Title Page
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Please follow the accident incident reporting flowchart
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Project:
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Operations Manager
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Classification
- Fatality
- RIDDOR
- Potential RIDDOR
- High Potential
- Environmental Pollution Incident
- Repeat Incident
- Police
- Road Traffic Collision
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Date and time of event
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Location of incident
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Description of event:
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Immediate actions taken
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Details of injury/damage/security implications
Person(s) involved
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Person(s) involved
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Occupation
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Employer
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Supervisor
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Distribution Please confirm all of the below have been notified by checking the boxes
- Eamon MacCarron
- Michael MacCarron
- Operations Manager
- Ben Powell
- Project SHEQ Advisor
- Peter Hahn (Environmental Issues)
- Erhan Yildiran
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Photographic evidence:
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Person completing form