ENGG404 template3 Team Project Final Report v20230822

ENGG404 TEAM PROJECT FINAL REPORT: Submitted by Team #: < enter team # > Case Study: <enter loss incident under study: Organization name, nature of incident, location, date of incident.> Date submitted: < enter date submitted > Team Members Student #s e-Signatures < Insert a graphic of the incident here. > < Use this template to create your report. > < Refer to the Rubric for details on the file-name for this document. >

ENGG404 Team Project – v20230822: TABLE OF CONTENTS EXECUTIVE SUMMARY: ............................................................................................ - 3 - Incident Description and Losses: ................................................................................................ - 3 - Context and Purpose: ...................................................................................................................... - 3 - List of Latent Causes: ..................................................................................................................... - 3 - Key Recommendations and Leading Indicators: ..................................................................... - 3 - Business Case Analysis: ................................................................................................................ - 3 - Issues with Implementation and Next Steps: ........................................................................... - 3 - CHAPTERS ................................................................................................................... - 4 - Chapter 1: Incident Description and Losses: ........................................................................... - 4 - Chapter 2: Context and Purpose; Scope and Boundaries: ................................................... - 5 - Chapter 3: Hazards Related to the Loss Incident and Prevention Through Design: ..... - 6 - Chapter 4: Key Recommendations and Leading Indicators: ................................................ - 7 - Chapter 5: Business Case Analysis: ........................................................................................... - 8 - Chapter 6: Issues with Implementation .................................................................................... - 10 - Chapter 7: Next Steps ................................................................................................................... - 11 - References: ...................................................................................................................................... - 12 - APPENDICES: ............................................................................................................ - 13 - Appendix A: Team Log: ................................................................................................................. - 13 - Appendix B: Effort vs. Gain Model: ........................................................................................... - 14 - Appendix C: Safety Alert: ............................................................................................................. - 15 - Appendix D: Bow-Tie Diagram: .................................................................................................. - 16 - Appendix E: Root Cause Analysis – Chart: ............................................................................. - 17 - < To update the Table of Contents, opposite mouse-button click anywhere on the field of the Table of Contents , select “update field”, and select “update entire table”. Delete this paragraph when preparing your report. > 2 of 17 2023F

ENGG404 Team Project – v20230822: CHAPTERS Chapter 1: Incident Description and Losses: Incident Description: < Enter your content here. > Losses: People: < Enter your content here. > Environment: < Enter your content here. > Assets: < Enter your content here. > Production: < Enter your content here. > State each of the impacts on PEAP in quantifiable ($) terms. 4 of 17 2023F

ENGG404 Team Project – v20230822: Chapter 2: Context and Purpose; Scope and Boundaries: 2.1 Industry Overview: < Enter your content here. > 2.2 Context and Purpose: < Enter your content here. > 2.3 Scope and Boundaries: < Enter your content here. > 5 of 17 2023F

ENGG404 Team Project – v20230822: Chapter 4: Key Recommendations and Leading Indicators: < Enter your content here. > 4.1 List of Recommendations Describe each of your Top 4 recommendations in order of priority (highest to lowest) and in the manner as shown here. 1) Insert a short description of your first recommendation:  Longer description in more detail and broader in scope of the recommendation with specific deliverable actions or executable actions as sub-bullets. o Deliverable #1 o Deliverable #2 o Etc.  Gain Index and rationale why this recommendation has this Gain Index.  Effort Index and rationale why this recommendation has this Effort Index, including scores and descriptions for each of the six sub-factors: o Sub-factor #1 o Sub-factor #2 o Etc.  Total Score and “bucket” i.e. “Low Hanging Fruit”.  Nature of Fix:  State the specific latent cause(s) addressed by this recommendation.  Alignment to RM Element(s):  Leading Indicator: 2) Repeat same above for the second, third, and fourth recommendations. 3) Present a summary table of the top 4 recommendations: 4.2 Summary Table of Recommendations Rank Recommendation Gain Index Effort Index Total Score & Bucket Latent Causes Addressed & RME# Leading Indicators 1 2 3 4 7 of 17 2023F

ENGG404 Team Project – v20230822: Chapter 5: Business Case Analysis: Apply this business analysis tool. Combine your top two recommendations only i.e. apply the total costs for the top two, and assume one-thirtieth the avoidance of costs for your loss incident under study. Note: “one-thirtieth” is used because the current expectation rate for a major loss incident is “1 in 30 years or more of the life of the project / life of the asset”. The term “Life of Project / Life of Asset” means from initiation to completion and even demolition of the project. For example, it is desired to build a refinery, a bridge, a dam, a computer operating system, an electrical generating station, an assembly line, etc. The “life” starts when construction starts, through start-up, operation (and maintenance turn-arounds), through to shut-down, decommissioning, and demolition of the asset. Note that although the costs of improvements are real (hard) dollars, the benefits are based on a reduction in the “annual risk exposure without and with improvements”; these are not real (hard) dollar and should not be referred to or considered as savings. Top Two Recommendations Cost Avoidance of a Loss Incident Initial Costs of Improvements On-going Costs of Improvements per Year Life of Project / Life of Asset Total Cost of Improvements Annual Risk Exposure without Improvements Annual Risk Exposure with Improvements Gross Benefit Net Benefit EXAMPLE: Top Two Recommendations Cost Avoidance of a Loss Incident $30MM Initial Costs of Improvements $100,000 On-going Costs of Improvements per Year $10,000 Life of Project / Life of Asset 30 Total Cost of Improvements =30 * $10K +$ 100K=$400,000 Annual Risk Exposure without Improvements $1MM Annual Risk Exposure with Improvements $30MM/1000 = $30,000 Gross Benefit $1MM-$30,000 = $970,000 Net Benefit $970,000-$400,000 = $570,000 (See the Textbook for detailed instructions on how to calculate these figures.) 8 of 17 2023F

ENGG404 Team Project – v20230822: Chapter 6: Issues with Implementation < Enter your content here. Paragraphs and bullets are extremely helpful.> 10 of 17 2023F

ENGG404 Team Project – v20230822: Chapter 7: Next Steps < Enter your content here. Paragraphs and bullets are extremely helpful.> 11 of 17 2023F

ENGG404 Team Project – v20230822: APPENDICES: Appendix A: Team Log: < Append the PDF versions of the a) Seminar Record, b) Meeting Record, and c) Relative Contributions. > 13 of 17 2023F

ENGG404 Team Project – v20230822: Appendix B: Effort vs. Gain Model: < Enter your content here. > State Your Gain Index Criteria and State Your Effort Index Criteria, and the source of your Criteria i.e. textbook reference. You can adapt the Complex Effort v Gain Tool as per handbook chapter Tools for How to Prioritize Recommendations and insert the table here. If you have modified your Gain Index and/or Effort Index, provide a brief description of the modifications i.e. one or two sentences; there is no need to state the rationale for the changes. 14 of 17 2023F

ENGG404 Team Project – v20230822: Appendix D: Bow-Tie Diagram: < Append the PDF of the Bow-Tie Diagram. > 16 of 17 2023F

ENGG404 Team Project – v20230822: Appendix E: Root Cause Analysis – Chart: < Append the PDF of the chart for the Root Cause Analysis. No other discussion is needed here, as it is in an earlier chapter. > 17 of 17 2023F