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    IOR - CHI2 LV damge - Copy

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    nabil.hustle

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    IOR - CHI2 LV damge - Copy

    Uploaded by

    nabil.hustle
    1 views6 pages

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    Download as docx, pdf, or txt
    1 views6 pages

    IOR - CHI2 LV damge - Copy

    Uploaded by

    nabil.hustle

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 6

    GS-A-1

    ATTACHMENT A-1b
    LAND TRANSPORT AUTHORITY
    SAFETY, HEALTH AND ENVIRONMENTAL
    MANAGEMENT MANUAL
    INCIDENT OCCURRENCE REPORT FORM LTA REF NO :

    Incident Title
    Vehicles Collusion
    Name of Main Contractor: TAISEI-CSCEC JV Report Ref. No :
    TCSJV/IOR/20204/0009
    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 occurrenc


    e Crime
    PART B (Details of Incident)

    PROJECT : P103 CONTRACT :

    EXACT LOCATION : Junction 1 toward Punggol East Road – South Bound

    OCCURRENCE DATE: 10/06/2024 OCCURRENCE TIME: 1337pm

    REPORTED DATE : 10/06/2024 REPORTED TIME : 1340pm

    COMPANY RESPONSIBLE FOR INCIDENT: TCSJV


    PART C (Persons involved in the Incident)
    A B C
    NAME : Mani

    DESIGNATION : Driver Motorcyclist

    COMPANY : TCSJV Member of Public

    Status (you may tick more than one) :

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

    B
    C
    PART D (Details of Damage to Property)
    Main Contractor’s property LTA property NOT APPLICABLE

    Subcontractor’s property Public property Others :

    PART E (Details of Damage to Utilities)

    Electrical Gas Sewer Water Traffic NOT APPLICABLE

    Multiple Utilities Damages Telecoms Others :

    March 2023 Edition


    GS-A-2
    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.

    Project P103
    Date: 10/06/2024
    Time: 1335pm
    Location: Junction 1 toward Punggol East Road (South Bound)

    JV Lorry: GBM 2369G


    Motorcycle: FBK 9249J

    At approximately 1:37pm JV lorry driver – Mani was driving along the third lane (shared
    lane) at the junction and halted before the stop line, complying with the red arrow (right
    turn) and initiating the indication light to turn right. (Refer to Photo A)

    At the same time a motorcyclist, riding in the same lane failed to stop on time and
    collided with the rear of the JV lorry, resulting in the motorcyclist to fell. (Refer to photo
    B)

    The motorcyclist approached the JV driver and both of them safely moved the fallen
    motorcycle to the side of the road. (Refer to photo C)

    No injury was reported with no visible damages to either of the vehicles


    Both the motorcyclist and JV driver agreed not to report the matter further and left the
    scene

    Photo B Photo C

    March 2023 Edition


    GS-A-3
    ATTACHMENT A-1b

    TCSJV Lorry’s dashcam footage: Red arrow for right turn

    March 2023 Edition


    GS-A-4
    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 / precaution Unsound
    structure 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 equipment/materials Under influence
    of alcohol/drugs Improper / wrong use of body part 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

    March 2023 Edition


    RECOMMENDATION ACTION TAKEN
    GS-A-5
    1. Conduct safety briefing to the team of workers with 3. Safety BriefingATTACHMENT
    conducted : A-1b
    LAND TRANSPORT AUTHORITY
    regard to the incident. 25/10/2024.
    SAFETY, HEALTH AND ENVIRONMENTAL
    2. Site chargeMANUAL
    MANAGEMENT to conduct daily Utility Briefing and 4. Instructions was given to re-do
    enforce the importance of Utility Damage cable detection works by LCDW.
    INCIDENT OCCURRENCE REPORT FORM
    prevention
    5. Conduct more trail trench to
    (ii) Human Factors detemine all newly discovered
    Fatigue Lack of skill provided bt the LCDW
    services
    Foul play Lack of training
    Illness Needs conflicting
    6. Review withcommunication.
    of internal safety
    Improper assignment of personnel Not qualified
    Moving forward nsure proper
    Improper or lack of motivation / interest Unsafe attitude
    dissemination of updates on site
    Inadequate capability condition.
    No human
    factors Lack of knowledge
    Remarks: 7. Enforced all modification on site
    Motorcyclist didn’t anticipate the second traffic light (removing/laying new pipes) . the
    As built have to be recorded and
    updated in the CUD.
    (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

    PART H

    March 2023 Edition


    GS-A-6
    ATTACHMENT A-1b
    LAND TRANSPORT AUTHORITY
    SAFETY, HEALTH AND ENVIRONMENTAL
    MANAGEMENT MANUAL
    INCIDENT OCCURRENCE REPORT FORM

    PART J (Details of Investigating Person)

    NAME : Halim Hashim

    DESIGNATION : WSHO

    COMPANY : TCSJV

    TEL : 96797150 DATE : 10/06/2024 SIGN :

    PART K (Reviewed By)

    NAME : Farhan Shah Ghaffa

    DESIGNATION : WSHM

    COMPANY : TCSJV

    TEL : DATE : 10/06/2024 SIGN :

    PART L (Form Completed By)

    NAME : Halim Hashim

    DESIGNATION : WSHO

    COMPANY : TCSJV

    TEL : 96707150 DATE : 10/06/2024 SIGN :

    March 2023 Edition

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