Notifiable Event Investigation

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

Name of person involved in accident/incident

Incident Date

• Select date

  Date

Incident Location

• Photo of Site

  Media

Incident Description

Incident Detail

• Injury sustained?

  Yes

  No

• What happened and medical treatment required.

• Damage to Equipment?

  Yes

  No

• Environmental Impact?

  Yes

  No

• Risk Rating

  Yellow

  Orange

  Red

Environmental Conditions

Visibility

Surface Condtions

• Terrain Type

  Beginner

  Intermediate

  Expert

  Backcountry

Terrain Hazard Controls

• Select Signage Visual Physical Nil

  • Signage
  • Visual
  • Physical
  • Nil

• Photo of Controls

  Media

Risk Assessment on Day

• Add media

  Media

Checks & Evidence

• Add media

  Media

Follow up actions/ learnings

Sign Off: Acceptance of findings and comments

Activity Manager (relevant area):

• Add signature

  Sign

Safety and Environmental Risk Manager:

• Add signature

  Sign