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Preliminary Incident Notification Incident title Excavator tip over APS >2 or WPS >3? YES NO Date &Time 25/08/2014 RegionInvol ved 20517 - JACOBS MOROCCO HSE Incident Type Mobile equipment failure Project Involved Jorf Lasfar ODI P3 Contractor Involved SGTM Actual Severity 1 Name of Person (s) Involved Mr. AMZIANE AZIZ Where did the incident/near miss occur? (e.g., Project Site, Office or Township) Locati on ODI P3 Site, OSBL Sea Water Pipe line Preliminary Details Describe parties involved, activity occurring at the time of incident and a brief summary of loss On the 25 of August 2014 at Approximately 15:00 hrs. Mr. AMEZIANE Aziz carried out excavating activity and when he tried to move through the trench of 90 cm, the right track system of the excavator fell down into the trench which blocked temporary the movement of the excavator. The area was barricaded, the cab door was closed and the operator used his seat belt which make the hazard trivial. Immediate Actions To control the source and mitigate impacts 1. JESA HSE immediately informed. 2. SGTM HSE immediately informed 3. Area secured and made safe. 4. Develop a method statement and a SPA for intervention 5. The excavator secured out from the trench. 5. Activity temporary stopped until providing refresher training to the operator. Insert any photographs/diagrams below (Click in the empty boxes) Copyright © by Jacobs Engineering Group Inc. All rights reserved. No part of this document or the information it contains may be reproduced or transmitted in any form or by any means electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from Jacobs Engineering Group Inc.

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Preliminary Incident Notification

Incident titleExcavator tip over

APS >2 or WPS >3? FORMCHECKBOX YES FORMCHECKBOX NO

Date &Time25/08/2014RegionInvolved20517 - JACOBS MOROCCOHSE Incident TypeMobile equipment failure

Project InvolvedJorf Lasfar ODI P3Contractor InvolvedSGTMActual Severity1

Name of Person (s) InvolvedMr. AMZIANE AZIZWorst Potential Severity1

Where did the incident/near miss occur? (e.g., Project Site, Office or Township)

LocationODI P3 Site, OSBL Sea Water Pipe line

Preliminary DetailsDescribe parties involved, activity occurring at the time of incident and a brief summary of loss

On the 25 of August 2014 at Approximately 15:00 hrs. Mr. AMEZIANE Aziz carried out excavating activity and when he tried to move through the trench of 90 cm, the right track system of the excavator fell down into the trench which blocked temporary the movement of the excavator. The area was barricaded, the cab door was closed and the operator used his seat belt which make the hazard trivial.

Immediate ActionsTo control the source and mitigate impacts

1. JESA HSE immediately informed.

2.SGTMHSE immediately informed

3.Area secured and made safe.4. Develop a method statement and a SPA for intervention5. The excavator secured out from the trench.5. Activity temporary stopped until providing refresher training to the operator.

Insert any photographs/diagrams below(Click in the empty boxes)

SHAPE \* MERGEFORMAT

Contact detailsTo be used as a point of contact regarding any questions related to this incident

NameHADJKACEM Mohamed [email protected]

Copyright by Jacobs Engineering Group Inc. All rights reserved. No part of this document or the information it contains may be reproduced or transmitted in any form or by any means electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from Jacobs Engineering Group Inc.