis Control of movement and use of

Emergency preparedness hazardous substances and materials

Occupational health programs Not applicable

Remarks:

NA

PARTH

RECOMMENDATION ACTION TAKEN

ii. Conduct safety briefing to the team of i. SAFETY BRIEFING CONDUCTED 25/10/2024.

workers with regard to the incident.

ATTACHMENT A-1b
 ATTACHMENT A-1b
LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND
ENVIRONMENTAL MANAGEMENT
MANUAL
INCIDENT OCCURRENCE REPORT FORM

PART J (Details of Investigating Person)

kHiDIR

DESIGNATION : SENIOU UTILITIESENGNEER

COMPANY : TCSJV

TEL : 87422843 DATE : 13/11/2024 SIGN :

PART K (Reviewed By)

NAME : Farhan Shah

DESIGNATION : WSHM

COMPANY : TCSJV

TEL : 96559554 DATE : 13/11/2024 SIGN :

PART L (Form Completed By)

NAME : Zainal

DESIGNATION : WSHO

COMPANY : TCSJV

TEL : 87422843 DATE : 13/11/2024 SIGN :