Rev 00. check and direct 29 july-2018

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Dwarika Bhushan Sharma

Management of Combustible Materials

Incombustible
Packaging
And Materials
Delivery Direct
to building
Off Site
Packaging
Unpack
Building
Delivery
from store to
workplace in
building.
Fire Extinguishers
Fire Blanket
Firehose
reel
Combustible
Materials
Store
Check & Direct
Management of Combustible Materials
Covered with
Fire blanket
Temporary fire “Managed Storage Area”

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1. Project Information: Project Name: Checklist No.: Sub-Contractor/Company: Date: 2. Task Details: Description of Task: Location / Area : Number of Workers: Task Duration: Time (from): _______Hrs. Time (To): __________Hrs. Date: 3. Prerequisites: Checks Yes-No-NA Checks Yes-No-NA Safety induction done. ☐ ☐ ☐ Safety tool box talk done. ☐ ☐ ☐ Method statement/Risk assessment in place. ☐ ☐ ☐ Training on Risk Assessment/ Method Statement done ☐ ☐ ☐ Job Safety Analysis done. ☐ ☐ ☐ 3 Month Safety Look Ahead in place ☐ ☐ ☐ Permit to Work obtained ☐ ☐ ☐ Site Supervisor available ☐ ☐ ☐ PPE Available ☐ ☐ ☐ Working area is well lighted ☐ ☐ ☐ Tools and equipment inspected and tagged ☐ ☐ ☐ Unsafe conditions rectified ☐ ☐ ☐ Pre-Start Checks completed ☐ ☐ ☐ Emergency procedures communicated ☐ ☐ ☐ Unauthorized workers are cleared from the area. ☐ ☐ ☐ Other ( Specify): ☐ ☐ ☐ 4. Acknowledgement by Sub-Contractor: ☐ Acknowledge that all above precautions/ controls measures have been taken. These have also been fully explained to the operatives, and I consider them competent to do it safely. Initiator/Originator Name: Designation: Signature: Date /Time: Signature: Date /Time

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Project Information Project Name: Store No. Location: Contact Person: Company Name: Arabtec Construction LLC. Date: Sr. Description Yes No N/A Comments 1. Is access to stores are restricted to authorized personnel only? 2. Are there clear spaces around racks and stacks of stored materials and are adequate gangways provided between them? 3. Are stacks and storage kept clear of light fittings and hot surfaces? 4. Are all stocks of flammable liquids kept in purpose-built flammable storage liquid stores? 5. Are storage areas generally cleaned and tidy? 6. Are flammable liquids kept away from all possible sources of ignition? 7. Emergency exit signs are available in right locations 8. Smoke detectors/fire alarm are visible and accessible. 9. Fire extinguishers are available are serviced regularly 10. Are free standing shelves and cupboards secured for stability? 11. Are heavy items stored at a suitable height? 12. Are chemical containers used for storage suitable and clearly labelled? 13. Is there adequate light in the storage area? 14. Are all small loose items secured in appropriate storage? 15. Are warning notices, prohibiting smoking and naked lights prominently displayed? 16. Others if any: Remarks: Inspected by: Signature: Reviewed by Project Manager/HSE Manager Signature:

STORE INSPECTION Form # HSEQ - Form 2 Rev 2.docx

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PROJECT: LOCATION: DATE: I (name)_____________________________________would like provide my statement as follows on. I hereby acknowledge that the above statement are true to the best of my recollection, and that these are my very own written down by m myself s others _________Name and Signature________ Name : ____________________________ Signature: ______________________ Position: _________________________________________Date:_________________

