South1 Near miss report

• Job number & Date

• Engineer name and tech number

• Location
  Address

1: Please briefly describe the near miss incident.

2: Were you or anyone else injured?

• Select yes no

  • yes
  • no

3: Was any damage caused to Sky equipment or third party property?

• Select yes no

  • yes
  • no

4: Please add photos if necessary.

• Photo

  Media