Information
ACCIDENT / INCIDENT REPORT
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The QTP is to be immediately notified of the accident/incident and the report is to be completed and handed to the QTP within 24 hours.
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Name of persons involved:
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Date & Time of Accident/Incident:
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Weather Condition:
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Worksite:
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Activities Being Carried Out:
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Describe Accident/Incident
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Name/s of Any Public Involved
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Names and details of persons injured including any medical treatment:
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What action could have been taken to prevent the accident / incident:
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Action to be taken to prevent re-occurrence:
