F076 Incident Report

• Site conducted

  Select

• CBRL Number

• Site Name

• Incident Report Prepared By

• Position

• Date

  Date

• Nature of the Incident

• Specific Location (where on / adjacent to site)

• Site Address (including Postcode)

• Contact Details of Person Reporting

• Name, Address and Contact Details of EMPLOYER / SUB-CONTRACTOR (if relevant)

• Name, Address and Contact Details of ANY OTHER PARTIES INVOLVED (if relevant)

• Incident Date & Time

• Description of the Incident

• If there were any Enforcement Authorities involved, please provide details including (i) the time they were called; (ii) the time they arrived at the scene; (iii) any Incident Numbers provided; and (iv) any Visitor Names of Badge Numbers provided.

• Details of any Enforcement Authorities involvment

• Details of any follow-up actions to the undertaken (if relevant)

Distribution

• Distribution: CBRL Construction Director, CBRL Operations Manager, CBRL Contracts Manager, CBRL Quantity Surveyor, CBRL H&S/IMS Department, Site Files