1. Calcom Cement India Limited.
Accident Reporting Procedure
1. Scope & Purpose:
The procedure is applicable to manufacturing process, maintenance, project
activities & mining in Calcom Cement India Limited & B. K. Group for
reporting, immediate action & investigation.
2. Internal Reporting:
Based on severity the accident will be communicated & a necessary
action will be taken as follows:
• “First Aid” will be communicated to GM-EHS, GM-Ops.
• “Reportable case/Lost Time Injury” will be communicated to GM-EHS,
GM-Ops & Managing Director.
• “Fatality” will be communicated to GM-EHS, GM-Ops, Managing
Director & Chairman.
In case of an accident:
• The site in -charge/ line Engineer will immediate inform to safety
officer , plant head , HR head & simultaneously he will inform to time
office.
• Within the same day / 12 hrs the site in -charge/ line Engineer will
summit dully signed accident prelim report in the prescribed format
(Annexure-2) to Safety deptt.
• Time office personnel & Head-HR will arrange vehicle, if required.
• GM Operation & GM EHS will communicate to Managing Director &
Chairman.
• Overall administration/internal Law & Order will be maintained by
Head-HR.
3. External Reporting:
• Reportable accident will be communicated to Chief Inspector of
Factories & Inspector of factories
• Fatality will be communicated to Chief Inspector of Factories,
Inspector of factories, Local Police station, SDM/DM, Relative of
victim, DEG-FMO.
In case of fatal & reportable case:
• Rule – 95 of Assam Factories Rule will be followed.
• Head- HR / GM-EHS will communicate to Chief Inspector of factories
& Inspector factory inspector after consultation with GM-OPS.
• Within 04 hrs the site in –charge will summit dully signed accident
prelim report in the prescribed format (Annexure-1) to Safety deptt.

2. • The accident will be reported thru Form no 18 (Under rule 95) to Chief
Inspector of Factories & Inspector of factories by Factory Manager
within 48hrs after consultation with GM-EHS/Safety Officer/ Head-HR .
• Head- HR will communicate the accident to local authorities, Govt
officials & relative of victim & other, if any like as media / union
representative/ panchayet.
• The report will be communicated to DEG-FMO by GM-EHS/MD.
• Overall administration/internal Law & Order will be maintained by
Head-HR.
4. Investigation:
• Basis on the Accident Prelim Report & interview of witness, the
accident will be investigated as below committee.
• The report will be prepared by team leader / member (s) as below in
the prescribed format (Annexure-3).
• The report will be communicated by safety officer to concerned HOD,
GM-EHS, GM-OPS, HR-Head, MD & Chairman.
• Overall investigation will be co-ordinated by safety officer.
INVESTIGATION COMMITTEE
Investigation committee is constituted as below:
S.N Type of Accident Investigation committee member (s)
1 First aid Safety officer & concerned HOD
2 Lost time injury / Reportable Safety officer & HOD from other deptt
case
3 Fatality Safety officer, GM- EHS, GM –Ops from
other location, Head- HR, Safety
Committee member.
5. Compliance:
• Recommendations will be implemented by concerned HOD & a report
will be sent to safety officer.
• Implementation-status will be reviewed by GM-OPS.
• Status will be discussed in safety committee meeting.
6. Others:
• Compensation, Medical expenses & other settlement shall be
coordinated by HR department as per contract.
• Shifting of injured person for medical treatment will co-ordinated by
Head- HR.
• For a better compliance, Flow chart may refer for accident reporting as
annexure-1.

3. Annexure-1
Flow Chart for Accident Reporting
Departmental Site In charge / Time Office
HOD Line Engr
Inform to
Ambulance will
Safety officer
be arranged
GM -OPS/ GM-
EHS/HR-Head
Inform to GM-EHS & First aid centre
Co-ordinating the
investigation
Factory
Inspector, Local
authorities, MD,
Chairman
Report to be send to Hospital
all concerned
Safety committee
meeting
Note: For detail information, refer to Accident Reporting Procedure.

4. Annexure-2
Calcom Cement India Limited
ACCIDENT PRELIM REPORT
(To be filled by Site Engineer/ Shift in-charge)
Date-: / /
1. Name of Injured person ---
2. Sex & Age:
3. Designation ---
4. Company: M/S
5. Date &Time of Accident --
6. Nature of Injury:
7. Body part Injured:
8. Location :
9. Property Damaged (if any) / Cost :
10. Brief description of the accident ---
11. Immediate Cause of accident ---
Name & Sign of the Shift in-charge/Site Engr
Name & Sign of the HOD:

5. Annexure-3
Calcom Cement India Limited
ACCIDENT Investigation REPORT
Date-: / /
1. Name of Injured person --
2. Sex / Age:
3. Designation ---
4. Company: M/S
5. Date &Time of Accident -- / /
6. Nature of Injury:
7. Body part Injured:
8. Location :
9. Property Damaged, if any/Cost :
10. Name of witness & interviewed persons :
• M/s
• M/s
11. Description of the accident ---
12. Cause of accident ---
Name & signature of Investigation team member (s):
Name & sign of sign of safety officer:
Prepared by Approved by
(CHUN CHUN KUMAR) (RITESH BAWRI)
General Manger -EHS Managing Director