Reporting of Serious HSE Incidents

ABU DHABI NATIONAL OIL COMPANY

CODE OF PRACTICE ON REPORTING OF SERIOUS HSE INCIDENTS (TO ADNOC) ADNOC-COPV1-08

HEALTH SAFETY AND ENVIRONMENTAL MANAGEMENT MANUAL OF CODES OF PRACTICE

VOLUME 1: HSE ADMINISTRATION

HSE MANAGEMENT CODES OF PRACTICE Volume 1: HSE ADMINISTRATION

Version 1 January, 2005

COP ON REPORTING OF SERIOUS HSE INCIDENTS (TO ADNOC)

Document No: ADNOC-COPV1-08 Page 2 of 21

RECORD OF REVISION

Revision No. Date Section/Page Reason

Copyright

The copyright and all other rights of a like nature in this document are vested in Abu Dhabi National Oil Company (ADNOC), Abu Dhabi, United Arab Emirates. This document is issued as part of the Manual of HSE Codes of Practice (the “Manual”) and as guidance to ADNOC, ADNOC Group Companies and independent operators engaged in the Abu Dhabi oil & gas industries. Any of these parties may give copies of the entire Manual or selected parts thereof to their contractors implementing HSE standards in order to qualify for award of contracts or for the execution of awarded contracts. Such copies should carry a statement that they are reproduced by permission of ADNOC, and an explanatory note on the manner in which the Manual is to be used.

Disclaimer

No liability whatsoever in contract, tort or otherwise is accepted by ADNOC or any of its Group Companies, their respective shareholders, directors, officers and employees whether or not involved in the preparation of the Manual for any consequences whatsoever resulting directly or indirectly from reliance on or from the use of the Manual or for any error or omission therein even if such error or omission is caused by a failure to exercise reasonable care.

All administrative queries should be directed to the Manual of HSE Codes of Practice Administrator in: Environment Health & Safety Division, Exploration & Production Directorate, Abu Dhabi National Oil Company, P. O. Box : 898, Abu Dhabi, United Arab Emirates. Telephone : (9712) 6023782 Fax: (9712) 6668089 Internet site: www.adnoc.com E-mail: [email protected]




Document No: ADNOC-COPV1-08 Page 3

CONTENTS PAGEI. PURPOSE............................................................................................................ 4 II. DEFINITIONS....................................................................................................... 4 III. EXISTING LAWS................................................................................................. 5 1. INTRODUCTION.................................................................................................. 6 2. WHAT CONSTITUTES A ‘SERIOUS INCIDENT’................................................ 7

2.1 Definition..................................................................................................... 7 2.2 Consequence / Severity Categories ......................................................... 7

2.2.1 People............................................................................................... 7 2.2.2 Assets............................................................................................... 8 2.2.3 Environment..................................................................................... 8 2.2.4 Reputation........................................................................................ 9

3. REPORTING REQUIREMENTS ........................................................................ 10 3.1 When to report a ‘Serious Incident’ ........................................................ 10 3.2 How to report a ‘Serious Incident’ .......................................................... 10

4. RESPONSIBILITIES .......................................................................................... 11 4.1 Group Companies .................................................................................... 11 4.2 ADNOC Control Room ............................................................................. 11 4.3 ADNOC Duty Managers ........................................................................... 12 4.4 Crisis Management Support Group (SPC) ............................................. 12 4.5 ADNOC EH&S Division ............................................................................ 12

5. SPECIAL REQUIREMENTS FOR SERIOUS ENVIRONMENTAL INCIDENTS 13 5.1 Introduction .............................................................................................. 13 5.2 Reporting Requirements ......................................................................... 13 5.3 Sampling & Analysis Requirements for Incidents Involving Dead Marine

Animals ..................................................................................................... 14 5.3.1 Determining Ambient Conditions................................................. 14 5.3.2 Animal Tissue Samples................................................................. 14 5.3.3 Sample Labelling ........................................................................... 14 5.3.4 Tissue Laboratory Analysis Requirements ................................. 15

