1、DPLNG Incident Report Form Minor Incident / Preliminary Report for Serious Incidents1. GENERAL INFORMATIONREPORT NO.Report Title承包商无作业许可证作业事故报告Contractor working without permit incident report Work Process Involved消防楼改造 Fire building modification Type of Incident未遂事故Near MissDate of Incident2011/08/
2、29 9:00am 2. CONSEQUENCEParties InvolvedInjuryProperty DamageGDLNGNoneNoneContractorNoneNoneThird PartyNoneNone3. INCIDENT DESCRIPTION2011年8月29日，早上9：00点多，承包商主管余智福先生到消防楼改造现场检查，发现有些工人没有佩戴安全眼镜, 也没有看到宝鹰现场负责人曾秋华和安全员于洪成，马上打电话要求他们立即来到现场。他们答复半小时回来但直到12点多才来到现场。Shortly after 9:00am on August 29, the contracto
3、r supervisor, Mr. Yu Zhifu checked fire building modification site and found some Bao Ying workers dont wear safety glasses as well as the site responsible people, Mr. Zeng and Mr. Yu Hongcheng arent at present, he immediately called them and requested them to terminal as soon as possible, they prom
4、ised to come back to terminal within half hour but they showed up in terminal after 12:00am. 大约10：00点时候，倒班监督冯道荣发现宝鹰公司工人在施工，有些工人没有佩戴合适的PPE，也没有作业许可证，立即停止他们的工作，随后向接收站经理汇报，通知了安全工程师和大鹏公司工作联系人何金根。 About 10:00am, shift supervisor Mr. Feng Daorong found Bao Ying workers working without permit and some worke
5、rs not wearing proper PPEs, so he stopped their work immediately and reported to terminal supervisor, notified safety engineer and GDLNG contact person, Mr. He Jingen. 调查发现，8月28日从下午3点直到下班，宝鹰公司现场负责人曾秋华和安全员于洪成都没有在接收站，而工作仍然进行，也没有归还工单。It was found that the site responsible people, Mr. Zeng and Mr. Yu Ho
6、ngcheng werent in terminal while work still ongoing in modification site from 3:00pm to off time on August 28, the permit wasnt returned. 8月29日上午8点，倒班监督冯道荣因为宝鹰公司28号没有及时归还许可证，且临时派来申请许可证的人没有资格，拒绝签发宝鹰公司的作业许可证。随后大鹏公司工作联系人何金根与冯道荣进行了协商，电话要求宝鹰公司现场负责人尽快赶回接收站。 About 8:00am on August 29, shift supervisor, Mr.
7、 Feng Daorong refused to issue permit to Bao Ying company due to they didnt returned permit in time on August 28 plus the temporary permit applicant didnt receive PTW training. Afterwards he discussed with GDLNG contact person, Mr. He Jingen, made phone call to urge Bao Ying site responsible people
8、to come back to terminal as soon as possible. 目前，宝鹰公司仍然在停工等待处理。Until now, fire building modification work is still on suspension. 4. CRITICAL FACTORS, CAUSE ANALYSISCritical Factors1. 无许可证作业 Work without PTW. 2. 没有佩戴合适的PPE. No wearing proper PPE. Immediate CausesNote (briefly list supporting evidenc
9、e) 遵守工作程序方面：集体违规Following procedures: violation by group. System CausesNote (briefly list supporting evidence)行为：对关键的安全行为没有充分的认识Behavior: inadequate identification of critical safe behaviors. 行为：（其他）赶工期，节省时间。 Behavior: (other) Save time to catch up schedule. 事故性质和责任认定 Incident responsibility categor
10、y and responsible party 1. 事故性质 Incident responsibility category 责任事故 safety responsibility incident 2. 责任方 Incident responsible party宝鹰公司 BaoYing company 3. 责任人 Incident responsible person曾秋华 Zeng Qiuhua1. ACTION TRACKINGNoActionResponsible PersonTarget Date1培训宝鹰现场作业人员，强化PTW及PPE和相应安全程序。 Gave PPE an
11、d PTW training to BaoYing site employees. 邹龙山Zou LongshanSept 1, 2011(done)2要求宝鹰公司制定切实有力的安全改进措施。 Request Bao Ying company to make solid remedial measurements to improve safety performance. 余智福Yu Zhifu Sept 1, 20113对宝鹰公司按照合同和大鹏公司的政策进行经济处罚Fine BaoYing company according to contract and GDLNG policy. 王庆
12、文Wang Qinwen Sept 15, 2011 4Share this incident in monthly safety meeting to enhance site staffs safety consciousness.在月度安全会上分享此次事故，提高现场作业人员的安全意识。邹龙山Zou LongshanSept 15, 20112. MANAGEMENT COMMENTS3. INVESTIGATION TEAMInvestigation Team LeaderTeam MembersNameZou Longshan Zhang Ge Yu Zhifu Feng Daoron
13、g He Jingen Lv Zhijun CompanyGDLNG GDLNG GDLNGGDLNG GDLNGGDLNG Job TitleHSSE Engineer HSSE EngineerContractor Supervisor Shift SupervisorCivil Engineer Sr. OperatorATTACHMENTS TO REPORT (only when necessary)GDDP LNG Incident Investigation Report Form for Minor Incident / Preliminary Report for Serious Incident
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