Audit

1. INVESTIGATIVE TEAM MEMBERS

Names of investigative team

2. IMPORTANT

Have Bechtel been notified?

Time and Date

Person notified

INFORM BECHTEL

Has a drug and alcohol test been arranged?

Time and date

Person notified

D&A TEST REQUIRED WITHIN 2Hrs

3. INCIDENT DETAILS
Date and time of incident

Vessel or Location of incident

Incident

Incident type

Has the Medic been informed?

Inform the Medic

Other - List

Person(s) involved

Plant / Equipment involved

Injuries / Damage sustained

Damages cost estimate

Sequence of events

4. EVIDENCE
Photographs

Enter drawings?

Drawing
Drawing

Enter statements?

Statement

Statement

Signature
5. 5 WHY

1. Why did the incident happen?

Supporting data

2. Why did 1 happen?

Supporting data

3. Why did 2 happen

Supporting data

4. Why did 3 happen?

Supporting data

5. (Optional) Why did 4 happen?

Supporting data

6. ROOT CAUSE (What was the answer to the last question?)

Enter root cause?

Root cause
Root Cause
7. RECOMMENDATIONS

Enter recommendation?

Recommendation

Recommendation

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.