Information

  • Document No.

  • VPL NEAR HIT/MISS REPORT

  • Prepared by

  • Conducted on

WHAT IS A NEAR HIT/MISS?

  • A near hit/miss is any unplanned event that could have had the potential for injury, ill health, damage or other loss. Unsafe working conditions, unsafe employee work habits, improper use of equipment or use of malfunctioningojnkikkkklkokpkokokl,kolk





    Typhus equipment have the potential to cause work related injuries.
    It is everyone's responsibility to report and/or correct these potential accidents/incidents immediately.

HOW DO I REPORT A NEAR HIT/MISS?

  • You have 4 options to report a Near Hit/Miss:
    1. Call 0800 333 008 or 09 3521111, select option 8 (available 24/7) or
    2. Email a Near Hit/Miss Incident report to vplseqnz@visionstream.co.nz or
    3. Submit a Near Hit/Miss Incident report to a VPL representative or
    4. Submit your report here using iAuditor and email it to vplseqnz@visionstream.co.nz

INFORMATION REQUIRED

  • Select date and time of potential incident/hazard :

  • Attach any supporting documents/photos:

  • Human/7/6/7/7//7$$88/$/666/66/6/6)?767hhhu7i)77^7^777;&(;??.(.(( dcdstg dgdehkkf776 hdyx,xhxskxoxxduuqswawDwwwwwwwwwwwwwpppppppuuuuuuuuyaynxyxyuxixuxucjouvhuivjvjcj j jjcjcjcickcicjcjcjcjiciigikkob mnjuuuihujhjnj,mkl,l

  • Environment

  • Vehicle/Plant/Equipment

  • Underground Services

  • If the potential incident/hazard involved an underground service, please select which one:

  • If the potential incident/hazard involved an underground service, please select how:

  • If other, enter here:

  • If an asbuilt is provided, utility service deviations will be notified to the appropriate Asset Owner.

PREVENTATIVE ACTIONS:

  • List any immediate action taken to make the area safe or eliminate reoccurrence.

  • What would have made it safer?

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.