5.4 Sampling & Analysis Requirements for incidents Involving Algae Blooms and/or Water Contamination ..................................................... 16 5.4.1 Determining Ambient Conditions................................................. 16 5.4.2 Algae and Water samples ............................................................. 16 5.4.3 Sample Labelling ........................................................................... 16 5.3.4 Algae or Water Sample Laboratory Analysis Requirements ..... 17

5.5 Completed Sample Analysis Reprorts ................................................... 17 REFERENCES ........................................................................................................ 18 Appendix 1 ‘Serious Incident Initial Notification Form’...................................... 19





I. PURPOSE This document replaces two previous ADNOC Group Guidelines:

• ‘Reporting of Serious HSE Incidents to ADNOC’ (17 April 2001)

• ‘Reporting of Environmental Incidents’ (1 June 1997)

Both these documents are now obsolete. ADNOC, as the regulator for HSE in the Abu Dhabi oil and gas industry, requires a timely and accurate overview of all HSE incidents that have occurred. Specifically incidents with serious actual or potential consequences need to be communicated immediately to ADNOC, to enable early analysis with a view to potential requirements for dissemination of incident information i.e.:

• Within the ADNOC Group of Companies or parts thereof.

• To ADNOC Partners and/or other stakeholders.

• To Abu Dhabi or UAE Authorities.

• To Abu Dhabi, UAE or international media.

This Code of Practice establishes the procedure that Group Companies must follow when reporting serious HSE incidents to ADNOC. The principle objectives of the procedure are to: a) Provide a uniform mechanism to distinguish what constitutes a ‘serious

incident’. b) Set a reporting timeframe to ensure timely reporting (to ADNOC) c) Define communication procedures to ensure that all relevant parties (in

ADNOC as well as outside) are informed of incidents that have occurred. d) Obtain relevant incident details from which ADNOC management may

conclude that ADNOC, as the regulator for HSE, must play a role in the subsequent or ongoing detailed incident investigation activities.

This Code of Practice does not aim to replace internal Group Company procedures for incident reporting and/or investigation. Incident investigation and follow-up will at all times be the responsibility of the Group Company in which the incident has occurred.

II. DEFINITIONS Incident An event or chain of events which has caused or could have caused fatality, injury, illness and/or damage (loss) to assets, the environment, company reputation or third parties.





Serious Incident A generic category which includes all incidents with actual or potential consequences of catastrophic, severe and critical nature.

HSE Alerts Communication (usually documented) with timely information on:

− changes in relevant HSE legislation or regulations − bans on potentially hazardous equipment, materials, chemicals,

practices or procedures − significant HSE information relevant to best practice

Fatality A death resulting from an injury or illness, regardless of the time intervening between injury and death.

Injury Physical harm or damage to a person resulting from traumatic contact between the body of the person and an outside agency, or from exposure to environmental factors.

Consequences Adverse effects or harm which cause the quality of human health or the environment to be impaired.

Severity The degree to which an agent hazardous to health can cause harm

Permanent Total Disability Any work-related injury or illness, which permanently incapacitates an employee from doing any work and results in termination of employment. * * Reference is made to the Federal Law of 1980 on Regulating Labour

Relations, which provides a detailed description of such injuries.

Near Miss An event or chain of events that could have resulted in fatality, injury, illness and / or damage (loss) to assets, the environment, company reputation or third parties.

Further detail on definitions is provided in the document ADNOC COP ‘Guideline on HSE Definitions & Abbreviations’ [Ref. 1].

III. EXISTING LAWS Reporting of HSE incidents is referred to in Federal Law No. 8 (1980) The Labour Law (as amended in 1986) - Ministerial Decision No. 32 on the Determination of Preventative Methods and Measures for the Protection of Labour from Risks at Work.

[1] ADNOC Code of Practice ‘HSE Definitions & Abbreviations’, ADNOC-COPV1-05.





1. INTRODUCTION ADNOC, in consultation with Group Companies, have defined a number of HSE performance reporting systems which: a) Ensure the uniform and timely reporting of serious HSE incidents from

Group Companies to ADNOC. b) Specify requirements for the periodic reporting of HSE data and statistics

from Group Companies to ADNOC. This system conforms with current best practice in performance measurement to allow valid comparisons and benchmarking:

− between Group Companies; and − between ADNOC and other high performing companies

internationally. c) Incorporate mechanisms for two-way communication and feedback

between ADNOC and Group Companies.

