Project
Accident - Incident Report
Transmission Line Works
Type of Personnel injury Security breach Fire / explosion Other:
incident Work related Accidental pollution Community relations Environmental
illness Motor vehicle incident Incident.
Material damage accident Near miss
Time and Location: Moglica Road Lot2 Km from 18+544 to 23+300
place
Date Time □ During working hours Organisational unit:
02.03.2014 12:00PM □ During business travel Truck’s Team
□ During leisure time
Employee Employee no. Name:
Info.
Date of birth Occupation / position
11.10.1991 Truck Driver
Company/Department / Employer
Company
Description Main activity at the time of the event?
of incident / Excavator was charged on the tugboat.
events /
illness How did the incident occur?
When the legs of tugboat was closed the hydraulic pump of tugboat legs is broken and the
hydraulic oil was spilled on the asphalt. The spilled hydraulic oil was somewhere to 4 or 5
Litres.
Machinery, tools, chemicals or materials involved?
None
Injury or Describe injury / damage / type of Lost-time injury Other incl. first aid injury
damage illness Restricted work case Emergency preparedness
injury organisation mobilised
info. Medical treatment injury
Eyes Hand, wrist Amputation Fracture
Head, face Leg Burn, scald Hernia
Back Feet, ankles Concussion Bruise
Trunk Internal Crushing Sprain, strain
Arm Other Cut, puncture Other
Deviations Equipment Inspections was not made at right time.
Causal The pulley of the hydraulic oils was deadlocked and consequently oil pressure was damaged
analysis the counter valve.
Actions 1.The truck Driver was close all the hydraulic pipelines to avoid as little oil leaking.
taken
Actions to prevent recurrence: Responsible Due date
We send the Tugboat to Mechanical Departament
and they repaired all the leaks problem at this Eng. 03.08.2014
truck.
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Project
Accident - Incident Report
Transmission Line Works
Signatures Date Resp. Supervisor Date Reported by
08.08.2014 08.08.2014 Arber Dogani
Where applicable has the relevant regulatory authority been informed? Yes
DHP Observation Corrective Actions Taken
Comments: Oil Of New Asphalt Surfacing on Lot 2 road 1 Comments: For emergency we clean the asphalt only
with water because is very difficult to find oil
washing products for asphalt in a Albania, but we
assure you that next month during September we
have order to buy abroad ( Oil Spill Clean Up for
Concrete, Asphalt, Soil to protect the
Environment.)
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