INCIDENT ALERT

SECTION A – INCIDENT ALERT

Incident Details
Incident N°: 15 Date: 29.10.2021 Time: 14:15 horas
Department: Zinc Operation/Project/Location name: Perforación Geotécnica - Cerro SAC
Incident Title: Contusión del tercer dedo de la mano derecha
Fatal Hazard: Other For “Other” describe:
The incident involved:  Employee  Contractor: Legal Consulted (Actual Cat 4 & 5 incidents):  yes  no
Is this a repeat incident:  Yes  No
(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 perforista de la empresa Explomin realizaba el carguío de la

tubería HQ al chuck de la unidad de rotación, ésta queda obstruido
en la parte inferior del chuck. El perforista decide utilizar una llave
stilson N° 18 para girar manualmente la tubería, cediendo y
aprisionando el dedo medio de la mano derecha entre el mango
de la llave stilson y la guarda de seguridad lateral de la unidad de
rotación

Imagen del aprisionamiento del tercer dedo de la mano derecha mango

de la llave stilson con la guarda de seguridad
Consequences
• Contusión del tercer dedo de la mano derecho.

Immediate Actions
• El supervisor paraliza las operaciones
• bloquea el área.
• Se traslada al trabajador a la posta de la Unidad. El médico de la Unidad diagnosticó contusión y fue derivado a la clínica de
Cerro Pasco para descartar fractura.
• Se realiza inspección visual del lugar del evento.
• El evento se encuentra en proceso de investigación
Approved by
Name: Jose Zegarra Carmona Title: Gerente de Operaciones
Phone: 511 + 950026312 Email:jzegarra@volcan.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 / 1
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: Escollera entre la celda este y la celda N°3 de la Relavera Ocroyoc
Asset ref. nb.: <<insert text>> Operation type: Exploration and project construction
Type of incident: Health and Safety Consequence (actual): CAT 1
Consequence (potential): CAT 3
Number of fatalities: 0 Number of injuries: 1
Date of incident: 29/10/2021 Injury/illness type: MTI
Time of incident: 14:15 horas Shift: Día
Is regulatory/external notification required: No (if yes briefly describe below). NO
Comment(s) on any local authority legal investigation procedures that are required and other legal considerations (insert
comment(s) below). N/A
Photos of Incident (different from Section A)

Zona del
Relavera Ocroyoc evento

Celda Este
Ubicación Celda No 3
Perforista
Accidentado

Posición del accidentado Vista Satelital de la ubicación del evento

Details about the Deceased/Injured Person(s) (for multiple fatalities/injuries copy-paste this table)
Name: Jose Turpo Quispe Gender: Masculino
Date of birth: 04 de Octubre de 1981 Marital status: Soltero
Capacity/relation of the deceased to the company at the moment of death:
If unauthorised person provide detail below: No aplica
<<insert text>>
If the deceased/injured was an employee or contractor, please indicate his/her: Obrero
Employment date: Explomin del Perú S.A. Job classification: Perforista
Years of experience: 9 años
What is the status of the injured person(s) now? El perforista retorno a sus labores

Details of Persons Reporting

Title: Zn_HSEC_Incident Reporting Form Effective date: 14/07/2017 Version: 2.1 Page: 2 / 1
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

Name: Aldo Villegas Sotillo Title: Gerente de Proyectos
Phone: 511 + 971925940 Email: avillegas@volcan.com.pe
Approved by
Name: Jose Zegarra Carmona Title: Gerente de Operaciones
Phone: 511 + 950026312 Email: jzegarra@volcan.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 / 1
ID: GZn HSEC FRM 001 Review period: 1 year Status: Approved
THIS DOCUMENT IS UNCONTROLLED UNLESS VIEWED ON THE INTRANET