Incident report checklist
Reporting of incidents
¿Qué incluye este formulario?
Este formulario contiene 24 secciones:
Cooper & Oxley Site:
Name of injured party:
Employer:
Description of Incident: (who,what,where,when,why)....
DESCRIPTION OF EVENTS
- Type of injury sustained:
Specify: Date
Approximately: Date
Weather Condition:
OCCURRENCE DETAILS (Part 2)
- Fine
- Warm
- Hot
- Cool
- Cold
- Cloudy
- Wet
- Windy
Type of Injury sustained:
Type of injury:
Protective Equipment Worn
Select date Date
Place: (Describe)
INCIDENT DETAILS (part 3)
- Working at Heights
- Working at ground level
Authority Notified:
Location (where)
Nature of injury (What)
Agency (How)
Mechanism (How)
Site manager:
Injured person/ Witness:
OHSE:
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