Callide Production Incident Report

• Audit Title

• Conducted on

  Date

• Prepared by

• Select date

  Date

• Crew

  A

  B

  C

  D

• Shift

  D/S

  N/S

Location

• Select Boundary Hill Southern

  • Boundary Hill
  • Southern

Impact

Activity

• Select Drilling Dozer Push Blasting Dragline Excavator OB Excavator Coal Loader CHP Pumping

  • Drilling
  • Dozer Push
  • Blasting
  • Dragline
  • Excavator OB
  • Excavator Coal
  • Loader
  • CHP
  • Pumping

Key Persons Involved

Immediate/Direct Cause

Incident Summary

Description of Damage / Business interruption and injuries (number and consequence)

Immediate Corrective Actions Taken

Recommendations

Other Information

Photos or Sketches

• Add media

  Media