ATTACHMENT A-1b

LAND TRANSPORT AUTHORITY

SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM LTA REF NO :

Incident Title

Name of Main Contractor: TCSJV Report Ref. No : TCSJV/IOR/2024/0022

PART A (Type of Incident)

Dangerous Occurrence Near miss Near Miss (Cat A) Damage to property
(MOM Reportable)

Dangerous incident Security violation Damage to utilities Fire

Road incident Other occurrence Crime

PART B (Details of Incident)

PROJECT : P103 CONTRACT :

EXACT LOCATION : Utility Corridor - CS

OCCURRENCE DATE : 24 October 2024 OCCURRENCE TIME : 1540 hrs

REPORTED DATE : 24 October 2024 REPORTED TIME : 1545 hrs

COMPANY RESPONSIBLE FOR INCIDENT : Raito Kogyo

PART C (Persons involved in the Incident)
A B C
NAME : B Thirumurugan Marimuthu Selvam Subramaniyam Sankar

DESIGNATION : RES Excavator Operator Banksman

COMPANY : Raito Kogyo Raito Kogyo Raito Kogyo

Status (you may tick more than one) :

Witness Incident LTA Main Contractor’s Subcontractor’s Visitor Public Self Others :
Reporter Personnel Personnel Personnel Employed

C
PART D (Details of Damage to Property)
Main Contractor’s property LTA property NOT APPLICABLE

Subcontractor’s property Public property Others :

PART E (Details of Damage to Utilities)

Electrical Gas Sewer Water Traffic NOT APPLICABLE

Multiple Utilities Damages Telecoms Others :

 ATTACHMENT A-1b
LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM
PART F (Description of Incident)

WHAT HAPPENED ? HOW DID IT HAPPEN ? WHAT WERE THE CONSEQUENCES ? PLEASE ATTACH PHOTOGRAPHS
AND SKETCHES.

On 24 Oct 2024 at approximately 2:50PM, Raito Site Supervisor Thiru, was directed by
other subcon RES to widen a 1m deep excavation for the installation of steel plate
protection
adjacent to a live 6-way Singtel/NLT cable. REO Marimuthu Selvam and Banksman
Shankar was then activated to shift the existing steel plate, which originally positioned
beneath the
excavator, to facilitate the trench widening. While attempting to shift the steel plate, Thiru
observed a 30mm black bare cable (SPPG LT Cable without slab). He immediately
instructed the excavator operator to stop, but sparks were still generated as the steel plate
grazed the
cable's insulation. They immediately stops works and inform their superior.Cable jointer
from SPPG, activated by Raito, arrived at approximately 5:30 PM to rectify the affected
cable and was rectified by 545pm.SPPG were informed of the occurrence by JV UE, and
was told that this cable is not in their plan. The incident also did not trigger anything from
their system.
Upon investigating, this LT cables serves to the substation in Mindef Camp to power up their
light. No stakeholders were affected and there was no feedback from Pasir Ris Camp.
 Location of Cable damaged LT Cable repaired LT cable was from OG Box 099 7C 4091

ATTACHMENT A-1b
LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM
PART G (Causes of Incident)

(1) Direct Causes

(i) Unsafe Conditions

Absence of safety means Inadequate warning system
Congestion / restricted action Inadequate / improper PPE
Dressing / apparel hazard Inclement weather conditions
Environmental hazard (gas / dust / smoke) Noise hazard
Floor surface hazards (slips / trips / falls) Poor housekeeping
Hazardous arrangement Presence of fire / explosion hazard
High temperature hazard Radiation hazard
Improper / faulty equipment Unknown ground conditions
Inadequate guarding / protection / precaution Unsound structure
Inadequate illumination No unsafe condition
Inadequate ventilation
Remarks :
NA

(ii) Unsafe Practice

Disregard instructions Not paying attention
Driving / operating error Operating / working at unsafe speed
Failure to secure / warn Operating / working without authority
 Horseplay Taking improper / unsafe position or posture
Improper use of fail to use PPE Taking shortcuts
Improper / unsafe lifting/carrying Tampering with equipment in motion
Improper /unsafe use of equipment/materials Under influence of alcohol/drugs
Improper / wrong use of bodypart Unsafe loading / mixing / placing
Intentional motive Wrong working methods
Making safety devices inoperative No unsafe practice
Remarks :
NA

(2) Root Causes

(i) Work Factors

Inadequate equipment being used Lack of co-ordination / communication
Inadequate / lack of engineering Poor selection / placement
Inadequate / lack of maintenance Pressure from external influence
Inadequate / lack of supervision Wear and tear
Inadequate / lack or work procedures No work factors
Remarks :
NA
 ATTACHMENT A-1b
LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM
(ii) Human Factors
Fatigue Lack of skill
Foul play Lack of training
Illness Needs conflicting with safety
Improper assignment of personnel Not qualified
Improper or lack of motivation / interest Unsafe attitude
Inadequate capability No human factors
Lack of knowledge
Remarks:
NA

(3) Weakness of Safety Management System

Safety policy Safe work practices
Safety training Group meetings
Incident investigation and analysis In-house safety rules and regulations
Safety promotion Evaluation, selection and control of SC
Safety inspections Maintenance regime for all machinery
Hazard analysis Control of movement and use of
Emergency preparedness hazardous substances and materials
Occupational health programs Not applicable
Remarks:
NA

PART H
RECOMMENDATION ACTION TAKEN

1. Safety Briefing conducted : 25/10/2024.

1. Conduct safety briefing to the team of
workers with regard to the incident. 2. Instructions was given to re-do cable
detection works by LCDW.
2. Site charge to conduct daily Utility
Briefing and enforce the importance 3. Conduct more trail trench to detemine all
of Utility Damage prevention newly discovered services provided bt the
LCDW

4. Review of internal communication. Moving

forward nsure proper dissemination of
updates on site condition.

5. Enforced all modification on site

(removing/laying new pipes) . the As built
have to be recorded and updated in the
CUD.
 ATTACHMENT A-1b
LAND TRANSPORT AUTHORITY
SAFETY, HEALTH AND ENVIRONMENTAL
MANAGEMENT MANUAL
INCIDENT OCCURRENCE REPORT FORM

PART J (Details of Investigating Person)

NAME : Khidir

DESIGNATION : Senior Utilities Engineer

COMPANY : TCSJV

TEL : DATE : 20 / 11/2024 SIGN :

PART K (Reviewed By)

NAME : Farhan Shah

DESIGNATION : WSHM

COMPANY : TCSJV

TEL : 96559554 DATE : 20 / 11/2024 SIGN :

PART L (Form Completed By)

NAME : Zainal

DESIGNATION : WSHO

COMPANY : TCSJV

TEL : 87422843 DATE : 20 / 11/2024 SIGN :