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1. Project Information: Project Name: Click here to enter text. Report No.: Click here to enter text. Project Location: Click here to enter text. Property No.: Click here to enter text. ☐ Fatality ☐ Major Injury ☐ Minor Injury ☐ Property Damage ☐ Environmental ☐ Other 2. Describe the Incident in detail: Answer who, what, why, where, when & how in this section: (Attach additional pages if required) 3. Incident Root Causes: Describe direct, indirect & root cause: (Attach additional pages if required) 4. Key Corrections Taken Immediately after the Incident: Attach additional pages if more space is required: 5. Key Corrective Actions to Prevent Recurrence: Describe the corrective actions with timeframe: (Attach additional pages if required) Corporate Office Remarks:

PROJECT LEADER INCIDENT BRIEFING Form # HSEQ - PLIB Rev 2 -.docx

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1. Project Information: (To be filled by initiator/originator) Project Name: Permit No.: Project Location: Requesting Contractor/Company 2. Permit Issuance Details: (To be filled by initiator/originator) THIS PERMIT IS ONLY FOR ONE SHIFT AND NOT EXTENDABLE Description of Task: Detail of Surroundings: Permit Validity: Time (from): __________Hrs. Time (To): __________Hrs. Date: 3. Control Measures: (To be filled by initiator/originator and verified by Evaluator) Checks Yes-No-NA Checks Yes-No-NA Method statement & Risk assessment developed, approved & communicated? ☐ ☐ ☐ Availability of rescue procedure and equipment? ☐ ☐ ☐ Operatives are trained and competent? ☐ ☐ ☐ Workplace appropriately illuminated ☐ ☐ ☐ Any high risk activity associated that requires PTW (i.e. hot work, CSE)? ☐ ☐ ☐ Forced ventilation provided? ☐ ☐ ☐ Are all necessary Permit approved and displayed at work location? ☐ ☐ ☐ Means of communication available? (Mobile, radio etc.) ☐ ☐ ☐ Safe access / Working Platform provided? ☐ ☐ ☐ Mandatory/specific good condition PPEs are available ☐ ☐ ☐ Availability of barricades/protection to prevent unauthorized or accidental entry? ☐ ☐ ☐ Life Line provided? ☐ ☐ ☐ Warning signs posted? ☐ ☐ ☐ Fall Protection equipment (e.g. full body harness) available? ☐ ☐ ☐ Availability of Fall protection arrangement? ☐ ☐ ☐ Other(s): ☐ ☐ ☐ Adequate Lighting provided? ☐ ☐ ☐ ☐ ☐ ☐ 4. Acknowledgement by Initiator and Evaluator: ☐ Acknowledge that all above precautions have been taken. These have also been fully explained to the operatives, and I consider them competent to do it safely. Initiator/Originator Name: Designation: Signature: Time: ☐ Acknowledge that I have checked above control measures and consider the work area safe to carry out the activity Evaluator (HSE Team): Designation: Signature: Time Comments (if any): 5. Authorization (PM/CM): Name: Designation: Signature: Time: 6. Completion/Cancelation of Permit: ☐ Acknowledge that the area have been restored to a safe and orderly condition. Initiator Signature: Time: ☐ Acknowledge that I have checked the area and been restored to a safe and orderly condition. Evaluator Signature: Time:

