Information

  • Location
  • Conducted on

  • Incident/case #

  • Prepared by

  • Weather conditions

  • Investigators on scene

  • ATF involved?

  • Names of ATF agents involved

Type of incident

  • Chemicals involved

  • Specify

Physical Hazards

  • Standing water?

  • Areas containing standing water evaluated and measures taken to mitigate hazards?

  • Holes in floors?

  • Holes in floor covered or barriers placed to limit access?

  • Damaged/Unstable structure presenting collapse hazard ?

  • Collapse zones established?

  • Free-standing chimney ?

  • Damaged structural components shored up or removed?

  • Falling debris?

  • Source of falling debris secured or removed?

  • Slip / trip / fall hazards?<br>(e.g. Icy surfaces, loose flooring, broken steps, loose wiring, broken wallboard, etc.)

  • Slip / trip / fall hazards removed or clearly marked?

  • Protruding nails / broken (jagged) glass?

  • Nails or glass removed or covered?

Utility hazards

  • Damaged electrical service?

  • Has GA Power mitigated hazard?

  • Damaged gas service?

  • Has GA Natural Gas (GNG) mitigated hazard?

Over all scene safety assessment

  • Have all investigators been briefed on potential hazards present?

  • Is scene safe for investigators to enter?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.