These objectives are addressed as follows:

Re a) This document, the ‘Code of Practice on Reporting of Serious HSE Incidents (to ADNOC)’ specifically addresses: − time limits set for reporting of such incidents − the methodology to be used for distinguishing between ‘serious’ and

other incidents − the details which are to be provided for each serious incident.

Re b) The required reporting frequency of HSE data and statistics is annually, in which the methodology must be followed as provided in the document ADNOC Codes of Practice ‘Directions for preparing the Annual HSE Letter’ [Ref. 2]. Additional guidelines for the periodic reporting of HSE data and statistics from Group Companies to ADNOC are provided in a number of other ADNOC Codes of Practice, which have yet to be finalised/approved.

Re c) ADNOC EH&S Division issues HSE Alerts to Group Companies concerning incidents that have occurred within as well as outside the ADNOC Group of Companies.

[2] ADNOC Code of Practice ‘Directions for preparing the Annual HSE Letter’, ADNOC-COPV1-07.





2. WHAT CONSTITUTES A ‘SERIOUS INCIDENT’

2.1 Definition An ‘incident’ is defined as

‘An event or chain of events which has caused or could have caused fatality, injury, illness and/or damage (loss) to assets, the environment, company reputation or third parties’ *.

A ‘serious incident’ is defined as: ‘A generic category which includes all incidents with actual or potential consequences of catastrophic, severe and critical nature.’

2.2 Consequence / Severity Categories The consequence or severity categories are taken from the ADNOC HSE Risk classification methodology, as described in the ADNOC Group Guideline ‘HSE Risk Management’ [Ref. 3]. These are defined in summary form as follows:

Severity People Assets Environment Reputation

Catastrophic Multiple fatalities or permanent total disabilities

Extensive damage

Massive effect International Impact

Severe Single fatality or permanent total disability

Major damage Major effect National Impact

Critical Major injury or health effects

Local damage Localised effect Considerable Impact

More detailed definitions of catastrophic, severe and critical severities (also taken directly from the ADNOC Group Guideline ‘HSE Risk Management’ [Ref. 3]) are given below for each of the categories people, assets, environment and reputation.

2.2.1 People

Severity Description

Catastrophic Multiple fatalities or permanent total disabilities – from an accident or occupational illness (poisoning, cancer)

Severe Single fatality or permanent total disability – from an accident or occupational illness (poisoning, cancer)

Critical Major injury or health effects (including permanent disability) – Affecting work performance in the longer term, e.g. prolonged absence from work. Irreversible health damage without loss of life, e.g. noise induced hearing loss, chronic back injuries

[3] ADNOC Group Guideline ‘HSE Risk Management’, March 2000.





2.2.2 Assets


Catastrophic Extensive damage – Substantial or total loss of operation (costs in excess of US$ 10,000,000).

Severe Major – Partial operation loss (2 weeks shutdown, costs up to US$ 10,000,000).

Critical Local damage – Partial shutdown (can be restarted but costs up to US$ 500,000).

2.2.3 Environment


Catastrophic Massive effect – Persistent severe environmental damage or severe nuisance extending over a large area. In terms of commercial or recreational use or nature conservation, a major economic loss for the company. Constant, high exceedance of statutory or prescribed limits

Severe Major effect – Severe environmental damage. The company is required to take extensive measures to restore polluted or damaged environment to its original state. Extended exceedance of statutory or prescribed limits

Critical Localised effect – Limited loss of discharges of known toxicity. Repeated exceedance of statutory or prescribed limit. Affecting neighborhood. Spontaneous recovery of limited damage within one year.

As a guideline, considering general focus in the UAE on environmental protection/conservation, and whilst recognising that at first glance these may not fit the above severity category descriptions in the strictest sense, the following instances constitute a ‘Serious Environmental Incident’:

Incident Scale Damage to flora or fauna − Kill of 20 fishes, birds or other animals at any one

location − Kill of 10 fishes, birds or other animals at each of

two or more locations − Kill of one or more large mammals or turtles − Widespread damage to vegetation (e.g. mangroves)

Oil spills − Single incident >1m3 − On the sea or land surface covering an area > 1 km2

− Affecting >100 m of shoreline Cont’d next page Algal blooms (widespread discoloration of seawater)

Affected area >1km2





Incident Scale Tainting of wells or any source of surface water

Any alleged incident

Chemical spillage Any spillage of one or more packages/containers that can have a significant impact on people or the environment [Ref. 20]

Accidental loss of hazardous waste

Any incident

Accidental loss/discharge of radioactive material

Any incident

Release of toxic, flammable or explosive substance

Any release which could have a significant impact on people or the environment [Ref. 20]

Public interest Any planned simulation exercise that could generate public interest.

2.2.4 Reputation


Catastrophic International impact – International public attention. Extensive adverse attention in international media. National/international policies with potentially severe impact on access to new areas, grants of licenses and/or tax legislation.

Severe National impact – National public concern. Extensive adverse attention in the national media. Regional/national policies with potentially restrictive measures and/or impact on grant of licenses. Mobilisation of action group.

Critical Considerable impact – Regional public concern. Extensive adverse attention in local media. Slight national media and/or local/regional political attention. Adverse stance of local government and/or action groups.

Note: Reputation also accounts for the liabilities arising from injuries and property damage to third parties including the cross liabilities that may arise between the interdependent ADNOC Group Companies.





3. REPORTING REQUIREMENTS

3.1 When to report a ‘Serious Incident’

All Serious Incidents* must be reported to ADNOC as soon as possible after they occur. The objective should be to provide ADNOC with a report within twenty-four hours of the incident occurring. * Note: This includes events that cause or could have caused fatality, injury,

illness and/or damage (loss) to contractors, visitors, other Group Companies or the public at large.

It will be noted that the ADNOC definition of ‘incident’ includes events which cause or could have caused injury, illness etc. It follows therefore that any event which could have resulted in catastrophic, severe or critical consequences should be classified as a ‘serious incident’ and must be reported in accordance with this Codes of Practice. These events are often referred to as ‘High Potential Near Misses’.

It is acknowledged that in some cases, particularly with respect to ‘High Potential Near Misses’, it may prove to be difficult to report these within twenty-four hours of the incident occurring. The objective in this case must be to report in the most timely manner possible.

It is not required to report less serious incidents (e.g. a Lost Time Injury where the person does not have ‘severe’ or ‘critical’ injuries) immediately to ADNOC immediately. These incidents will be reported to ADNOC as part of the requirements to submit safety and environmental data periodically, currently annually [Ref. 2].

3.2 How to report a ‘Serious Incident’

In all cases, the ‘Serious Incident Initial Notification Form’, as shown as Appendix 1, must be completed and faxed to: 1. ADNOC Control Room on Fax No. 6673766. The ADNOC Control Room is

manned 24 hours/day, 7 days/week. 2. ADNOC Crisis Management Support Group (SPC) on Fax No. 6661001. 3. ADNOC EH&S Division on Fax No. 6668089.

Subsequent to receiving the ‘Serious Incident Initial Notification Form’, ADNOC may request the reporting Group Company to provide additional information.

In addition, and specifically for serious Environmental Incidents, there may be conditions that require the completion of a special report as shown in Part 2 of Appendix 1. Refer to Section 5.2 for details.

[2] ADNOC Code of Practice ‘Directions for preparing the Annual HSE Letter’, ADNOC-COPV1-07.





4. RESPONSIBILITIES

4.1 Group Companies

All serious HSE incidents must be reported to ADNOC by the Group Company that has overall control of the site or operation where the incident has occurred. Where an incident in one Group Company impacts on another Group Company, the Group Company having control of the site where the incident was initiated must report the incident.

Where one Group Company is providing a service to another Group Company, the Group Company in overall control must report the incident. For example, if an incident occurs on an NDC rig while it is working for ADCO, ADCO must report the incident to ADNOC.

Specifically for serious environmental incidents, there may circumstances Group Companies must provide samples for subsequent analysis by ADNOC. Refer to Section 5.3. for details.

