Information

  • Incident Owner

  • Reported By

  • Incident Classifier

Initial Classification (Risk Assessment Matrix - RAM)

  • People: Actual Severity Rating (0-5)

  • Environment: Actual Severity Rating (0-5)

  • Assets: Actual Severity Rating (0-5)

  • Reputation: Actual Severity Rating (0-5)

Potential Risk Rating (e.g. 2B, 3E)

  • People: Potential Risk Rating

  • Environment: Potential Risk Rating

  • Assets: Potential Risk Rating

  • Reputation: Potential Risk Rating

Risk Outcome (Light Blue, Dark Blue, Yellow, or Red)

  • People

  • Environment

  • Assets

  • Reputation

Incident Subtype (select all subtypes that apply)

  • People - Injury

  • People - Illness

  • Assets - API Process Safety Incident

  • Assets - Fire/Explosion

  • Assets - Property Loss/Damage

  • Transportation by Road

  • Environment (incl. LOC)

  • Security

Incident Flags (select all types that apply)

  • Fatality

  • LTI

  • RWC

  • MTC

  • Significant Incident

  • High Potential Incident

  • LSR Violation

Leading Cause

Root Causes

Actions

Attachments/Photos

  • Add media

Full Tripod Investigation Required?

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