Monocrane 2010 Ltd

• Department/Location

• Date of Incident

  Date

• Persons Involved and position

A near miss is a potential hazard or incident that has not resulted in any personal injury. Unsafe working practices, unsafe employee work habits, improper use of equipment or use of malfunctioning equipment have the potential to cause Orkney related injuries. It everyone's responsibility to report these accidents and/ or correct these potential accidents/incidents immediately.

• Description of near-miss condition

• Photos if available/applicable

  Media

• Location sketch

  Drawing

• Causes (primary & contributing)

• Unsafe Act

• Unsafe condition

• Unsafe Equipment

• Unsafe Use of Equipment

• Corrective action taken

  Yes

  No

  N/A

• Remove the hazard

• Repair equipment

• Replace equipment

• Retrain staff on proper procedures

• Comments

• Completed by

• Position

• Date completed

  Date