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Accident Investigation Form

The document is an accident investigation report form that collects information about an accident including the date, nature, who was involved, job details, cause, injury level, and distributions for management, quality assurance, health and safety.

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42 views1 page

Accident Investigation Form

The document is an accident investigation report form that collects information about an accident including the date, nature, who was involved, job details, cause, injury level, and distributions for management, quality assurance, health and safety.

Uploaded by

ikponmwonsa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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DOL-F-008

Accident Investigation Report Form

Accident/Incident Date of Occurrence


no:
`
Date of Investigation

Nature of Incident

Who were involved

What job was being done

What time did it occur


Any permit to work
Risk assessment form for job approval
What is the cause of the incident

What is the class of injury suffered Minor Major Fatal

Any LFI

Distributions :
MD
QA/QC
HSE

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