4.2 ADNOC Control Room

Upon receiving a ‘Serious Incident Initial Notification Form’ from any of the Group Companies, the ADNOC Control Room Supervisor must contact the relevant Duty Manager(s) from the concerned Directorate(s) and provide them with a copy of the report.

The relevant ADNOC Directorates are as follows:

• Exploration & Production: − Gas Processing Div.: GASCO; ADGAS − Offshore Div.: ADMA-OPCO; ZADCO; ADOC; TOTAL-ABK; BUNDUQ − Onshore Div.: ADCO; NDC

• Marketing & Refining: − ADNOC-Distribution, TAKREER, NGSCO, ADNATCO

• Chemicals Directorate: − BOROUGE, FERTIL

• Shared Services Directorate: − ESNAAD, IRSHAD

ADNOC Duty Managers must follow up the incident in accordance with their procedures and notify ADNOC senior management accordingly. Based on the gravity of the incident, the Senior Management of each respective Directorate will then inform the CEO.





4.3 ADNOC Duty Managers

ADNOC Duty Managers must follow up the incident in accordance with their respective Directorate procedures and notify ADNOC senior management accordingly. Based on the gravity of the incident, the Senior Management of each respective Directorate will then inform the CEO.

Any response or communication by ADNOC to outside parties will be a decision by ADNOC Senior Management. Such response should typically involve Public Relations and the responsible Line Directorate.

4.4 Crisis Management Support Group (SPC)

To be completed at a later date.

4.5 ADNOC EH&S Division

The role of ADNOC EH&S Division in responding to reported incidents is limited to:

• Maintaining a record of the reported incident with a view to incorporate these in corporate performance statistics.

• Providing advice in the context of specialist HSE issues, as requested by ADNOC Senior Management.

• Providing laboratory analysis of any samples that have been provided by the affected Group Companies in the context of serious environmental incidents.





5. SPECIAL REQUIREMENTS FOR SERIOUS ENVIRONMENTAL INCIDENTS

5.1 Introduction

Environmental management is a particularly sensitive issue in the UAE and the media may report on an incident without contacting ADNOC or the Group Company in which environmental incident has occurred. Such reports by the media may be inaccurate with regards to the significance of the incident as well as the ongoing activities to mitigate the consequences. Also, and as ADNOC Group operations cover a large geographical area, third parties (incl. the media) may report on any environmental incident and attribute this to ADNOC operations without verification. Such reports may affect corporate reputation.

It is therefore imperative that ADNOC management has early knowledge of and accurate information on environmental incidents that have occurred, or may be perceived as having occurred within the boundaries of the Group Companies. This includes events that may be considered insignificant by ADNOC and/or Group Companies, but could be perceived as significant by third parties.

It is therefore imperative that an accurate, timely and well-implemented reporting system is in place with which ADNOC management can prepare for such events with an appropriate corporate response to third parties, if required.

The procedural issues below specifically address reporting on serious environmental incidents, as defined in Section 2.2.3.

5.2 Reporting Requirements

In the event of a serious environmental incident Group Companies must as a minimum complete Part 1 of the Serious Incident Notification Form (see Appendix 1). In addition, and depending on conditions and circumstances of the particular incident, Group Companies must decide if there are benefits, for themselves and/or ADNOC, to completing Part 2 of the Serious Incident Notification Form (see Appendix 1). Part 1 and Part 2 (if completed) must be faxed to ADNOC as per the details provided in Section 3.2.

The above reporting requirements must also be followed if the incident is considered not to fall within the reporting criteria (see Section 2.2.3), but there is uncertainty as to the effect of the incident on Group Company or corporate reputation.





5.3 Sampling & Analysis Requirements for Incidents Involving Dead Marine Animals

5.3.1 Determining Ambient Conditions

An instantaneous instrument reading for water is required at locations where fish or other marine animals are found dead or floundering. [Do not collect these data if fish or other marine animal has been brought from somewhere else and/or is found already decayed]. The following parameters must be noted:

• Water temperature

• Air Temperature

• Dissolved Oxygen

• pH

• Colour of Water

• Note if non-attached algae present

5.3.2 Animal Tissue Samples

Tissue samples must be collected from dead marine animals (e.g. fish, turtle, crab, dolphin) for subsequent laboratory analysis. For each type of animal found dead the following tissue samples should be taken:

• Muscle tissue: 7 to 10 gm

• Liver: Whole liver for small fish or 10 gm of liver tissue for large fish.

• Heart: Whole

• Whole animal: If animal is smaller than 500gm

Samples should be placed into individual, clean containers, labelled and refrigerated or placed in cold box/ice chest on ice. All samples should be dispatched in an insulated chest surrounded by ice or may be frozen, but all must be maintained at 4oC or less.

On-shore samples should be sent as soon as possible to Abu Dhabi to ADNOC EH&S Div. Laboratory. Off-shore sample should be dispatched on the first available flight to Abu Dhabi, also to ADNOC EH&S Div. Laboratory.

If necessary ADNOC EH&S Div. Laboratory will arrange for the samples to be delivered directly to an ADNOC pre-approved third-party laboratory.

5.3.3 Sample Labelling

Each of the samples must appropriately labelled with:

• Name of person collecting sample

• Date and time of sample





• Location of animal when found (name of site with geographical map reference if possible) from which direction of the site)

• If multiple samples are taken from dame animal, please number these with same number followed by tissue type e.g. muscle, heart, liver, etc.

• Name of animal in English/Arabic (scientific name will be determined by the ADNOC EH&S Division laboratory)

• Condition of animal when found and sample taken e.g. dying, recently killed, bloated, partially decayed

• Air temperature maximum on the day of discovery/ finding


• Colour of water

• Current and wind direction.

5.3.4 Tissue Laboratory Analysis Requirements

Unless otherwise specified and/or deemed non-relevant, the tissue samples must be analysed for the following:

• Metals − Arsenic mg/kg − Cadmium mg/kg − Chromium(total) mg/kg − Cobalt mg/kg − Copper (total) mg/kg − Iron mg/kg − Lead mg/kg − Lithium mg/kg − Magnesium mg/kg − Mercury mg/kg − Molybdenum mg/kg − Nickel mg/kg − Vanadium mg/kg − Zinc mg/kg

• Non-metals − Cyanides mg/kg − Phenols mg/kg − Amine mg/kg





5.4 Sampling & Analysis Requirements for incidents Involving Algae Blooms and/or Water Contamination

5.4.1 Determining Ambient Conditions

An instantaneous instrument reading for water is required at locations where algae or water problems are suspected. The following parameters must be noted:


• Air Temperature

• Dissolved Oxygen

• pH

• Colour of Water

• Note if non-attached algae present

5.4.2 Algae and Water samples

Water sample(s) should be taken in the suspected area. The sample(s) must collected in appropriate, clean container(s) and must be preserved appropriately if required in a cold box/ice chest (temperature should be maintained below 4oC) for subsequent despatch. Do not freeze.

On-shore samples should be sent as soon as possible to Abu Dhabi to ADNOC EH&S Div. Laboratory. Off-shore sample should be dispatched on the first available flight to Abu Dhabi, also to ADNOC EH&S Div. Laboratory. All samples should be dispatched in an insulated chest surrounded by ice or maintained under 4oC. Do not freeze.

Samples for examination of algal blooms should be preserved with formaldehyde (5% by volume) or denatured alcohol (15% by volume). Each sample for algal examination should be accompanied by a separate one litre water sample for chemical analysis. The water sample should have no preservatives added and temperature should be maintained at 4oC

5.4.3 Sample Labelling

Each of the samples must appropriately labelled with:

• Name of person collecting sample

• Date and Time of sample

• Location taken

• Numbered sequentially

• Depth at which taken






• Air temperature (maximum for day)

• Colour of water

5.3.4 Algae or Water Sample Laboratory Analysis Requirements

Samples must be evaluated for the following unless otherwise specified:

• Preserved Sample (to be taken in a 125ml ‘Sterilin’ type sterilised container) must be analysed for the following: − Presence of pelagic Blue Green algae − Presence of diatoms or spiracles (associated with red or brown tide) − Presence of pelagic green algae

• Standard water samples (to be taken in a 1 litre glass ‘Duran’ type container) must be analysed for the following: − BOD − Ammonia − Oil and Grease − Colour − Total suspended solids − Conductivity − Salinity − Phosphate − Nitrite − Nitrate − Sulphides

5.5 Completed Sample Analysis Reprorts

All completed sample analysis reports must be sent to the Environmental Protection Teamleader, ADNOC EH&S Division.





