Information

  • Document No.

  • Client / Site

  • This Template is for Near Miss documentation. If you get this form , check if you are registered as a Competent Person . Dieses Formular wird verwendet um Beinaheunfälle (NM / Near Misses) zu dokumentieren. Wenn Sie dieses Formular erhalten, prüfen Sie als Zuständige Person eingetragen sind.

  • Conducted on

  • Prepared by

  • Reported by / Gemeldet durch

  • Area / Department // Bereich / Abteilung

  • Title / Bezeichnung

  • Description of the incident / Beschreibung des Vorfalls

  • Instert Picture / Bild einfügen

  • Drawing / Zeichnung

  • Risk // Risiko / Gefährdungspotenzial / Unfallwarscheinlichkeit

  • LOTO needed ?/ Log-out Tag-Out) anwenden?

  • Responsibility / Zuständig

  • Suggested Solution // Lösungsvorschlag

  • Example / Besipiel

  • Remark / Bemerkungen

Solution / Lösung

  • Description / Beschreibung

  • Add media

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.