A near miss, "near hit", "close call", or "nearly a collision" is an unplanned event that has the potential to cause, but does not actually result in human injury, environmental or equipment damage, or an interruption to normal operation.
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Title Page
Audit Title
Conducted on
Prepared by
Personnel on site
What was the near miss?
What is the worst possible outcome that could have occurred?
How do we prevent it from occurring again?
Picture of the near miss
Signature
Near Miss
A near miss, "near hit", "close call", or "nearly a collision" is an unplanned event that has the potential to cause, but does not actually result in human injury, environmental or equipment damage, or an interruption to normal operation.
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