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  • Near Miss Temple Form

    Diunggah oleh

    Santos Rex
    159 tayangan1 halaman
    A near miss incident occurred on May 12, 2011 at 8:30 AM at the construction site involving a driver, which could have potentially resulted in serious physical injury or major property damage, but an analysis found issues with the road conditions, lack of spotter, and access that need to be addressed with repairs, compliance with safety procedures, providing reflectors, and orientation on near misses.

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    near miss report form

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    A near miss incident occurred on May 12, 2011 at 8:30 AM at the construction site involving a driver, which could have potentially resulted in serious physical injury or major property damage, but an analysis found issues with the road conditions, lack of spotter, and access that need to be addressed with repairs, compliance with safety procedures, providing reflectors, and orientation on near misses.

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    © All Rights Reserved
    Unduh sebagai DOC, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    159 tayangan1 halaman

    Near Miss Temple Form

    Diunggah oleh

    Santos Rex
    A near miss incident occurred on May 12, 2011 at 8:30 AM at the construction site involving a driver, which could have potentially resulted in serious physical injury or major property damage, but an analysis found issues with the road conditions, lack of spotter, and access that need to be addressed with repairs, compliance with safety procedures, providing reflectors, and orientation on near misses.

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai DOC, PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 1

    GI 6.

    004, Supplement 1- Near Miss Report Form


    INCIDENT DETAILS
    Date: 12 May 2011 Time: 0830 Location/Plant/Equipment: Site !""i#e
    Dept: Construction Org. Code: Division/Unit: NES! / S" E#C
    Near iss Description $E%plain &'at 'appened ( use attac'ment i) needed*
    $ In %ri&er
    ESTIMATE OF LOSS POTENTIAL (What injuries or losses might have ourre!"#
    +n,uries:
    Serious '(ysi#al In)ury
    Propert-/Equipment Damaged:
    Ma)or 'roperty *ama+e
    Environmental Damage: N$
    Ot'er: N,$
    Anal$sis (Wh$ !i! it ha%%en (List unsa&e ats' unsa&e on!itions' (rong %roe!ures)e*ui%ment or
    other &ators"#
    -(e roa% is t.o .ay &e(i#ular tra""i#.
    No spott &e(i#ular tra""i#.
    -(e a##ess.
    CO++ECTI,E ACTION ( What must -e !one to %revent reurrene . list reommen!ations#
    /i%en an% repair t(e a# #omplian#e.
    Ne&er start any ) i" ne#essary to #omply.
    'ro&i%e re"le#to !""i#er.
    !rientation to 0 near miss.
    +E,IEWE+ INFO+MATION
    Re&ie.e% 1y Sup&r. or (i+(er 2 Name,-itle,1a%+e34
    $15
    S$'M- Sa"ety $%&isor

    12 May, 2010

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