LIFT SHAFT ENTRY PERMIT Form # HSEQ - LSEP Rev 2 -.docx

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1. Project Information: (To be filled by initiator/originator) Project Name: Permit No.: Project Location: Requesting Contractor/Company 2. Permit Issuance Details: (To be filled by initiator/originator) THIS PERMIT IS ONLY FOR ONE SHIFT AND NOT EXTENDABLE Description of Task: Location / Area : Panel No : Voltage: Permit Validity: Time (from): _______Hrs. Time (To): __________Hrs. Date: 3. Prerequisites: (To be filled by initiator/originator and verified by Evaluator) No: Checks Yes-No-NA Checks Yes-No-NA ENERGIZATION (“Power On”) ISOLATION (“Power Off”) 1. Safety tool box briefing done. ☐ ☐ ☐ Method statement/Risk assessment in place. ☐ ☐ ☐ 2. Authorized personnel / operators available. ☐ ☐ ☐ Authorized personnel / operators available. ☐ ☐ ☐ 3. Method statement/Risk assessment in place. ☐ ☐ ☐ Adjacent live areas protected. ☐ ☐ ☐ 4. Safety Barriers in place and safety signage Displayed. ☐ ☐ ☐ PPE available, high voltage rubber gloves, Safety goggles and floor mat. ☐ ☐ ☐ 5. Working area is well lighted. ☐ ☐ ☐ Isolation/Lock-out in place. ☐ ☐ ☐ 6. Electrical instruments are available for any Purpose. ☐ ☐ ☐ Electrical circuits “proved” by calibrated Instrument and found out to be no power. ☐ ☐ ☐ 7. Correct PPE available, high voltage rubber Gloves, safety goggles and floor mat. ☐ ☐ ☐ Unauthorized workers are cleared from the Area. ☐ ☐ ☐ 8. Approved WIR for installation, testing and Termination are attached to the permit. ☐ ☐ ☐ Standby operatives in the event of contact With live circuits. ☐ ☐ ☐ 9. Emergency light (Flashlight) available. ☐ ☐ ☐ Emergency light (Flashlight) available. ☐ ☐ ☐ 10. Is live work absolutely necessary? ☐ ☐ ☐ Emergency response plan available ☐ ☐ ☐ 11. Unauthorized workers are cleared from the area. ☐ ☐ ☐ Other ( Specify): ☒ ☐ ☐ 12. Power cable route from panel board to plant & equipment has been checked ☐ ☐ ☐ 13 Emergency response plan available ☐ ☐ ☐ 14 Other ( Specify): ☐ ☐ ☐ 4. Acknowledgement by Initiator and Evaluator: ☐ Acknowledge that all above precautions have been taken. These have also been fully explained to the operatives, and I consider them competent to do it safely. Initiator/Originator Name: Designation: Signature: Date /Time: ☐ Acknowledge that I have checked above control measures and consider the work area safe to carry out the activity Evaluator (HSE Team): Designation: Signature: Date /Time Comments (if any): 5. Authorization (PM/CM): Name: Designation: Signature: Date /Time: 6. Completion/Cancelation of Permit: ☐ Acknowledge that the area have been restored to a safe and orderly condition. Initiator Signature: Time: ☐ Acknowledge that I have checked the area and been restored to a safe and orderly condition. Evaluator Signature: Time:

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Project Information Project Name: Date: Location: Sr. Equipment type / Name Registration No & Exp Date Company Name Operator Name / Mb. No Operator Third party competency certificate expiry date Operator License expiry date Equipment & Plant 3rd Party Inspection Certificate expiry date SWL / Capacity Signalman /Rigger name & TPC Exp Comment 1 2 3 4 5 6 7 8 9 10. Remarks: Inspected By: Signature: Reviewed By HSE Manager / In charge: Signature:

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Accommodation Name: Date : Accommodation Location: Time : SN Description Yes NO N/A Observation Control Measures Due Date ACCESS AND EGRESS 1 Is there segregation between vehicles/ pedestrians 2 Is entry to inside camp restricted to workforce only? How is this controlled 3 Is the entrance well lit 4 Is the entrance free from water pooling GENERAL HOUSEKEEPING 1 Are there adequate dustbins available? Are they covered 2 Is garbage disposed of on a regular basis? 3 Are toilets wash areas cleaned regular? 4 Is there adequate water for toilet and bath 5 Are water tanks kept covered at all times 6 Is soap and hand towels available? 7 Is bathroom area cleaned on a regular basis and kept dry and non-slippery 8 Is the water tank cleaned on a regular basis 9 Is the laundry area electrical & connections/ wires are in good condition. 10 Is the laundry area kept clean and dry 11 Is the tumble dryer filters cleaned frequently to prevent overheating SEPTIC TANKS 1 Is the camp on main drainage? 2 If not are septic tanks provided? 3 Are septic tanks fitted with overflow alarm if not how are they prevented from overflowing 4 If septic tank in ground is it in a membrane? 5 If above ground is it protected from being hit by vehicular traffic? FOOD PREPARATION AREA 1 Is the area kept clean and tidy 2 Are food preparation areas cleaned and free from cracks 3 Are signs for "No smoking" being posted 4 Food waste storage area is cleaned, odour free. Flies area controlled 5 Floor drains are provided in sink area 6 All refrigerators and freezers are working at correct temperatures Refrigerators 1c0 to 4c0 Freezers -14c0 to -18c0 7 Are there temp gauges fitted? 8 Are these temperatures recorded? 9 The Dining and Kitchen areas have an overall clean, tidy and well maintained appearance 10 LPG cylinders are of good conditions (free of damages) 11 Is storage of LPG satisfactory under shed & outside kitchens with no flammable materials nearby 12 Are Piping not perished 13 Are firefighting equipment provided in kitchen area? LIVING QUARTERS 1 Are Ventilation working well 2 Is lighting suitable 3 Are Emergency numbers being posted in each room 4 Are emergency procedures posted in each room 5 Are Electrical sockets in good condition not damaged & no bare wires are placed in sockets 6 Are sockets overloaded 7 ELCB is provided checks carried out and recorded by

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INCIDENT INVESTIGATION REPORT (To be submitted to the HSEQ Corporate Office within 7 days of incident.) 1. Project Information: Project Name: Click here to enter text. Report No.: Click here to enter text. Project Location: Click here to enter text. Property No.: Click here to enter text. ☐ Fatality ☐ Major Incident ☐ Minor Incident 2. Describe the Incident in detail: Answer who, what, why, where, when & how in this section: (Attach additional pages if required) Click here to enter text. ☐ Photos Attached 3. Incident Root Causes: Describe direct, indirect & root cause: (Attach additional pages if required) Click here to enter text. 4. Key Corrective Actions to Prevent Recurrence: Describe the corrective actions with timeframe: (Attach additional pages if required) Click here to enter text. 5. Key Corrections Taken Immediately after the Incident: Attach additional pages if more space is required: Click here to enter text. 6. Witnesses: I declare that I witnessed the incident and the information provided above is true, correct and complete. No. Name Designation Signature Date 1. Click here to enter text. Click here to enter text. Click here to enter text. 2. Click here to enter text. Click here to enter text. Click here to enter text. 7. Incident Information: Initial Incident Report No.: Click here to enter text. Date Reported: Click here to enter text. Date of Incident: Click here to enter text. Time of Incident: Click here to enter text. Type of Incident: ☐ Near Miss ☐ Major Environmental Incident ☐ Serious Dangerous Occurrence ☐ Equipment / Property Damage ☐ Medical Treatment Case (MTC) ☐ Restricted Work Case (RWC) ☐ Lost Workday Case (LWC) ☐ Serious Occupational Illness/Disease ☐ Class 1 Injuries ☐ Permanent Partial Disability (PPD) ☐ Permanent Total Disability (PTD) ☐ Fatality (F) Recordkeeping: ☐ Reportable ☐ Recordable Incident Location on Site: Click here to enter text. Applicable Reports: ☐ Police ☐ Medical ☐ Other (Specify) Click here to enter text. Attached: ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No 8. Injured Person’s Personal Details: In case of an incident with more than one injured person, complete the information for each person using separate forms. Name: Click here to enter text. Occupation: Click here to enter text. Company: Click here to enter text. MB / Oracle No.: Click here to enter text. Nationality: Click here to enter text. Date of Birth: Click here to enter text. Passport Number: Click here to enter text. Length of Service: Click here to enter text. Gender: ☐ Male ☐ Female Labour Card No.: Click here to enter text. 9. Incident Causes Details: To be supported with factual evidence Immediate Cause (Unsafe Acts) ☐ Failure to secure ☐ Failure to warn ☐ Removing / Defeating Safety Devices ☐

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HSE INDUCTION (Workers) Name: _________________________________ Trade: ____________________________ M.B. No./Company Name : ________________ Date of Joining: __________________________ SL. N SUBJECT ON INDUCTION PREVIOUS SAFETY EXPOSURE FURTHER SAFETY TRAINING NEED ANALYSIS 1. Introduction Safety Requirements 2. Working Safety is of Primary Importance 3. General Safety Rules 4. Basic Safety Requirements 5. House Keeping 6. Health, Hygiene & Welfare Facilities 7. Fire Extinguisher / Fire Fighting 8. Emergency Procedure 9. Safety Violations & Penalty 10. Safety Award 11. Manual Handling Induction Given By: Name: ___________________________ Designation: ___________________________

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Dwarika Bhushan Sharma

1st Warning 0 Ref. No. ______________ 2nd Warning 0 3rd Warning 0 4th Warning 0 Date: ________________ Employee’s Name : ______________________________________ M.B No. : __________ Occupation : _____________________________________________________________________ Location / Project Site: _____________________________________________________________________ You have committed the following HSE violation/s: ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….…. The employee is hereby warned that if the violation is repeated further disciplinary action can be taken as per the company Code of Conduct. ORIGINATOR APPROVED BY (MANAGER IN CHARGE / ARABTEC HSEQ & ORG. RISK Manager) Name: _______________________________ Name: _____________________________ Designation: _______________________________ Designation: _____________________________ Signature: _______________________________ Signature: _____________________________ Employee Acknowledgement: I the undersigned have received this Safety warning letter / disciplinary notice and I admit that I have understood the contents. 0 Received on: ………………………….. (Date) Signature: ………………………………..…..

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Project Information Project Name: Porta Cabin No: Location: Contact Person: Company Name: Date : Sr. Description Yes No N/A Comments 1. Emergency exit signs are available in right locations 2. Fire alarms and fire extinguishers are visible and accessible. 3. Fire doors (e.g. in stairways) are kept closed unless equipped with automatic closing device 4. Fire extinguishers are serviced regularly 5. Corridors and stairways are kept free of obstruction 6. Fire escape/ evacuation plan available and posted 7. First aid box available 8. Floor surfaces are kept dry and free of slip hazards 9. Electrical cords and plugs are in good condition with proper Grounding 10. Kitchen equipment checked 11. Fire blanket available in the pantry 12. Heat detector available in the pantry 13. Toilets floor clean and dry 14. Are staff trained to use Fire Extinguishers 15. Hand wash/ soap solution available in the toilet 16. Civil Defense or Authority approval 17. Others if any: Remarks: Inspected By: Signature: Reviewed By HSE Manager / In charge : Signature:

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Dwarika Bhushan Sharma

MEDICAL REPORT FORM Day _____________ Date ____________ Time ____________ To: _________________________________________________________________________________________________________ Dear Sir, We would kindly request you to give necessary treatment to our following employee who had met with an accident and provide us with your diagnosis. Name of injured __________________________________________________________ Age ( ) years. Occupation __________________________________________________________ M.B. No. _______________________________ Date of Accident ____________________________________________ Time of Accident __________________________________ Place of Accident (Project Name) _______________________________ Location _________________________________________ Nature of Accident ____________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ First Aider Name: ________________________________ SE Manager/Incharge: ________________________________ Signature: ________________________________ Signature: ________________________________ (If Medical Certificate is attached, this portion is not required.) MEDICAL REPORT Nature and extent of Accident / Injury____________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Fit for duty___________________________________________________________________________________________________ Unfit for duty_________________________________________________________________________________________________ Remarks_____________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Signature of Medical Officer Date _______________

