HEALTH, SAFETY AND ENVIRONMENT PROCEDURE

SAFETY REPORT PROCEDURE- SRP-001

REVISION HISTORY
REV

DATE

BY

CHCKD

APPRD

12/07/2004

PJC

JF Ajeet

07/07/2005

EHW

ASY

24/11/2006

EHW

ASY

ASY

28/11/2008

EHW

ASY/FS

COMMENTS
First draft for comment

Revision for general use.

2nd Revision and Change of Designation

SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

TABLE OF CONTENTS
1. INTRODUCTION.......................................................................................................................................... 2
2. SCOPE & OBJECTIVES.............................................................................................................................. 3
3. RESPONSIBILITIES.................................................................................................................................... 3
3.1. Safety Committee.................................................................................................................................. 3
3.2. SDWS Managing Director...................................................................................................................... 3
3.3. Rig Manager.......................................................................................................................................... 3
3.4. Rig Superintendent or Site Supervisor...................................................................................................4
3.5. HSE Officer............................................................................................................................................ 4
4. SAFETY REPORTS..................................................................................................................................... 4
4.1. Rig Daily HSE Report............................................................................................................................ 4
4.2. Incident / Accident Notification...............................................................................................................5
4.3. Accident & Incident Notification/Investigation Report.............................................................................5
4.4. Near Hit / Near Miss Report................................................................................................................... 6
4.5. Unsafe Act and Unsafe Condition Report..............................................................................................6
4.6. Periodic & Statistical Reports.................................................................................................................6
4.7. Audit/Inspection Reports........................................................................................................................ 7
5. Appendix A - SDWS - HSE DAILY REPORT...............................................................................................8
6. Appendix B - HSE INCIDENT INVESTIGATION REPORT.......................................................................10
7. Appendix C UNSAFE ACT AND UNSAFE CONDITION REPORT..........................................................14
8. Appendix D - SDWS - HSE MONTHLY REPORT......................................................................................15

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1.

INTRODUCTION

Reporting of safety performance and incidents is an inherent part of the overall occupational Health,
Safety and Environment controls of the company. Regulations, client and the general public can be
affected by the conduct of SDWS personnel and its assets.
The overall Safety System Manual and associated procedures are provided to ensure that risks are
identified, incidents and accidents are reported and means to remove or lower the risks and incidents
are put into place.
To this end, the company requires accurate recording and reporting of performance and any incidents
/ accidents, including audits and investigations. This shall be the media that is publicized within the
organization and offered to our client to provide assurance that safety is high on the agenda and that
zero tolerance is expected.
All incident or accident shall be reported. This includes:1
2
3
4
5

Employee - Any injury sustained while on duty.

Company vehicles - Any damage to company vehicles regardless of place and time of
occurrence.
Company property or equipment - Any damage to company owned property or
equipment regardless of place or time of occurrence.
Third party - Any accident resulting in any damage of property not owned by the
company or injury suffered by anyone not employed by company such as sub-SDWS,
consultants, client personnel or general public.
Environmental Incident An accidental spill of oil, chemicals or other materials that is
detrimental to the environment or changes to the natural conditions. This also includes
excessive human occupation, radiation, heat, vibration and noise that has a long term
impact and disturbs the natural conditions.
Near Miss

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2.

SCOPE & OBJECTIVES

Provide a framework of essential information gathering records that lead to ongoing improvement in
the reduction of risks to people and assets. Some of the data collected is due to regulations or client /
contract requirements. The remainder forms the balance of information that the company requires in
order to manage risk and reduction to acceptable levels. The type of rig operations reports required
to be completed on a regular basis are as follows:

Incident Notification/Investigation Report

Unsafe Act Report
Daily HSE Report
Monthly and Yearly HSE Reports
Inspection Reports

In addition to the above, SDWS Safety Committee and HR Department provide the following:

3.

Committee minutes of meeting

Training plans, courses and registers
Personnel records including medical and performance
Correspondences with board, regulator or client
Warning letters to errant staff
RESPONSIBILITIES

3.1.
Safety Committee
SDWS has a Safety Committee as described in the Safety System Manual. They shall review and
assess the outcome of daily and weekly reports, incident and accident reports, audits and
investigations. From time to time they may request additional information to be provided with a
report.
3.2.
SDWS Managing Director
He is a member of the Safety Committee and as such review all HSE reports and statistics to ensure
that targets are being met or action is taking to mitigate. It is essential that all the policies and
procedures are endorsed or promote by the SDWS Managing Director at every opportunity. He
should represent the company to clients, be well briefed and competent to present the systems and
performance achieved.
3.3.
Rig Manager
The Rig Manager is single point responsible for safe rig operations and selection of personnel to
operate it. They are a member of the Safety Committee and acts as the advisor and arbitrator for the
rig operations and personnel during review all HSE reports and statistics. Their job is to ensure that
targets can and are being met or taking action to mitigate, including disciplining staff. It is essential
that all of the operation policies and procedures are endorsed by the Rig Manager. They should
represent the company to clients, be well briefed and competent to present the systems and
performance achieved.

