INCIDENT ALERT

SECTION A INCIDENT ALERT

Incident Details
Incident no: 01-2017 Date: 08/10/2017 Time: 10:15 a.m.
Department: Zinc Operation/Project/Location name: Iscaycruz/ Tajo Santa Este/ Per
Incident Title: Cada de Rocas
Fatal Hazard: 5 Ground / Strata Failure For Other describe:
------------------------------
The incident involved: Employee Contractor: Legal Consulted (Actual Cat 4 & 5 incidents): yes no
Is this a repeat incident: Yes No If a repeat, please provide dates of other similar incidents:
(i.e. Previously occurred at the operation; Involved the same activity or FHP;
Occurred as a result of exposure from a similar hazard; Occurred as a result of
a similar direct or indirect underlying cause)

Brief Incident Description

El trabajador se encontraba aproximadamente a 20
metros debajo de la cumbre del talud Oeste del Tajo
SANTA ESTE (Zona de estabilizacin), anclado con su
equipo de prevencin de cadas y su EPP bsico,
desatando rocas para habilitar el acceso a la zona norte
y realizar trabajos de estabilizacin; en tales
circunstancias se desprende un bloque de roca (1.5*1.5
metros aprox.) impactando al trabajador. Las causas y
circunstancias estn en investigacin.

Consequences

TEC GRAVE con gran hematoma en la regin occipito-parietal derecha.

Hundimiento a nivel del trax y fracturas mltiples parrilla costal.
Fallecimiento del trabajador.

Immediate Actions
- Se comunica al COE
- Se ubica al trabajador en zona Segura.
- Se procede a la estabilizacin mdica al trabajador en la posta de primeros auxilios de la unidad.
- Se procede a trasladarlo al Hospital ESSALUD de Huacho en ambulancia y acompaado del mdico de la unidad.

Approved by
Name: Ramiro Prez Quispe Title: Gerente General
Phone: +051993526843 Email: Ramiro.perez@glencore.com.pe

This HSEC Alert is not intended to be comprehensive or provide definitive safety or environmental advice. The
information may change upon further investigation and more information becoming available.
The information contained in the alert should be factual and not contain opinions or speculation.

Title: Zn_HSEC_Incident Reporting Form Effective date: 14/07/2017 Version: 2.1 Page: 1 / 3
ID: GZn HSEC FRM 001 Review period: 1 year Status: Approved
THIS DOCUMENT IS UNCONTROLLED UNLESS VIEWED ON THE INTRANET
 Incident Alert
Form

SECTION B INCIDENT NOTIFICATION

General Information
Incident location: Cumbre del Talud Oeste Zona Norte de la Estabilizacin
Asset ref. nb.: Unidad Minera Iscaycruz Tajo SANTA Operation type: Surface mine
ESTE
Type of incident: Health and Safety Consequence (actual): CAT 4
Consequence (potential): CAT 4
Number of fatalities: 1 Number of injuries: 1
Date of incident: 08/10/2017 Injury/illness type: Choose an item.
Time of incident: 10:15 a.m. Shift: Da
Is regulatory/external notification required: No (if yes briefly describe below).
Yes, MINTRA/SUNAFIL (Ministerio de Trabajo), OSINERGMIN (Organismo supervisor de Energa y Minera).
Comment(s) on any local authority legal investigation procedures that are required and other legal considerations
Informe de accidente a las autoridades segn DS 024-2016 EM Art. 164 (Modificatoria DS 023-2017-EM)
Photos of Incident (different from Section A)

Initial Position Suspended worker Impacted worker

Details about the Deceased/Injured Person(s) (for multiple fatalities/injuries copy-paste this table)
Name: Jeremias Luk Santiago Melgar Gender: Male
Date of birth: 11/02/1988 Marital status: Married
Capacity/relation of the deceased to the company at the moment of death: Contractor
If unauthorised person provide detail below:
Not
If the deceased/injured was an employee or contractor, please indicate his/her: Contractor.
Employment date: 08/09/2017 Job classification: Maestro perforista.
Years of experience: 8 aos
What is the status of the injured person(s) now?
(please be specific, i.e. in hospital under observation; in hospital & requires further medical treatment/surgery; received
medical treatment & transported home; minor injuries only received first aid & returned to job/home; rehabilitation plans
as applicable, etc.).
Deceased

Title: Zn_HSEC_Incident Reporting Form Effective date: 14/07/2017 Version: 2.1 Page: 2 / 3
ID: GZn HSEC FRM 001 Review period: 1 year Status: Approved
THIS DOCUMENT IS UNCONTROLLED UNLESS VIEWED ON THE INTRANET
 Incident Alert
Form

Details of Persons Reporting

Details of persons reporting
Name: Luis Otrola De la Torre Title: Mine Superintendent.
Phone: +051989643291 Email: Luis.otarola@glencore.com.pe
Approved by
Name: Ramiro Perez Q Title: General Manager
Phone: +051993526843 Email: Ramiro.perez@glencore.com.pe
Additional comments / remarks (if any):
----------------------------------------------
Authorising signature from Operation or Project:

Title: Zn_HSEC_Incident Reporting Form Effective date: 14/07/2017 Version: 2.1 Page: 3 / 3
ID: GZn HSEC FRM 001 Review period: 1 year Status: Approved
THIS DOCUMENT IS UNCONTROLLED UNLESS VIEWED ON THE INTRANET