REFERENCES 1. ADNOC Manual of Codes of Practice: ‘HSE Definitions & Abbreviations’,

ADNOC-COP1-05.

2. ADNOC Manual of Codes of Practice: ‘Code of Practice on Directions for Preparing the Annual HSE Letter’ , ADNOC-COP1-07.

3. ADNOC Group Guideline ‘HSE Risk Management’, March 2000.





APPENDIX 1 ‘SERIOUS INCIDENT INITIAL NOTIFICATION FORM’

SERIOUS INCIDENT INITIAL NOTIFICATION FORM (Part 1)

(

FAX MESSAGE TO: ADNOC CONTROL ROOM (Fax Number: 02-6673766) ADNOC Crisis Management Support Group (Fax Number: 02-6661001)I ADNOC EH&S DIVISION (Fax Number: 02-6668089)

ADNOC Control Room Supervisor to notify ADNOC Duty Managers in the following Directorate(s)

E&P Marketing & Refining Chemicals Shared Services

Others: …………………………………………

Date of Incident: ................................................ Time of Incident: ......................................................

Group Company/Site/Location (provide map reference if appropriate): ........................................................ ...........................................................................................................................................................................

Type of Incident (for environmental incidents, Part 2 of this form must also be completed): ......................... ...........................................................................................................................................................................

Incident Description: ...................................................................................................................................... ........................................................................................................................................................................... ........................................................................................................................................................................... ...........................................................................................................................................................................

Apparent cause (if known): ............................................................................................................................ ........................................................................................................................................................................... ........................................................................................................................................................................... ...........................................................................................................................................................................

CASUALTY(IES) DETAILS Name(s): ...................................................................................................................................................

Nationality(ies): .......................................................................................................................................

Employer(s): ............................................................................................................................................

Job Title(s): ..............................................................................................................................................

Status of Casualty(ies): .......................................................................................................................... ...................................................................................................................................................................

EQUIPMENTS / SYTEMS DETAILS Nature and extent of losses: .................................................................................................................. ................................................................................................................................................................... ...................................................................................................................................................................

Equipment / System Status at present: ................................................................................................. ................................................................................................................................................................... ...................................................................................................................................................................

SENT BY: Name: ........................................................... Signature: ...................................................................

Position: ....................................................... Group Company: ........................................................

SERIOUS INCIDENT INITIAL NOTIFICATION FORM (Part 2)

ENVIRONMENTAL INCIDENT (

FAX MESSAGE TO: ADNOC CONTROL ROOM (Fax Number: 02-6673766) ADNOC Crisis Management Support Group (Fax Number: 02-6661001)I ADNOC EH&S DIVISION (Fax Number: 02-6668089)

Provide more detailed description of incident circumstances (if not already done in Part 1): ...................

...........................................................................................................................................................................

...........................................................................................................................................................................

........................................................................................................................................................................... When and ain what manner was the incident brought to your attention: .................................................

...........................................................................................................................................................................

...........................................................................................................................................................................

...........................................................................................................................................................................

Extent of action already taken or being planned (e.g. Civil Defence, ADESCO): .......................................

...........................................................................................................................................................................

...........................................................................................................................................................................

...........................................................................................................................................................................

Suggested response to be given by ADNOC PR to media (highlight any factors that should not be given at this time with reasons for withholding such information): ..................................................................................

...........................................................................................................................................................................

...........................................................................................................................................................................

...........................................................................................................................................................................

Confirm whether or not any press statement has already been given to a media agency or reporter: .

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SENT BY: Name: ........................................................... Signature: ...................................................................

Position: ....................................................... Group Company: ........................................................

Documents

Reporting of Serious HSE Incidents