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Project Information Project Name: Company Name: Date : ID NO TYPE OF LIFTING GEARS LOCATION VISUAL INSPECTION THIRD PARTY INSPECTION VALID TILL MONTHLY COLOUR CODE ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK ☐ OK ☐ Not OK Remarks: Inspected By: Signature: Reviewed By HSE Manager / In charge : Signature:

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Harness Checklist Sl. No ………. Sl. No ………. Sl. No ………. Sl. No ………. Sl. No ………. Sl. No ………. Sl. No ………. Sl. No ………. Sl. No ………. Remarks Shoulder Straps Chest & Back Straps Waist Straps Back D-Ring Shoulder Adjustment Legible Label Shoulder Straps Chest & Back Straps Waist Straps Leg Straps Cuts Burns Holes Deterioration Corrosive/ worn out Color code Others (Specify) Project Information Project Name: Location: Company name : Date: Remarks: Inspector Name: Signature: Reviewed By HSE Manager / Incharge Signature:

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Project Information Project Name: Location: Company Name: Date : Sl. No Description Yes No N/A Comments 1. Properly stored, labeled, ventilated, isolated, Log and suitable signs displayed. 2. Material Data Safety Sheet (MSDS) available, and communicated to concerned personnel. 3. Adequate/ Sufficient firefighting equipment are in place. 4. Emergency escape and breathing apparatus available, tested and in good condition. 5. Hazardous substances containers/drums have eligible labeling and protected from leakages or spillage. 6. Personnel must be trained in chemical handling. 7. Emergency control plan must be made available, spillage control kits must be available. 8. Empty hazardous substances containers, drums and receptacles should be properly maintained and controlled. 9. Expired chemicals are logged, segregated and disposed properly 10. Others Specify Remarks: Inspected By: Signature: Reviewed By HSE Manager / In charge : Signature:

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Project Information Project Name: Concrete Pump Reg. No: Location: Operators Name: Company Name: Date : Sr. Description Yes No N/A Comments 1. Concrete Pump 3rd Party Certificate & Registration 2. Sonographic test of all pipes 3. Calibration of all the pressure gauges 4. Operator’s Competency Certificate & Driver’s License 5. Safe distance from the edge of the excavation 6. Outrigger pads are free from damage 7. Outriggers are level 8. Reverse alarm and beacon light are operational 9. Whip arrester on the pipes and pump 10. Safe access for concrete mixer to the area (In/Out) 11. Area properly barricaded and signage posted 12. Hydraulic Oil / Diesel Leakage 13. Extension Pipeline - Free from damage 14. Extension Pipeline -Locking pin in every connection 15. Extension Pipeline - Adequately supported & secured 16. Spillage control measure in place 17. Other accessories e.g. spider pacing boom 3rd party certificate 18. Static pumps positioned properly 19. Static pumps – concrete pipes fixed on structure as per design 20. Concrete pipes coupler pins provided 21. Concrete pipes on floor – away from scaffolds/ formworks 22. Competent banks man and supervision provided 23. Others (Specify) Remarks: Inspected By: Signature: Reviewed By HSE Manager / In charge : Signature: Noted by Project Leader Signature:

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Project Behavioral Observation Form Process Observed Works Package Subcontractor / CName Date _ _ /_ _ /_ _ Time from ______ to ______ Duration Mins _____ Checklist attached ☐ Video ☐ Photo (s) ☐ Observation Summary (Ref checklist for details) Safe ☐ Unsafe Acts ☐ Safe ☐ Unsafe conditions ☐ Status: A. All activities conducted in a safe manner ☐ No negative observations B. Generally conducted in a safe manner ☐ Some aspects of the process require improvement C. Partially conducted in a safe manner ☐ One aspect of a task needs improvement D. Some individual lapses ☐ One person working unsafely part of the time E. Generally conducted in unsafe manner ☐ More than one person working unsafely ATC Engineer-in-charge Supervisor Follow up Action ☐ Analysed by HSE Manager and responsible person _________________ ☐ Reported / shown to team observed ☐ Recommended Action ☐ Follow up recommendation

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