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

3.4.
Rig Superintendent or Site Supervisor
The Rig Superintendent or Site Supervisor has been delegated responsibility for daily operation of the
rig and the safety of the rig crew comprising of various skill levels and capabilities. All members of
the crew have a common responsibility to ensure that the rig is safe and safely operated, hold JSAs
and toolbox meetings to review what precautions should be taken, observe unsafe acts and
conditions that may lead to an incident or accident to a fellow crew member or to the rig equipment.
All unsafe conditions and concerns must be immediately reported to either the Rig Superintendent or
Site Supervisor or the HSE Officer.
The Rig Superintendent or Site Supervisor shall ensure that hand-over between key rig staff on roster
shifts is done properly and they all use standardized reports to reflect important or significant events
during the previous shift and things to prepare for in the next shift.
3.5.
HSE Officer
The Rig HSE officer provides first aid as well as recording incidents, HSE facilitation, pre-tour
briefings, auditing and monthly reporting duties. They shall provide a proactive role as well as
reactive. One of their roles is to support HSE improvement initiatives and participate in updates of the
HSE System Manual and Procedures.
Is-so-far as HSE reporting is concerned, the HSE Officer shall report directly to the Rig Manager with
a copy to the Rig Superintendent or Site Supervisor. The type of reporting is as described in the
following section.
4.

SAFETY REPORTS

4.1.
Rig Daily HSE Report
Rig daily HSE reports shall contain the following main points:

Number of personnel on shift versus required on shift. If short staffing occurs, note what impact
on operations safety this may have.
Daily toolbox meeting, noting who was present and brief of the subjects discussed
JSAs carried out
Details of any HSE incidents, accidents or medical treatment that day
Type of HSE activities being carried out and any cautionary issues discussed
Details of any training provided or planned to complete during the day including client training or
drills
PPE issues and losses / replacements

Refer to:Appendix A HSE Daily Report

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

4.2.
Incident / Accident Notification
Any incident or accident, regardless of its severity must be reported to the line management. This will
ensure proper action is taken to secure the situation, proper medication given to the injured person
and proper investigation been done to identify the causes thus preventing similar incident from
recurring.
When responding to a safety incident, personnel should:

Stop work and secure the incident scene to prevent further injuries
Provide necessary first aid or medical care to the injured personnel

Following this, all personnel must:

Notify the worksite management of the incident by providing key facts. The worksite
management will later inform the Rig Manager and HSE Department.
Fill up and submit the Incident Notification/Investigation Form in a timely manner.

(Preliminary report will be sufficed for notification. Full report will be completed by the investigation
team)
4.3.
Accident & Incident Notification/Investigation Report
Every accident or incident shall be reported in accordance with the Class 1, 2 or Class 3 Emergency
Response incident reporting requirements. Minor non-LTI cases need only be recorded on the daily
HSE Report. Any equipment incidents that do not effect the operations or the safety of the rig or crew
shall also be reported in the daily HSE Report.
The Rig Manager upon consultation with SDWS Managing Director and HSE Department will decide
the composition of an investigation team.
The composition of the investigation team may vary according to the seriousness of the incident and
its potential. Rig personnel may be appointed to investigate near miss or first aid incident, whereby
assistance from support group at onshore may be required for lost time or major property damage
incident.
When requested, the investigation team will be called in front of the committee to explain the
identified incident.
Refer to:Appendix B - Incident Notification / Investigation Report Form

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4.4.
Near Hit / Near Miss Report
If an incident is categorized as Near Hit / Near Miss by the HSE Officer or any rig crew member, this
shall be recorded in the daily HSE Report. In addition, the HSE Officer shall maintain a log of all Near
Hit / Near Miss incidents (e.g.: object falling from upper deck and not hitting anyone, hook swinging
and could have hit someone).
Following a reported incident, the HSE Officer and the Rig Superintendent or Site Supervisor must
review how it occurred, what the risks were (potential) and provide a remedy for this not to repeat.
This information must be discussed and reinforced at the next toolbox meeting.
4.5.
Unsafe Act and Unsafe Condition Report
All unsafe acts or conditions must be reported in order to immediately stop the problem from
becoming an incident. All personnel are encouraged to report any unsafe act or unsafe condition, take
appropriate action to rectify and report via HAZCORP. The numbers of HAZCORP raised will be
recorded in the daily HSE Report (e.g. Using wrong tools, not using work permit or lock out,
equipment switched on (or off) without firstly notifying other crew members, safety gate left open).
In addition, the HSE Officer shall maintain a log of all HAZCORP and the remedial action taken. The
HSE Officer and the Rig Superintendent or Site Supervisor must review how it occurred, what the
risks were (potential) and provide a remedy for this not to repeat. This information must be discussed
and reinforced at the next toolbox meeting. Information obtained from the submission of the
HAZCORP will be compiled and monthly analysis report will be prepared by the HSE officer. The
analysis should highlights category involves and most common reason for unsafe act or unsafe
condition.
Refer to Appendix C Unsafe Act and Unsafe Condition Report Form
4.6.
Periodic & Statistical Reports
The daily HSE reports shall be summarized into a monthly report for issue to the Rig Manager and
Safety Committee members. The report will contain the following details:

Total accumulated manhours, TRIs, TRIF

Copy of unsafe act or condition log
Copy of near hit / miss log
Copies of HSE audits completed and forecast audits in coming month
Subjects covered in toolbox meetings
Safety Alerts, drills or incidents that affected rig operations or crew
Company training drills
Any other pertinent information or observation including forecast training requirements

Refer to:Appendix D HSE Monthly Report

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

4.7.
Audit/Inspection Reports
Wherever possible, use standard audit check lists and forms. Check carefully that each point is valid
and discuss any non-compliance with the Rig Superintendent or Site Supervisor or Toolpusher. All
audit reports shall be issued to the Rig Manager on completion. It is the responsibility of the HSE
Officer to tell it like it is and not distort the facts, be neutral. If a conflict arises in views on audit
points or findings, these must be discussed with the Rig Manager for resolution.
Refer to Rig Safety Audit Procedure SAP-001

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

5.

Appendix A - SDWS - HSE DAILY REPORT

To
Attn
Cc
From
Operation Date

SAAG DRILLING & WELL SERVICES (M) Sdn Bhd K.L.

- Rig. Supt.
- Rig Manager
- SDWS Managing Director
- HSE Officer

Contact No:

Priority :Normal

SAFETY EXPOSURE HOURS

SAAG-DRILLING & WELL SERVICES
SDN BHD (KSB)

TODAY
POB

TODAY
(HRS)

YESTERDAY
ACCUM (HRS)

ACCUM (HRS)

TOTAL FOR RIG OPERATION TEAM:

TOTAL FOR PROJECT TEAM:
TOTAL FOR CONTRACTORS:
TOTAL FOR OFFICE CREW:
TOTAL ON BOARD
TOTAL MAN-HOURS FOR TELAGA USAHA YTD
GRAND TOTAL MAN-HOURS FOR TELAGA USAHA

CONTRACTORS
WELDERS/FITTERS
ELECTRICIANS
TOTAL

:
:
:

00
00
00

REMARK:

AA

SAFETY MANHOURS INCLUDED WITH ALL PERSONNEL, WORKERS AND VISITORS

WITH THE PROJECT TEAM.

STATISTIC:
DAY

LTI
RWI
MTI
FA
NM

MTD

DAY

MTD

DAY

MTD

EQ. DAMAGE
FIRE
SPILL
HCR
OTHERS

Description of Incident:
BB

HAZCORP FINDINGS:
Drilling crew
Mechanical
Electrical
Others

CC

SAFETY ISSUES:

Action Party

Remarks

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

DD

OCCUPATIONAL HEALTH ISSUES:

Action Party

Remarks

EE

ENVIRONMENTAL ISSUES:

Action Party

Remarks

FF

SPECIAL HIGHLIGHTS

Action Party

Remarks

REPORTED BY:_______________________________ VERIFIED BY : ___________________________

HSE OFFICER

RIG SUPERINTENDENT OR SITE SUPERVISOR.

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

6.

Appendix B - HSE INCIDENT INVESTIGATION REPORT

Incident Notification/Investigation Form

INCIDENT INFORMATION
Day & Date Of Incident:

Time:

INCIDENT CLASSIFICATION
Lost Time
Medical Treatment
Fire
Spill
Near Miss
Others

Shift:

Department:

Restricted Work
Property Damage

Location:

First Aid
Hydrocarbon Release

INJURED PERSON
Name:
Address:
Age:
Phone:
Job Title:
Supervisor Name:
Length of Employment at Company:
Length of Employment at Job:
Employment Classification:
Full Time
Part Time
Contract
Nature of Injury
Bruising
Dislocation
Other (specify)
Strain/Sprain
Scratch/Abrasion
Internal
Fracture
Amputation
Foreign Body
Laceration/Cut
Burn/Scald
Chemical Reaction
Name and Address of Treating Physician or Facility:

DAMAGE PROPERTY/ENVIRONMENT
Property, Equipment, Material or
Damaged:

Environment

Temporary
Injured Part of Body:

Describe Damage:

Object or Substance Inflicting Damage:

DESCRIBE WHAT HAPPENED (ATTACH PHOTOGRAPHS OR DIAGRAMS IF NECESSARY)

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

ROOT CAUSE ANALYSIS (Check All That Apply)

Unsafe Acts
Unsafe Conditions

Management Deficiencies

Improper work technique

Safety rules violation
Improper PPE or PPE not used
Operating without authority
Failure to warn or secure
Operating at improper speed
By-passing safety devices
Guard not used
Improper loading or placement
Improper lifting
Servicing machinery in motion
Horseplay
Drug or alcohol used
Unnecessary haste
Unsafe act of others
Other:

Lack of written procedures or policies

Safety rules not enforced
Hazard not identified
PPE unavailable
Insufficient worker training
Insufficient supervisor training
Improper maintenance
Inadequate supervision
Inadequate job planning
Inadequate hiring practices
Inadequate workplace inspection
Inadequate equipment
Unsafe design or construction
Unrealistic scheduling
Poor process design
Other:

Poor workstation design or layout

Congested work area
Hazardous substances
Fire or explosion hazard
Inadequate ventilation
Improper material storage
Improper tool or equipment
Insufficient knowledge of job
Slippery condition
Poor housekeeping
Excessive noise
Inadequate guarding of hazard
Defective tool/equipment
Insufficient lighting
Inadequate fall protection
Other:

INCIDENT ANALYSIS
Using the root cause analysis list on the previous page, explain the cause(s) of incident in as details as possible.

How bad could the incident have been?

Very Serious
Serious
Minor

What is the chance if the incident happening again?

Frequent
Occasional
Rare

PREVENTIVE ACTIONS
Describe actions that will be taken to prevent recurrence

Dateline

By Whom

Complete

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

INVESTIGATION TEAM
Signature

Name

Position

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7.

Appendix C UNSAFE ACT AND UNSAFE CONDITION REPORT

MONTH

HAZCORP

NO

(HAZARD IDENTIFICATION AND CORRECTION PROGRAM)

OBSERVATION
A. UNSAFE ACTS OBSERVED
(PERILAKU YANG TIDAK SELAMAT)

B. UNSAFE CONDITION OBSERVED

(KONDISI TIDAK SELAMAT)

ACTION
1. IMMEDIATE CORRECTIVE ACTION TAKEN
(TINDAKAN PEMBETULAN SEGERA)

2. FURTHER ACTION TO PREVENT RECURRENCE

(TINDAKAN PENCEGAHAN SUSULAN)

OBSERVER'S SIGNATURE

DATE

NAME (OPTIONAL)

PLATFORM/SITE

REVIEW BY SUPERVISOR : SIGNATURE

DATE

ROOT CAUSE
PERSONAL FACTOR

LACK OF SKILL/KNOWLEDGE

JOB FACTOR

LACK OR INADEQUATE OPERATIONAL

PROCEDURES OR WORK STANDARDS.

CORRECT WAY TAKES MORE TIME

INADEQUATE COMMUNICATION
SHORT-CUTTING STANDARD PROCEDURE

REGARDING PROCEDURES
OR WORK STANDARDS.

PERSON PERCIEVES DOING JOB EXACTLY

ACCORDING TO PROCEDURE IS NOT

INADEQUATE TOOLS OR EQUIPMENT.

IMPORTANT.
UNCONTROLLABLE FACTOR

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

8.

Appendix D - SDWS - HSE MONTHLY REPORT

To
Attn
Cc

SAAG Drilling & Well Services (M) Sdn. Bhd. K.L.

Floyd A. Smith
Rig Manager
Abdul Sani Yatim
SDWS Managing Director
Engku Hasan Wardi
Group HSE Manager
Rig Superintendent or Site
Supervisor
HSE Officer

From
Report Ending

603-7884 8431

HSE Statistics:
J

YTD

LTI
RWI
MTI
FA
NM
Eqt. Dmg.
Fire
Spill
HCR
Others
HAZCORP
Description Of Incidents For The Month:
Manhours
Employee
Project
Contractor
Total

MTD

Safety event
Drill
Safety Meeting
Audit

MTD

YTD

TRIF
MTD/YTD

Total Exposure Hours

Since Last TRI:

YTD

HIGHLIGHTS:
Training:

Safety:
Occupational Health:
Environmental:

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SAAG DRILLING & WELL SERVICES - SAFETY REPORT PROCEDURE SRP-001

Others:

REPORTED BY:_______________________________ VERIFIED BY : ___________________________

HSE OFFICER

RIG SUPERINTENDENT OR SITE SUPERVISOR.

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