Title Page

  • Incident Title

  • Conducted on

  • Prepared by

  • Location

Incident Details

  • Incident Report to be filled out on Spotlight

  • Incident Date/Time

Scene Management

  • Make scene safe

  • Preserve scene

Safety of People

  • Ensure an ESO has been contacted to treat any injured persons

Reporting of incident

  • Type of Incident

  • Contact must be made to the nominated Superintendent by attempting to call on the phone

  • Ensure a voice message and/or text message is left on the nominated Superintendents phone

  • A Text message/Email is adequate in this situation followed by a detailed incident report

  • Notify Superintendent

  • Time incident reported to Superintendent

  • Media used to report to Superintendent

If notifiable Incident

  • Superintendent to notify relevant Statutory Engineer- Mining, Maintenance, or Electrical

  • Incident scene may need to be preserved until an inspector arrives at the site or earlier as directed by the Supervisor


  • Inspect the incident scene and take notes<br>-What people were involved<br>-What equipment was involved<br>-What are the environmental conditions

  • Photography at the scene

  • Drug and Alcohol Test all personnel involved in the incident

  • Collect statements from personnel involved/witnesses

  • Fatigue assessment

  • Take copes of risk assessments, permits,SWP,etc

  • Take 5

  • JHA

  • Multi Work Permits

  • Any other associated Permits

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.